Gastrointestinal System Flashcards by Kelsey Thornton

Antacids Examples

Aluminum hydroxide
Magnesium hydroxide (Milk of Magnesia)
Sodium Bicarbonate

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Aluminum Hydroxide Complications

constipation

hypophosphatemia

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Magnesium Hydroxide Complications

Diarrhea
Renal Impairment
Hypermagnesemia

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Sodium Bicarbonate Complications

Constipation

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Antacids Indications

peptic ulcer disease

GERD

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Antacids Precautions

prolonged use can result in hypophosphatemia

can decrease medication absorption

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Antacids Administration

use only aluminum based preparations in renal impairment
other medications should be taken 1 hr before or after antacids
older adults with poor nutritional status are at increased risk of hypophosphatemia
do not self prescribe antacids for longer than 2 weeks

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Proton Pump Inhibitors Examples

Omeprazole
Lansoprazole
Rabeprazole sodium
Esomeprazole

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Proton Pump Inhibitors Indications

gastric and duodenal ulcers
GERD
Zollinger-Ellison syndrome

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Proton Pump Inhibitors Precautions

contraindicated during lactation

use caution with COPD

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Proton Pump Inhibitors Complications

increased risk of osteoporosis with long term use
pneumonia in COPD clients
acid rebound

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Proton Pump Inhibitors Administration

Seek appropriate care even when taking OTC preparations
take prior to eating
do not crush, chew, break tablets
notify prescriber of signs of GI bleed
modify diet as prescribed

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Histamine 2 Receptor Antagonists Examples

Ranitidine Hydrochloride
Cimetidine
Nizatidine
Famotidine

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Histamine 2 Receptor Antagonists Indications

Gastric and duodenal ulcers
GERD
Zollinger-Ellison syndrome

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Histamine 2 Receptor Antagonists Precautions

Contraindicated during lactation

use caution in COPD

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Histamine 2 Receptor Antagonist Complications

decreased libido/impotence
lethargy
depression
confusion

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Histamine 2 Receptor Antagonist Administration

Seek appropriate care even when taking OTC preparations
take prior to eating
do not crush, chew, break tablets
notify prescriber of signs of GI bleed
modify diet as prescribed

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Sucralfate Classification

Mucosal Protectats

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Sucralfate Indications

gastric and duodenal ulcers

GERD

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Sucralfate Precautions

chronic renal failure

Sucralfate Administration

administer on an empty stomach at least 1 hr before meals

Do not administer within 30 min of antacids

Antiemetics Indications

nausea/vomiting

Antiemetics Examples

promethazine
metoclopramide
ondansetron
scopolamine

Promethazine Complications

drowsiness
anticholinergic effects
severe respiratory depression in children <2
EPS
potentiates effects when given with narcotics

Promethazine Precautions

cardiovascular disease | hepatic disease

Promethazine Administration

monitor vital signs safety precautions give IM in large muscles

Metoclopramide Complications

``` drowsiness diarrhea restlessness EPS tardive dyskinesia ```

Metoclopramide Precautions

seizures cardiovascular disease pheochromocytoma

Metoclopramide Administration

Instruct client about rapid GI emptying | discontinue with signs of EPS

Ondansetron Complications

Headache | EPS

Ondansetron Interventions

Administer tablets 30 min prior to chemotherapy and 1-2 hr before radiation

Ondansetron Precautions

risk for dysrhythmia | do not administer to clients with prolonged QT interval

Scopolamine Complications

blurred vision sedation anticholinergic effects

Scopolamine Precautions

increased mydriatic effect causes increased occular pressure | use caution with glaucoma

Scopolamine Interventions

apply transdermal patches behind ear | use lubricating eye drops

Antidiarrheals Examples

Diphenoxylate plus atropine Loperamide Paregoric

Antidiarrheals Indications

management of diarrhea

Antidiarrheals Precautions

increased risk of megacolon for clients who have IBS | contraindicated in clients with COPD (paregoric)

Antidiarrheals Complications

constipation drowsiness dry mouth blurred vision

Antidiarrheals Administration

monitor fluid and electrolyte status | avoid caffeine intake

Stool Softeners/Laxatives Examples

Psyllium Docusate sodium Bisacodyl Magnesium hydroxide (Milk of Magnesia)

Psyllium Indication

decrease diarrhea (bulk forming)

Ducosate Sodium Indication

relieve constipation (surfactant)

Bisacodyl Indication

preprocedure colon evaculation (stimulant)

Magnesium hydroxide (Milk of Magnesia) Indication

Prevent painful elimination (low dose osmotic) | Promote rapid evacuation (high dose osmotic)

Stool Softeners/Laxatives Precautions

contraindicated in clients with fecal impaction, bowel obstruction most laxatives are contraindicated in clients with ulcerative colitis and diverticulitis (psyllium may be used)

Stool Softeners/Laxatives Complications

fluid and electrolyte imbalances GI irritation can lead to toxic levels of magnesium fluid retention (laxatives with sodium)

Stool Softeners/Laxatives Administration

Contraindicated with fecal impaction, bowel obstruction, acute surgical abdomen encourage regular exercise and promote regular bowel elimination monitor for chronic laxative use/abuse provide adequate fluid and fiber intake to avoid obstruction