Gastrointestinal Medications

Question 1

The stomach secretes?

secretes three things, and is essential for what

Answer 1

acid, enzymes, and hormones that are essential to digestive physiology.

Question 2

Natural defenses of the stomach include:

Answer 2

Somatostatin
Bicarbonate ion
Mucus
Prostaglandin E2

Question 3

Prostaglandin antagonists include:

Answer 3

• NSAIDs/ASA (damages GI mucosa directly)
• Corticosteroids

Question 4

7 things

Peptic ulcer risk factors

Answer 4

1. Infection with Helicobacter pylori
2. Close family history of PUD
3. drugs
4. Blood group O
5. Smoking tobacco
6. Excessive caffeine
7. Psychological stress

Question 5

Which three drugs put patients at higher risk to get peptic ulcers

Answer 5

glucocorticoids, NSAIDs, and platelet inhibitors

Question 6

6 things

NSAID-induced PUD risk factors

Answer 6

1. Long-term use
2. Advanced age
3. History of ulcers
4. Corticosteroids
5. Anticoagulants
6. Alcohol and smoking

Question 7

4 things

What are the goals of peptic ulcer disease pharmacotherapy*

Answer 7

Relieve symptoms
Promote healing
Prevent complications
Prevent future recurrence

Question 8

PPI’s end in what family name

Answer 8

“Prazole”

Question 9

what do proton pump inhibitors do?

Answer 9

block gastric acid secretion

Question 10

PPI’s are the drug of choice for what two diseases

Answer 10

peptic ulcer disease and gastroesophageal reflux disease

Question 11

H2 receptor antagonist are primarily excreted by the

Answer 11

kidneys

Question 12

What is the half life of H2 receptor antagonist

Answer 12

Half-life from 1 to 4 hours

Question 13

what is the onset of action for H2 receptor antagonist

Answer 13

30-minute onset of action

Question 14

Where does rapid absorption of H2 receptor antagonist occur

Answer 14

small intestine

Question 15

H2 receptor antagonist seem to end in what family name

Answer 15

“tidine”
Ranitidine (Zantac)
Cimetidine (Tagamet)
Famotidine (Pepcid)
Nizatidine (Axid)

Question 16

H2 receptor antagonist cause harm to fetus
True or false

Answer 16

False, fetus is not effected

Question 17

these three populations of people are at a increased risk for ADR’s when taking antacids

Answer 17

malnourished people
Alcoholics
Renal disease

Question 18

antacid ADRs

Answer 18

Constipation and at high doses, aluminum products bind with phosphate in GI tract

long-term use can result in phosphate depletion.

Question 19

The nurse should be mindful to hold any antacids if their patient has a suspected

Answer 19

bowel obstruction

Question 20

Prolonged use with low serum a) … is a contraindication for antacids

Answer 20

phosphate

Question 21

what effect do anticholinergics have on antacids

Answer 21

increase effects of antacids.

Question 22

Aluminum & calcium antacids may inhibit absorption of

Answer 22

dietary iron.

Question 23

antacids should not be taken with other meds. This is because the antacids will

Answer 23

interfere with absorption

Question 24

Antacids decrease absorption of these 10 medications :(

Answer 24

cimetidine, fluoroquinolones, digoxin, isoniazid, chloroquine, NSAIDs, iron salts, phenytoin, tetracycline, and thyroxine.

Question 25

The nurse should be cautious to hold any antacids if the patient has symptoms of

Answer 25

appendicitis, undiagnosed GI bleeding, or a suspected obstruction

Question 26

When administering antacids, the nurse should consider what three things

Answer 26

1. PMH 2. Watch kidney laboratory values 3. Monitor for bowel changes & worsening symptoms

Question 27

Anticholinergic agents (scopolamine) and antihistamines (dimenhydrinate/diphenhydramine) are used for what?

