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Gastrointestinal System Flashcards

1
Q

Therapeutic Use

Histamine (H2) antagonist - ranitidine

A 
Gastric and duodenal ulcers
Heartburn, dyspepsia
Erosive esophagitis
Gastrointestinal reflux disease (GERD)
Aspiration pneumonitis
Hypersecretory disorders such as Zollinger-Ellison syndrome (gastrin)
Systemic mastocytosis (histamine)
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2
Q

What is the suffix for Histamine (H2) antagonists?

A

-tidine

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3
Q

Adverse Effects

Histamine (H2) antagonist - ranitidine

A

Impotence, reduced libido with cimetidine (Tagamet), not ranitidine
Confusion, aplastic anemia, agranulocytosis, and arrhythmia
Increased susceptibility to pneumonia

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4
Q

Nursing Interventions

Histamine (H2) antagonist - ranitidine

A

For clients who develop impotence or reduced libido, recommend switching to ranitidine
For clients who develop CNS effects, recommend switching to ranitidine
Monitor older clients for confusion

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5
Q

Client Education

Histamine (H2) antagonist - ranitidine

A

Take all medications as prescribed
Avoid smoking
Avoid foods or medications that irritate the GI tract
Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis

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6
Q

Therapeutic Use

Proton Pump Inhibitors (PPI) - omeprazole

A 
Gastric and duodenal ulcers
Prolonged dyspepsia
Gastrointestinal reflux disease (GERD)
Erosive esophagitis
Hypersecretory disorders such as Zollinger-Ellison syndrome, systemic mastocytosis
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7
Q

What is the suffix for Proton Pump Inhibitors (PPI)?

A

-prazole

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8
Q

Adverse Effects

Proton Pump Inhibitors (PPI) - omeprazole

A

Bone-loss (long term use)
Headache, abdominal pain, nausea, vomiting, and diarrhea
Hypomagnesemia

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9
Q

Therapeutic Use

Mucosal Protectant - sucralfate

A

Acute duodenal ulcers

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10
Q

Expected Pharmacological Action

Mucosal Protectant - sucralfate

A

Sucralfate causes a chemical reaction to occur in the stomach, creating a gel that coats ulcers and creates a barrier between the stomach and gastric secretions

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11
Q

Therapeutic Use

Antacids - aluminum hydroxide

A

Peptic ulcer disease

Gastrointestinal reflux disease (GERD)

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12
Q

Expected Pharmacological Action

Antacids - aluminum hydroxide

A

Antacids are alkaline compounds that neutralize gastric acid

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13
Q

Adverse Effects

Antacids - aluminum hydroxide

A

Constipation (aluminum and calcium antacids)
Diarrhea (magnesium antacids)
Hypophophatemia

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14
Q

Medication Administration

Antacids - aluminum hydroxide

A

Administer orally up to four times a day
Make sure clients chew tablets thoroughly and follow with at least 8 oz of water
Do not give within 1 to 2 hours of administering drugs that interact with antacids

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15
Q

Therapeutic Use

Prostaglandin E analog - misoprostol

A

Prevention of ulcers from long-term NSAID use

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16
Q

Adverse Effects

Prostaglandin E analog - misoprostol

A

Diarrhea, abdominal pain

Dysmenorrhea, uterine cramping, spotting (women), miscarriage

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17
Q

Medication Administration

Prostaglandin E analog - misoprostol

A

Administer orally four times a day, with meals and again at bedtime
Confirm nonpregnant state before initiating drug therapy, as this drug can cause spontaneous abortion
Make sure women of childbearing age use effective contraception during drug therapy

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18
Q

Adverse Effects

Serotonin Antagonist - ondansetron

A 
Serotonin syndrome, torsade de pointes, and Steven-Johnson syndrome
Headache
Dizziness
Diarrhea
Constipation
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19
Q

Therapeutic Use

Antihistamine/anticholinergics - dimenhydrinate

A

Antiemesis, vertigo, motion sickness

20
Q

Medication Administration

Antihistamine/anticholinergics - dimenhydrinate

A

Give dimenhydrinate orally, IM, or IV
Give the initial dose 30 to 60 minutes before the activity that triggers nausea
Give subsequent doses before meals and at bedtime
Make sure clients swallow chewable tablets whole

21
Q

Client Education

Antihistamine/anticholinergics - dimenhydrinate

A 
Do not take prior to driving or activities requiring mental alertness
Sit or lie down if feeling drowsy
Change positions gradually
Suck on hard candy or chew gum
Sip water
Increase fluid and fiber intake
Increase activity levels
Urinate every 4 hours and report any undesirable changes in urinary elimination
22
Q

Adverse Effects

Dopamine Antagonist/Prokinetic - metoclopramide

A

Sedation
Restlessness
Diarrhea
Extrapyramidal symptoms, especially tardive dyskinesia (long-term, high doses, irreversible), neuroleptic malignant syndrome

23
Q

Evaluation of Medication Effectiveness

Dopamine Antagonist/Prokinetic - metoclopramide

A

Absence of nausea and vomiting

24
Q

Medication Administration

Bulk-Forming Agents - psyllium

A

Give orally one to three times a day with at least 8 oz of fluid
Mix powdered forms with 8 oz of fluid
Expect soft, formed stools 1 to 3 days after initiating therapy
Tell clients that taking it before meals might reduce apepetite

