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Pharm > GI > Flashcards

GI Flashcards

1
Q

PUD/GERD: how to prevent and treat it?

A

*avoid NSAIDS
*infection by H. pylori

*lifestyle changes
*pharmacotherapy (PPIs, H2 receptor blockers, antacids, antibiotics (NOT GERD)
*eliminate infection
*ulcer healing

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2
Q

GERD: What is it?

A

This is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining.

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3
Q

Lifestyle changes

A

*watch what you’re eating (spicy foods)
*lose weight
*quit smoking
*elevate head of the bed
*eat slowly

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4
Q

omeprazole

A

*Proton pump inhibitors (PPI)
*all end in -prazole
*MOA: reduces acid secretion in stomach by binding to enzyme
*Short-term, 4-8 week therapy for peptic ulcers and GERD
*administer before meals
*Adverse: HA, nausea, diarrhea, rash, ab pain
*Long-term use = high risk of gastric cancer/kidney injury

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5
Q

aluminum hydroxide (simethicone)

A

*antacid
*MOA: neutralizes stomach acid by raising pH of stomach contents
*Adverse: minor constipation
*give antacids 2 hours before or after other drugs because they affect absorption

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6
Q

Antibiotics (not GERD)

A

*Administered to treat H. pylori infections
*2+ antibiotics given concurrently for increased effectiveness, less potential for resistance
*amoxicillin
*clarithromycin
* tetracycline
*Metronidazole

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7
Q

Sucralfate

A

*misc. med to treat PUD
*sucrose + aluminum hydroxide produces a gel-like substance that coats the ulcer

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8
Q

Misoprostol

A

*misc. med to treat PUD
*Prostaglandin-like substance
*inhibits gastric acid secretion and stimulates production of protective mucus

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9
Q

Metoclopramide

A

*misc. med to treat PUD
*used short term in patients who fail to respond to first-line agents
**Stimulates motility of the upper GI tract and accelerates gastric emptying

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10
Q

Constipation Laxatives

A

*Not to be used in fecal impaction, bowel obstruction and acute abdominal surgery
*Monitor chronic laxative use/abuse
*Provide fluids to prevent obstructions

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11
Q

Bulk forming laxative

A

*Psyllium mucilloid
*Absorb water, add to the size of the fecal mass
*Prevention and treatment of chronic constipation
*Slow onset of action

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12
Q

Saline osmotic laxative

A

*magnesium hydroxide (Milk of magnesia)
*Polyethylene glycol (Miralax)
*Cause water to be retained in the fecal mass
*Produce a bowel movement in 1–6 hours
*FDA warning: May cause severe dehydration and electrolyte depletion

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13
Q

Stimulant laxative

A

*bisacodly & senna
*Promote peristalsis by irritating the bowel mucosa
*Rapid-acting
*More likely to cause diarrhea and cramping
*Only to be used occasionally
*may cause dependence
*may cause depletion of fluid and electrolytes

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14
Q

Stool softener laxative

A

*docusate (Colace)
*Cause more water and fat to be absorbed into the stools (fluffy floaties)
*prevents constipation

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15
Q

Herbal agent: aloe

A

*laxative

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16
Q

Diarrhea

A

*Increase in frequency and fluidity of bowel movements
*Occurs when colon fails to reabsorb enough water
*Is a type of body defense
*Eliminates toxins/pathogens/meds
*If prolonged, can lead to fluid, electrolyte, and acid–base imbalance
*Monitor frequently
*May be related to pseudomembranous colitis

17
Q

Diphenoxylate with atropine

A

*Antidiarrheals, Opioids
*Schedule V no risk for dependence
*MOA: slows peristalsis
*Use: for moderate to severe diarrhea
*Adverse: dizziness and drowsiness

18
Q

Loperamide

A

*Imodium
*Antidiarrheals
*adverse: CARDIAC ARREST, QT INTERVAL PROLONGATION, TORSADES DE POINTES

19
Q

Crohns

A

ulcerations most common in the small intestine, but can occur anywhere in the GI tract

20
Q

IBS

A

*irritable bowel syndrome
*AKA spastic colon or mucous colitis
*Symptoms: abdominal pain, cramping, bloating, gas, constipation alternating with diarrhea, mucus in stool
*Impaired function of lower GI with no detectable disease
*Stress and dietary factors precipitate symptoms
*treatment with 5-aminosalicylic acid (5-ASA) agents, glucocorticoids and immunosuppressant drugs

21
Q

Ulcerative colitis

A

erosions in the large intestine

22
Q

sulfasalazine

A

*IBD med
* MOA: inhibits mediators of inflammation in the colon such as prostaglandins and leukotrienes.
*Adverse: N/V, diarrhea, dyspepsia (upper abdomen discomfort), photosensitivity

23
Q

Glucocorticoids that treat IBS

A

*Prednisone
*methylprednisolone
*hydrocortisone

24
Q

Immunosuppressant
drugs that treat IBS

A

*methotrexate
*infliximab (Remicade)

25
Q

Emesis

A

*vomiting
*Controlled by the “vomiting center” in medulla of brain

26
Q

Emetogenic potential

A

*capacity of drug to induce vomiting

27
Q

Nursing Considerations for GI meds

A

*Monitor use of alcohol (can increase gastric irritation)
*Administer PPIs before meals
*Llifestyle changes
*Labwork
-H. Pylori serum test
-serum phosphorus and serum calcium levels during use of antacids
-electrolytes
-occult blood

28
Q

prochlorperazine

A

*antipsychotic antiemetics
*Phenothiazines
*MOA: blocks dopamine receptors in brain which inhibits signals to vomiting center in medulla
*Adverse: anticholinergic side effects + extrapyramidal symptoms

29
Q

Antihistamines

A

*antiemetic
*MOA: block the effects of histamine at the H1 receptor.
*adverse: anticholinergic effects.
*Use cautiously in patients with pyloric obstruction, prostatic hypertrophy, hyperthyroidism, cardiovascular disease, or severe liver disease, pregnancy and lactation

30
Q

ondansetron

A

*antiemetic/five ht3 antagonists
*MOA: Serotonin receptor blocker
*Decreased N/V following chemo, radiation, or surgery.
*adverse: extrapyramidal reactions, serotonin syndrome, tachycardia

31
Q

other drugs that can be used as antiemetics?

A

corticosteroids and benzodiazepines

32
Q

Natural remedy: peppermint

A

*Abdominal bloating and pain
*Irritable bowel remedy

33
Q

Natural remedy: ginger

A

Nausea and Vomiting

34
Q

serotonin syndrome

A

confusion, restlessness, hyperreflexia, agitation, diaphoresis, tremor, and fever

Pharm (8 decks)

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