Answer 27

Simple nausea, for example, nausea due to motion sickness

Question 28

Serotonin (5-HT3) receptor antagonists (Zofran) is used for

Answer 28

Chemotherapy-induced nausea and vomiting

Question 29

What is the primary indication for the use of antiemetic medication

Answer 29

Chemotherapy-induced nausea and vomiting

Question 30

Phenothiazine (Methotrimeprazine (Nozinan) or Hydroxyzine (Atarax)) and related drugs (dopamine antagonists - Metoclopramide (Reglan)) are used for what

Answer 30

Antineoplastic therapy

Question 31

Ondansetron (Zofran) mechanism of action

Answer 31

Blocks serotonin receptors in the chemoreceptor trigger zone

Question 32

What is the off label use for ondansetron (zofran)

Answer 32

cholestatic or opioid-induced pruritus

Question 33

when is Ondansetron (zofran) typically administered

Answer 33

at least 30 min prior to chemotherapy and continued for several days after

Question 34

what is the therapeutic use for Ondansetron (Zofran)

Answer 34

Treatment of serious N/V

Question 35

Ondansetron (Zofran) Therapeutic classification

Answer 35

Antiemetic

Question 36

Laxative such as - Metamucil & surfactant-type - docusate sodium) are a).. forming

Answer 36

bulk

Question 37

Laxative (bulk forming - Metamucil & surfactant-type - docusate sodium) is used for what

Answer 37

Promotes defecation Prevents and treats constipation

Question 38

# Saline Cathartic How do sennosides promote defecation

Answer 38

**pulls water into stool** Implies accelerated, stronger, and more complete bowel emptying through osmosis

Question 39

# 4 things Pharmacotherapy with Laxatives, what do they treat

Answer 39

Simple, chronic constipation Accelerate removal of ingested toxic substances Accelerate removal of dead parasites Cleanse the bowel prior to diagnostic or surgical procedures

Question 40

When giving laxative, what should the nurse be careful to monitor for

Answer 40

Monitor for retrosternal pain* Report right away

Question 41

Before giving metamucil, the nurse should be sure to do what assessment

Answer 41

Assess bowel movements and GI functioning

Question 42

How much fluids should metamucil me mixed with?

Answer 42

Mix powder and granules with at least 8 ounces of a pleasant-tasting liquid immediately before use

Question 43

The nurse needs to make sure the patient is doing what when taking metamucil

Answer 43

drinking lots of what girlie pop

Question 44

in order to relieve discomfort when taking metamucil, it may be indicate to do what

Answer 44

Smaller, more frequent doses spaced throughout the day

Question 45

when taking metamucil, what two drugs should be monitored closely

Answer 45

Monitor warfarin and digoxin levels closely

Question 46

# anti diarrheal Adverse effects of Diphenoxylate with Atropine.

Answer 46

Dizziness Lethargy, drowsiness Anticholinergic effects of atropine

Question 47

diphenoxylate with atropine may cause drowsiness or dizziness so it is important to?

Answer 47

Maintain a safe environment

Question 48

In young children who are taking diphenoxylate with atropine, the nurse should monitor for signs and symptoms of?

Answer 48

Monitor for signs and symptoms of dehydration | should monitor in all populations though

Question 49

When taking diphenoxylate with atropine, what should be reported to the provider

Answer 49

abdominal distention and signs of decreased peristalsis to provider

Question 50

# 4 things IBD is treated with

Answer 50

1. 5-ASA agents 2. immunosuppressants 3. biologic therapies 4. anti-inflammatory drugs*

Question 51

# 3 things The goal of pharmacotherapy with IBD is

Answer 51

Reduce symptoms Keep in remission (Immunosuppressive agents) Alter progression of the disease

Question 52

what is sulfasalazine (Azulfidine)

Answer 52

Agent for inflammatory bowel disease

Question 53

examples of sulfa drugs | Sulfonamides is the basis of several groups of drugs.

Answer 53

Sulfonylureas Sulfonamide antibiotics Loop & Thiazide Diuretics

Question 54

# 6 things Contraindications/precautions for taking Sulfasalazine

Answer 54

Patients with sulfonamide or salicylate hypersensitivity Patients with urinary obstruction May worsen blood dyscrasias Hepatic impairment Dehydration Diabetes or hypoglycemia