Gastrointestinal Sys(Pharm) Flashcards
Cimetidine
Generic name: Cimetidine
Trade name: Tagamet
Famotidine
Generic Name: Famotidine
Trade name: Pepcid
Prochlorperazine
Generic Name: Prochlorperazine
Trade Name: Compazine
Hydroxyzine
Generic Name: Hydroxyzine
Trade Name: Atarax-Vistaril
Meclizine
Generic Name: Meclizine
Trade Name: Antivert
Metoclopramide
Generic Name: Metoclopramide
Trade Name: Reglan
Psyllium
Generic Name: Psyllium
Trade Name: Metamucil
Bisacodyl
Generic Name: Bisacodyl
Trade Name: Dulcolax
Magnesium Hydroxide
Generic Name: Magnesium Hydroxide
Trade Name: MOM
Docusate Sodium
Generic Name: Docusate Sodium
Trade Name: Colace
Diphenoxylate HCl
Generic Name: Diphenoxylate HCl
Trade Name: Lomotil
Loperadmide HCL
Generic Name: Loperadmide HCL
Trade Name: Imodium
Lactulose
Generic Name: Lactulose
Trade Name: Cephulac
Sucralfate
Generic Name: Sucralfate
Trade Name: Carafate
Omeprazole
Generic Name: Omeprazole
Trade Name: Prilosec
Ondansetron HCL
Generic Name: Ondansetron HCL
Trade Name: Zofran
Magnesium Sulfate
Generic Name: Magnesium Sulfate
Trade Name: Epsom Salt
Antacids(Action)
ANTI_ULCER
neutralize and decrease acidity
Antacids(Indication)
ANTI-ULCER
- Hyperacidity
- Heartburn and Acid Indigestion
- Sour Stomach
- Gastroesophageal Reflux Disease(GERD)
- Peptic Ulcer Disease(PUD)
- Zollinger Ellison Syndrome=peptic ulcer with hyper secretion/hyperacidity due to tumor
- Hyperphophatemia related to renal failure=elevated levels of phosphorus=Amophjel)
- Calcium deficiency=Tums
- Magnesium deficiency=MOM
Goal of Antacid therapy:
- reduce pain
- maintain ph btw 3 and 4
- acute ill goal to have ph level at 7
Side Effect and preparation
ANTI-ULCER
Magnesium
-given for alcohol pt
SE: diarrhea/toxicity
Aluminum
- given for hyperphosphate in renal patient
- SE: common=constipation, toxicity resemble Alzeihmers: forgetful
Calcium
- given for hypocalcemia in post menopausal pt
- SE: common=bloating, hypercalcemia, rebound activity
Sodium Bicarb
-SE: alkalosis rebound acidity, common: systemic alkalosis
-all can cause electrolyte imbalance and systemic alkalosis
Antacid
ANTIULCER
Dose
- liquid(suspension), shake for 15-30ml, do not follow with water
- solid=tablet, chew thoroughly=follow with full glass of water
- frequency=acute: q1hr while awake, long term: 1-2hrs PC(after meals) and HS(hour of sleep)
- therapy will contine 4-6 weeks after symptoms no longer exist
- give antacids 1before 2hrs after any medication
Nursing implication
- antacids work for about 3hrs
- change stool whitish color
- Blood electrolyte monitoring
- drug can cause alkolosis/electrolyte imbalance
- can be used in renal patients to treat hyperphosphate
Drug
-Magnesium Hydroxide(MOM)
Antisecretory(H2 receptor Antagonist)(Action)
ANTIULCER
- block h2 receptor site on parietal cells decreasing the volume and pH of gastric acid
- work day and night
- effect volume and ph level
Antisecretory(H2 receptor Antagonist)(Indication)
ANTIULCER
- short term: 4-8weeks
- hypersecretory states
- PUD
- GERD
- Zollinger Ellison
Antisecretory(H2 receptor Antagonist)(DRUG)
ANTIULCER
-H2 blockers taken with food
Cimetidine(Tagamet)
- 300mg q6hrs
- long term qhs=400-800mg
Famotidine(Pepcid)
-po/im/iv=20-40mg QD
Nizatidine
-only on empty stomach
Antisecretory(H2 receptor Antagonist)(SIDE EFFECTS)
ANTIULCER
- common with cimetidine(tagament)=drowsiness
- cns stimulation, depression
- cns- dizziness, headache, disorientation, hallucination, depression
- cardiac- decrease hr, decrease bp, cardiac arrhythmia=more common w/ iv route
- Hema- decrease bone marrow=severe adv=monitor infection/cbc/bleeding
- MS-skin rash,muscle pain
- GI-Diarrhea
- Men-decrease sperm count,impotence,not drug of choice for male, gynecomastia
Antisecretory(H2 receptor Antagonist)(Interaction)
ANTIULCER
- cigarette smoke=reverse effect of h2 blocker
- CNS depressants=increase drowsiness
- Antiarrhythmics=drop bp/hr=i/v
- Methyl-Xanthines=bronchodilator=can cause theophyline toxicity(n/v) with cimetidine(tagament)
- warfarin
- dilantin
- tricyclic antidepressants
Antisecretory(H2 receptor Antagonist)(CONTRAINDICATION)
ANTIULCER
- children under 16
- lactating women
- chronic liver disease
- chronic kidney disease
- can alter results of allergy test=stop for 4 days effect allergy testing
- can alter results gastric acid testing
- monitor mental status= in older age
- h2 prevent secretion of HCL effect volume and acidity
Antisecretory(H2 receptor Antagonist)(Nursing Implication)
ANTIULCER
- give with food except for Nizatidine
- IV fusion= slow= concern about bp/hr/cardiac
- IM forms=deep IM=large muscle =pepcid/xantac
- promoting absorption= 1hr b4 = 2hr after
- CNS depression= tagament caused drowsiness common= driving/operate heavy machinery=once a day dose=given at hr of sleep
Antisecretory(H2 receptor Antagonist)(Nursing Implication)
ANTIULCER
- bowel plan
- assess for mood changes=commonly seen with 2-3 days of treatment
- examine for bleeding daily
- foods to avoid=avoid foods that irritate gi- caffeinated/spicy foods/alcohol
- resolution gynecomastia=restores over time,stop use
- smoking reverse the effects
- monitor stool/vomit from gi tract, resp tract
- gi bleed=hyperacidity conditions
