Gastrointestinal Medications Flashcards
Ranitidine (Zantac) and famotidine (Pepcid) are examples of
H2 receptor blockers
H2 receptor antagonists block H2 receptors in stomach, reducing
Stomach acid secretion
When should H2 receptor blockers be administered
With meals and at bedtime
Omeprazole (Prilosec) and pantoprazole (Protonix) are examples of
Proton pump inhibitors (PPIs)
PPIs side effects
GI upset, C.diff, bone fractures (with long-term use)
PPIs nursing consideration
Monitor for diarrhea, cramping, bloody stools
Medication indicated for duodenal ulcers by reacting with stomach acid to form a thick paste that adheres to ulcers
Sucralfate (Carafate)
Key side effect of sucralfate (Carafate)
Constipation
When should sucralfate (Carafate) be administered?
1 hr before meals and at bedtime (4x/day)
Sucralfate (Carafate) patient education
Increase intake of fluids and fiber
Antacid that binds phosphate in the stomach and neutralizes stomach acid
Aluminum hydroxide (Amphojel)
Key side effect of aluminum hydroxide (Amphojel)
Constipation
Administration of aluminum hydroxide (Amphojel)
After meals and at bedtime; take 1-2 hrs before or after other meds
Prostaglandin that prevents gastric ulcers in patients taking NSAIDs and can also be used to induce labor by ripening the cervix
Misoprostol (Cytotec)
Misoprostol (Cytotec) side effects
Dysmenorrhea, miscarriage, GI upset
Misoprostol (Cytotec) nursing consideration
Assess women of childbearing age for pregnancy BEFORE administration for ulcer prevention — will cause miscarriage!
Docusate sodium (Colace) and docusate calcium (Kaopectate) are examples of
Stool softener laxatives
Administration of stool softeners
Administered with full glass of water
Psyllium (Metamucil) and methylcellulose are examples of
Bulk-forming laxatives
Administration of bulk-forming laxatives
Administer with full glass of water, followed by another glass of
Bisacodyl (Dulcolax) and sennosides (Senokot) are examples of
Stimulant laxatives
Stimulant laxatives are indicated for
Constipation, bowel prep before surgery/procedure
Magnesium hydroxide, magnesium citrate, lactulose, and polyethylene glycol (MiraLax) are examples of
Osmotic laxatives
Osmotic laxative that can be used for hepatic encephalopathy (due to elevated ammonia in the body)
Lactulose
Nursing consideration for osmotic laxatives magnesium hydroxide or magnesium citrate
Watch for signs of hypermagnesemia/magnesium toxicity
Common side effects of most laxatives
Cramping, bloating, diarrhea, N/V
Loperamide (Imodium) and diphenoxylate/atropin (Lomotil) are examples of
Antidiarrheals
Antidiarrheal side effects
Constipation, drowsiness, dry mouth
Antidiarrheal patient education
Suck on candy for dry mouth
Which Antidiarrheal carries a risk for dependence with prolonged use?
Diphenoxylate/atropine (Lomotil)
Ondansetron (Zofran), promethazine (Phenergan), and meclizine (Antivert) are examples of
Antiemetics
Side effects of Ondansetron (Zofran)
Headach, constipation, diarrhea, QT prolongation (monitor EKG!)
Promethazine and meclizine are not only indicated for N/V, but can also be used for treatment of
Motion sickness
Promethazine and meclizine side effects
Anticholinergic: drowsiness, dry mouth
Antiemetics nursing consideration
If given for chemotherapy; administer PRIOR to therapy (vs treating n/v that is already occurring)
Metoclopramide (Reglan) is indicated for conditions such as
N/V, gastroparesis (delay gastric emptying), GERD
Metoclopramide (Reglan) works by
Accelerating gastric emptying
Metoclopramide (Reglan) side effects
Drowsiness, GI upset, EPS (muscle rigidity, tremors, tardive dyskinesia, restlessness)
Metoclopramide (Reglan) administration
30 min before meals and at bedtime
Medication used to treat IBS with diarrhea
Alosetron (Lotronex)
Medication used to treat IBS with constipation
Lubiprostone (Amitiza)
Medication used to treat IBS with constipation
Lubiprostone (Amitiza)
Alosetron (Lotronex) key side effect
Constipation (black box: risk for ischemic colitis)
Lubiprostone (Amitiza) side effects
Diarrhea, nausea, headache
Sulfasalazine (Azulfidine) is an example of
GI anti-inflammatory
Sulfasalazine (Azulfidine) side effects
Blood dycrasias (anemia, agranulocytosis), rash, crystalluria, fever
Sulfasalazine (Azulfidine) nursing consideration
Monitor CBC
Sulfasalazine (Azulfidine) patient education
May cause orange-yellow discoloration of urine/skin
Simethicone (Gas-X) is an example of
An antiflatulant
Administration of simethicone (Gas-X)
After meals and at bed time
Pancreatic enzyme indicated for pancreatic insufficiency related to pancreatitis, cystic fibrosis, GI bypass surgery
Pancrelipase (Pancrease)
Pancrelipase (Pancrease) side effects
Diarrhea, nausea, cramps
Pancrelipase (Pancrease) administration
Immediately before or with meals and snacks; swallow pills WHOLE (do NOT crush); if pill is difficult to swallow, may open fill and sprinkle on applesauce (acidic food)