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pharmacology > gastrointestinal medications > Flashcards

gastrointestinal medications Flashcards

1
Q

types of antacids

A

aluminum compounds, magnesium compounds, calcium compounds, sodium bicarbonate

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2
Q

antacids (general)
MOA:
I:
CI:
INT:

A

MOA: neutralize HCl = increase pH
I: any GI disease and as a calcium supplement
CI: renal disease/pregnant; hypercalcemia/magnesemia
INT: do not give with other meds

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3
Q

kinetics of antacids (general)
O:
D:

A

O: immediate
D: with food = 3hrs, without food 20-60min

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4
Q

side effects of antacids (general)

A

systemic imbalance (high Mg, low Phos)
Na retention
osteomalacia
diarrhea

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5
Q

pt education with antacids

A

take 2 hrs after other meds
1-3 hrs after meals
no max dose for >2weeks
keep hydrated to flush out

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6
Q

aluminum carbonate
C:
I:
CI:
SE:

A

C: antacid; aluminum compound
I: use with magnesium to counter laxative effect
CI: CHF, HTN, renal disease
SE: constipation

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7
Q

alka-seltzer
C:
I:
CI:
K:
SE:

A

C: antacid, sodium bicarbonate
I: inc urinary pH = excretion
CI: CHF, HTN, renal disease
K: onset quick, duration short
SE: metabolic alkalosis

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8
Q

TUMS, Rolaids
C:
I:
K:
SE:

A

C: antacid; calcium carbonate
I: source of dietary calcium
K: duration long
SE: constipation, belching, flatulence, kidney stone

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9
Q

magnesium hydroxide
C:
I:
CI:
SE:

A

C: antacid; magnesium compounds
I: laxative
CI: renal failure (kidney can’t rid Mg)
SE: diarrhea

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10
Q

omeprazole (Prilosec)
C:
MOA:
I:
CI:
INT:
SE:

A

C: proton pump inhibitor (PPI)
MOA: irreversible bind H+/K+/ATPase enzyme = block all HCl prod
I: most effective to dec acid
CI: crushed/opened caps, liver dis/preg/breastfeeding
INT: benzos, phenytoin, iron, dig
SE: HA, PNA, inc fx risk, malabs of calcium

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11
Q

what are other proton pump inhibitors ?

A

esomeprazole, lansoprazole, pantoprazole

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12
Q

t/f: omeprazole is high PB and has good bioavailability

A

true

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13
Q

education with omeprazole (Prilosec)

A

take 1hr before meals
long term = calcium citrate supplement
swallow whole

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14
Q

sucralfate (Carafate)
C:
MOA:
I:
INT:
SE:

A

C: pepsin inhibitor
MOA: no pepsin = no breakdown of stomach lining = protective barrier for 6hrs
I: PUD, stress ulcers
INT: not with other drugs
SE: constipation, nausea

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15
Q

frequency to take sucralfate (Cerafate)

A

QID before meals

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16
Q

ondansetron (Zofran)
C:
MOA:
I:
SE:

A

C: antiemetic; serotonin receptor antagonist
MOA: inhib type 3 serotonin receptors on afferent vagal nerve
I: prevent n/v in chemo + anes
SE: HA, prolonged QT int, torsades de pointes, dizzy

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17
Q

what is the first approved drug for chemo induced n/v and is better taken with dexmethasone (corticosteroid)

A

ondansetron (Zofran)

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18
Q

metoclopramide (Reglan)
C:
MOA:
I: + off label?
SE:

A

C: antiemetic
MOA: blocks dopamine receptors in CTZ
I: inc upper GI motility, post op n/v, off label GERD
SE: sedation, diarrhea

19
Q

misoprostol (Cytotec)
C:
MOA:
I:
CI:
SE:

A

C: synthetic prostglandin
MOA: protect gastric mucosa = inc mucus and bicarb = inc cell regen
I: prevent NSAID ulcers
CI: pregnancy category X
SE: cramps, diarrhea

20
Q

what to tell female patients with giving misoprostol (Cytotec)

A

take other forms of BC, drug is in pregnancy category X

21
Q

cimetidine (Tagamet)
C:
MOA:
I:
CI:
INT:
SE:

A

C: histamine 2 receptor antag. (H2 blocker)
MOA: displace histamine from H2 receptor = no proton pump stim = no HCl
I: prevent ulcer, GERD, esophagitis, upper GI bleed
CI: elder, COPD, immunocomp = risk PNA
INT: alc, warfarin, CCB, caffeine (inc)
azoles, smoke, dig (dec)
SE: thrombocytopenia, dizziness, HA, PNA, leukemia

