GastroIntestinal Meds

Question 1

Indication:

Antiemetics

Answer 1

To treat nausea and vomiting especially post-operative or with chemotherapy.

Question 2

Mechanism of action:

Antiemetics

Answer 2

Works on the CNS to suppress nausea and vomiting.

Question 3

Generic names:

Antiemetics

Answer 3

• ondansetron
• metoclopramide
• promethazine

Question 4

Most common side effects:

Antiemetics

Answer 4

• sedation
• anticholinergic

Question 5

Nursing considerations:

Antiemetics: sedation

Answer 5

Assess for falls and implement fall and safety precautions.

Question 6

Side effects and Nursing considerations:

Antiemetics: anticholinergic side effects

Answer 6

1. causes blurry vision - implement safety / fall precautions
2. causes urinary retention - monitor intake and output
3. causes dry mouth - give candy or ice chips
4. causes constipation - encourage fluids/fiber/walking

“can’t see, can’t pee, can’t spit, can’t shit”

Question 7

Indication:

Antidiarrheal

Answer 7

To treat:

• diarrhea
• ulcerative colitis
• irritable bowel syndrome

Question 8

Generic names:

Antidiarrheal

Answer 8

• diphenoxylate/atropine
• loperamide
• bismuth subsalicylate

Question 9

Most common side effects:

Antidiarrheal

Answer 9

Sedation or drowsiness: take safety and falls precautions.

Question 10

When should a client with diarrhea not take an antidiarrheal medication?

Answer 10

Do not give a client with an active gastrointestinal infection.

The client will be unable to get rid of the infection if they can’t excrete it.

Question 11

With what type of medication is there a cross-sensitivity with bismuth subsalicylate?

Answer 11

Cross-sensitivity with aspirin and NSAIDs.

Do not give if there is an allergy.

Question 12

Indication:

Laxatives / Stool softeners

Answer 12

To prevent or treat constipation.

Question 13

Generic names:

Laxatives / Stool softeners

Answer 13

• polycarbophil, psyllium
• lactulose
• milk of magnesia
• bisacodyl
• senna glycoside
• docusate sodium

Question 14

Nursing considerations:

Laxatives / Stool softeners

Answer 14

• drink with a full glass of water to help pass stool
• teach that daily use is not necessary because daily movements are not needed

Question 15

Indication:

Antilipidemic

Answer 15

To decrease cholesterol for those at risk for stroke and myocardial infarction.

Question 16

Generic names:

Antilipidemic

Answer 16

• atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin
• ezetimibe

Question 17

Most common adverse reactions and nursing considerations:

Antilipidemic: -statin

Answer 17

Rhabdomyolysis (muscle breakdown)

• assess for severe muscle pain, spasms, and dark-colored urine
• hold medication and notify HCP

Medication may cause muscle cells to break down.

Question 18

What is the food-med interaction with Antilipidemic (-statin)?

Answer 18

Avoid grapefruit juice.

​Will increase drug level and cause toxicity.

Question 19

What labs should be checked for a client taking antilipidemics?

Answer 19

Before meds are started and every 6 - 12 months for a client on antilipidemics, check: liver function tests such as ALT and AST.

This is to assess if the medications are affecting the liver adversely and to evaluate if the medicine is working.

Question 20

Indication:

Proton pump inhibitor

Answer 20

Decreases acid secretion and treats:

• GERD
• heartburn
• ulcers

Question 21

Generic names:

Proton pump inhibitor

Answer 21

dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole

Question 22

Nursing considerations:

Proton pump inhibitor

Answer 22

Give 30 - 60 minutes before meals.

To protect stomach before eating.

Question 23

Indication:

H-2 receptor blocker

Answer 23

To heal and prevent ulcers by limiting gastric acid secretion.

Question 24

Generic names:

H-2 receptor blocker

Answer 24

• famotidine
• ranitidine
• cimetidine

Question 25

# Generic names: Antacids

Answer 25

* aluminum hydroxide * calcium carbonate * magnesium oxide

Question 26

# Indication: Antacid

Answer 26

* to treat acid indigestion and GERD * to treat ulcers

Question 27

# Nursing considerations: Antacid

Answer 27

* don't take with other meds: prevents absorption * wait at least 1 hour when taking other meds * take ~2 hours after meals with water

Question 28

# Generic names: Pancreatic enzymes

Answer 28

* **_pancre_**lipase * **_pancre_**atin

Question 29

# Indication: Pancreatic enzymes

Answer 29

To treat: * cystic fibrosis * pancreatitis

Question 30

# Nursing considerations: Pancreatic enzymes

Answer 30

Take right before meals to help with food digestion.

Question 31

# Indication: sucralfate

Answer 31

To treat and prevent duodenal ulcers.

Question 32

# Indication: vitamin B12 / cyanobalamin

Answer 32

To treat pernicious anemia: common after gastric surgery.

Question 33

# Indication: ferrous sulfate / iron

Answer 33

* to treat iron deficiency anemia * to prevent anemia during pregnancy

Question 34

What **color** can iron turn stool?

Answer 34

greenish-black

Question 35

# Side effect and nursing consideration: ferrous sulfate / iron

Answer 35

May cause constipation: taking with vitamin C helps absorption. ## Footnote If iron is absorbed into the bloodstream, it won't just stay in the gut leading to constipation.

Question 36

# Indication: folic acid / folate

Answer 36

* to prevent folate deficieny anemia from diet or alcoholism * to prevent neural tube defects during pregnancy

Question 37

What **color** can folic acid / folate turn urine?

Answer 37

bright yellow

Question 38

# Indication: vitamin B3 / niacin

Answer 38

To lower cholesterol.

Question 39

# Side effect: niacin

Answer 39

facial flushing

Question 40

# Adverse reaction and nursing consideration: niacin

Answer 40

**Hepatotoxic**: check liver function tests before giving (ALT and AST).

Question 41

# Mechanism of action: Antidiarrheal

Answer 41

Slows the passage of stool.

Question 42

# Mechanism of action: Laxatives / Stool softeners

Answer 42

Pulls fluid into colon and/or adds bulk to soften the stool.

Question 43

# Adverse reaction: Laxatives / Stool softeners

Answer 43

Fluid and electrolyte imbalances: assess F&E status.

Question 44

# Mechanism of action: Antilipidemic

Answer 44

Prevents enzyme that makes cholesterol.