GI Flashcards
GI conditions and medications
Diseases associated with gastric hyperacidity
acid reflux (GERD), peptic ulcer disease (PUD), esophageal damage
parietal cell secretes
hydrochloric acid
parietal cell receptors
histamine, gastrin, H+, K+, ATPase pump
acetylcholine
antacids MOA
alkaline compound to neutralize stomach acids, stimulates production of prostaglandins, mucus, HCO3
antacids indication
PUD, gastritis, heartburn(GERD)
antacid contraindication
allergy, renal failure/electrolyte disturbances
antacids: nursing
teach pt to avoid caffeine, harsh spices, black pepper
antacids compounds
aluminum, calcium, magnesium (MOM: SE– diarrhea, mag toxicity with renal impairment), sodium (uses: maintains pH balance/ESRD. Avoid with HTN/CHF)
H2 receptor antagonists MOA
binds to H2 receptor on parietal cells, reduces hydrogen ion secretion
H2 receptor antagonists uses
GERD, PUD
H2 receptor antagonist SE
CNS changes (especially elderly)
H2 receptor antagonists
famotidine (pepcid) – decrease dose with elderly/renal
cimetidine (tagamet)
proton pump inhibitors (PPI) claim to fame!!
most effective antiulcer medications woot woot
PPI MOA
Irreversibly inhibits H+, K+, ATPase pump
PPI uses
erosive esophagitis, GERD, ulcers
PPI SE
possible risk for GI infections (because stomach juices are more basic, and acid does better job at combating things)
examples of PPIs
pantoprazole (protonix)
esomeprazole (nexium)
sucralfate (carafate) MOA
protective barrier against environment to work
sucralfate indications
acute ulcers, PUD
sucralfate SE
constipation
sucralfate: nursing
take 1 hour AC and at HS
misoprostol (cytotec) classification
prostaglandin E analogue
misporostol GI use
decrease ulcers with long term aspirin use
misoprostol SE
HA, GI cramping, diarrhea, vaginal bleeding
misprostol PLLR
causes uterine contractions – used for abortions
antiflatulant
simethicone (mylicon)
diarrhea intestinal result
fluid and electrolyte imbalance
acute vs chronic diarrhea
acute: 3 days - 2 weeks
chronic: more than three weeks
antidiarrheal contraindication
colitis, GI obstruction, pseudomembranous colitis (toxic megacolon)
absorbents MOA
coat GI wall and bind to bacteria/toxin
absorbents
activated charcoal, bismuth subsalicylate (pepto-bismol) *can cause reys syndrome in kids
anticholinergics MOA
decrease peristalsis, GI muscle tone, secretions
anticholinergics
hyoscyamine, diphenoxylate+atropine (lomotil) –> opioid agonist
opioids MOA
decrease intestinal motility/ decreased GI pain
increased GI absorption
opioids
diphenoxylate+atropine (lomotil)
loperamide (lmodium)
probiotics MOA
replenish normal GI bacteria/suppress diarrhea causing bacteria
probiotics
lactobacillus organisms
constipation
abnormal, infrequent, difficult passage of stool
causes of constipation
drug SE, lifestyle, metabolic/endocrine, neurogenic disorders
laxative MOA
ease/stimulate defecation
produce soft, formed stool over 1+ days
laxative contraindications
acute surgical abdomen
appendicitis (abd pain, n/v)
obstruction
undx abd pain
bulk forming laxatives claim to fame!!
most natural and safest, acts like fiber (take with lots of water)
bulk forming laxative
psyllium (metamucil)
emollient laxative MOA
lubricates stool/intestines by pulling in water and fat to soften stool
*makes it easier to go
emollient laxative
docusate sodium (colase)
mineral oil
hyperosmotic laxatives MOA
increases water in stool; promotes peristalsis/evacuation
*makes you go
hyperosmotic laxatives
Polyethylene glycol (Miralax)
Lactulose (Chronulac)
lactulose also used for?
hepatic encephalopathy to decrease ammonia level (15-45u/dL)
stimulant laxative MOA
directly causes intestinal peristalsis
*makes you go
stimulant laxatives
bisacodyl (dulcolax)
senna (sennakot)
antocholinergics MOA
bind to and block ACH in the brain
dry up secretions and reduce smooth muscle spasms
antihistamines (H1 blockers) SE
dry mouth, blurred vision, drowsiness
anticholinergic SE
dry mouth, blurred vision, drowsiness
antihistamines
dimenhydrinate (dramamine)
diphenhydramine (benadryl)
antidopaminergics (dopamine blocker) MOA
some anticholinergic effects (ACH)
block dopamine receptors – antipsychotic effects
anticholinergic SE
dry mouth, blurred vision, drowsiness, EPS (parkinsonism effects) / NMS
anticholinergics
prochlorperazine (compro)
promethazine (phenergan)
prokinetic MOA
dopamine blockers, increases GI motility, increases gastric emptying
prokinetics use
delaeyd gastric emptying, GERD, N/V
prokinetic SE
drowsiness, depression, suicidal thoughts, EPS/NMS, seizures
prokinetics
metoclopramide (reglan)
serotonin blockers MOA
block serotonin receptors in GI, CTS, medulla
serotonin blockers use
n/v r/t chemotherapy, post op, ratiation
serotonin blockers SE
HA, diarrhea
prototype serotonin blocker
ondansteron
tetrahydrocannabinols (THC) use
n/v w chemotherapy, appetite stimulant w AIDS
THC contradictions
psychiatric disorders
THC SE
drowsieness, euphoria, vision changes
THC
Dronabinol (marinol) – schedule 3