22
Q

why is PNA a side effect of cimetidine (Tagamet)

A

cimetidine = H2 blocker = no HCl prod = nothing to kill bacteria from food = bacteria climbs up to resp tract = PNA

23
Q

education for cimetidine (Tagament)

A

takes 4-6wks for ulcer to heal; continue to take
don’t use OTC bc diff potency
IV slow infusion (prev hypotension and cardiac dysrhyth)

24
Q

other H2 blockers

A

famotidine, nazotidine

25
Q

polyethylene glycol (MiraLax)
C:
MOA:
I:
SE:

A

C: laxative: milder osmotic
MOA: retain water + soften/swell fecal mass
I: peds and geri
SE: BM in 1-3 days, bloating, cramp, flatulence, nausea

26
Q

when to expect a BM after taking polyethylene glycol (MiraLax)

A

after 1-3 days

27
Q

lactulose
C:
MOA:
I:
does it work fast or slow?

A

C: laxative: milder osmotic (hyperosmotic)
MOA: breakdown by flora and CO2 = inc osmotic pressure = fluid –> stool + ammonia evacuation
I: tx of hepatic encephalopathy (gets rid of ammonia)
works fast

28
Q

other hyperosmotic laxatives

A

glycerin

29
Q

magnesium hydroxide (Milk of Magnesia)
C:
MOA:
I:
CI:
INT:
SE:

A

C: laxative: saline
MOA: salt –> int = retain water to inc pressure = stim stretch receptors = inc peristalsis
I: constipation, bowel prep for surgery, antacid
CI: kidney pts (can’t get rid of Mg)
INT: take other meds 2hrs apart
SE: overactive bowel #1 (cramps, diarrhea), electrolyte imb

30
Q

kinetics of magnesium hydroxide (Milk of Magnesia): low dose vs high dose onset?

A

low dose onset = 6-12 hrs
high dose onset = 2-6 hours

31
Q

when taking magnesium hydroxide (Milk of Magnesia), other meds should be taken ____ apart

A

2 hrs apart

32
Q

what are some other saline laxatives

A

magnesium sulfate (Epsom Salts), magnesium citrate

33
Q

mineral oil
C:
MOA:
I:
CI:
SE:

A

C: laxative: emollient/lubricant
MOA: lubricates int/stool = help with passage
I: peds patients
CI: warfarin
SE: malabsorption of fat sol. vitamins; oily stools

34
Q

education when taking mineral oil

A

take on empty stomach, mix with juice

35
Q

polycarbophil (FiberCon)
C:
MOA:
I:
CI:
what to remind the pt?

A

C: laxative: bulk forming
MOA: fibers attracts water to int = soften + stim peristalsis
I: constipation, diarrhea (forms stools)
CI: CHF, HTN
remind pt to inc water intake

36
Q

kinetics of polycarbophil (FiberCon): onset?

A

O = 12-24hrs

37
Q

docusate sodium (Colace)
C:
MOA:
I:
how to admin?

A

C: laxative: stool softener/surfactant
MOA: add fat + water = stool soften and build (DOES NOT STIM PERISTALSIS)
I: prevent constipation, for pts who shouldn’t strain
admin with full glass of water

38
Q

what are other stool softener/surfactant laxatives?

A

docusate calcium (Surfak)

39
Q

stimulants/irritant laxatives
name some:
MOA:
I:
CI:
SE:

A

cascara, senna (Senokt), castor oil, biscodyl (Dulcolax)
MOA: direct effect on nerves = inc peristalsis
I: short term use
CI: long term use, fecal obs/impaction
SE: high risk dependency, pt can’t have BM without it

40
Q

polyethylene glycol - electrolyte solution (Peg-Es, Golytely)
C:
MOA:
I:
CI:
SE:

A

C: bowel evacuant
MOA: ostmotic agent + electrolyte = bowel evac w/o fluid + electrolyte imb
I: bowel prep for surgery
CI: constipation
SE: cramps, diarrhea, anal irritation, epigastric distress, bloating

41
Q

how to tell if bowel prep has been successful?

A

all fecal output is clear (no traces of brown)

42
Q

drugs that can increase or stimulate peristalsis

A

stimulants/irritants (cascara, senna, castor oil, biscodyl)
magnesium hydroxide (MoM) - saline laxative
polycarbphil (FiberCon) - bulk forming laxative

43
Q

drug that does NOT stim peristalsis?

A

docusate sodium (Colace)

pharmacology (15 decks)

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