25
Client Education | Bulk-Forming Agents - psyllium
Take with at least 8 oz of water or juice Report difficulty swallowing, chest pain, or absence of bowel movements Report persistent diarrhea Drink plenty of fluids Advise clients to increase exercise and fluid intake (at least 2 to 3 L/day) and consume high-fiber foods (bra, fresh fruits/vegetables)
26
Therapeutic Use | Surfactant Laxatives/Stool Softeners - docusate sodium
Constipation | Prevention of fecal impaction, straining during defecation, painful elimination of hard stools
27
Contraindications | Surfactant Laxative/Stool Softeners - docusate sodium
Gastrointestinal obstruction, perforation, concurrent use of mineral oil, fecal impaction, nausea, vomiting, undiagnosed abdominal pain
28
Adverse Effects | Stimulant Laxatives - bisacodyl
``` Diarrhea, mild abdominal cramps Burning sensation (suppositories) Proctitis (prolonged use of suppositories) Laxative abuse ```
29
Therapeutic Use | Opioids - diphenoxylate with atropine
Diarrhea | Reduction of volume of ileostomy effluent (loperamide/atropine)
30
Adverse Effects | Opioids - diphenoxylate with atropine
``` Drowsiness Anticholinergic effects (dry mouth) Cardiac arrest, QT interval prolongation, torsades de pointes, ventricular arrhythmias, syncope Constipation Allergic reactions ```
31
Contraindications | Opioids - diphenoxylate with atropine
``` Children younger than 2 years Inflammatory bowel disease Advanced hepatic disease Glaucoma Severe fluid and electrolyte imbalance Pseudomembranous enterocolitis Diarrhea due to poisoning Ileus Gastrointestinal bleeding Ulcerative colitis Renal or liver dysfunction History of chemical abuse Prostatic hypertrophy ```
32
Nursing Interventions | 5-HT3 Blocker - alosetron
Make sure clients meet specific criteria and sign the required treatment agreement before administration Risk management program: Client, provider, pharmacist; Outlines potential adverse effects; outlines criteria that must be met for treatment; only for women who did not improve with traditional therapies Give orally twice daily Reevaluate after 4 weeks without improvement and recommend an increased dosage if the client is tolerating the drug Stop therapy after 8 weeks if diarrhea persists
33
Client Education | 5-HT3 Blocker - alosetron
Report constipation immediately and stop taking the drug | Report abdominal pain, bloody diarrhea, or rectal bleeding immediately and stop taking the drug
34
Therapeutic Use | 5-HT4 Receptor Agonist - lubiprostone
Irritable bowel syndrome with constipation (IBS-C) in women age 18 or older Chronic idiopathic constipation (CIC) in men and women
35
Contraindications | 5-HT4 Receptor Agonist - lubiprostone
Severe diarrhea, diverticulitis, Crohn's disease, ulcerative colitis, volvulus, gastrointestinal obstruction
36
Therapeutic Use | 5-aminosalicylates - sulfasalazine
Mild to moderate inflammatory bowel disease
37
Adverse Effects | 5-aminosalicylates - sulfasalazine
Headache, pneumonitis, anorexia, nausea, vomiting, diarrhea, drug-induced hepatitis, crystaluria, infertility, oligospermia, orange-yellow discoloration of urine, exfoliate dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, rash, photosensitivity, yellow discoloration of urine, agranulocytosis, aplastic anemia, blood dyscrasias, eosinophilia, hemolytic anemia, megaloblastic anemia, thrombocytopenia, peripheral neuropathy, angioedema, hypersensitivity reactions including anaphylaxis, fever
38
Adverse Effects | Immunosuppressants - azathioprine
Progressive multifocal leukoencephalopathy, retinopathy, pulmonary edema Nausea, vomiting, diarrhea, anorexia, hepatotoxicity, mucositis, pancreatitis Alopecia, rash Anemia, neutropenia, thrombocytopenia, leukopenia, pancytopenia Arthralgia Malignancy (including post-transplant lymphoma, HSTCL, and skin cancer), serum sickness, chills, fever, Raynaud's phenomenon
39
Contraindications | Immunosuppressants - azathioprine
Active infection or immunization with live virus vaccines, pancreatitis, anuria
40
Therapeutic Use | Aloe
Used to heal burns because of its anti-inflammatory and analgesic properties
41
Therapeutic Use | Echinacea
Stimulates the immune system
42
Therapeutic Use | Feverfew
Decreases the number and severity of migraine headaches
43
Therapeutic Use | Ginger
Used to treat morning sickness, motion sickness, and nausea from surgery
44
Therapeutic Use | Gingko Biloba
Claims to improve memory
45
Therapeutic Use | St. John's Wort
Used for mild depression
46
Therapeutic Use | Block Cohosh
Treats manifestations of menopause
47
Therapeutic Use | Saw Palmetto
Treats symptoms of benign prostate hypertrophy

Pharmacology (9 decks)

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