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NURS 305 - Exam 5 > GI > Flashcards

GI Flashcards

1
Q

What is the drug class of aluminum hydroxide (Maalox)

A

Antacid

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2
Q

aluminum hydroxide (Maalox) is a combination of …

A

Aluminum and magnesium (aluminum salt)

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3
Q

Describe the MOA of aluminum hydroxide (Maalox)

A

Neutralizes gastric acid to increase the pH of the stomach

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4
Q

What are the indications of aluminum hydroxide (Maalox)?

A
  • Peptic ulcers
  • Gastritis
  • Gastric hyperacidity
  • Heartburn
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5
Q

What are the contraindications of aluminum hydroxide (Maalox)?

A
  • Severe renal failure or electrolyte disturbances: potential toxic accumulation of electrolytes
  • GI obstruction - antacids may stimulate GI motility when they are undesirable because of the presence of an obstructive process requiring surgical intervention
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6
Q

What are the interactions associated with aluminum hydroxide (Maalox)?

A
  • Adsorption
  • Chelation
  • Increased stomach pH
  • Increased urinary pH
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7
Q

What are the side effects of aluminum hydroxide (Maalox)?

A
  • Anorexia
  • N / V
  • Abdominal cramps
  • Constipation
  • Weakness
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8
Q

What are the adverse effects of aluminum hydroxide (Maalox)?

A
  • Electrolyte imbalances
  • Osteoporosis
  • Nephrolithiasis
  • GI obstruction
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9
Q

Describe the education associated with aluminum hydroxide (Maalox)

A
  • Administer other meds at least 2 hours before or after antacids
  • If taken on empty stomach, effective for 30 to 60 min
  • Chewable tablets followed by water
  • Liquid - drink 2-4 oz (no more) water after
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10
Q

What is the drug class of famotidine (Pepcid)?

A

H2 antagonist - antihistamine

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11
Q

Describe the MOA of famotidine (Pepcid)

A

Antagonizes H2 (responsible for gastric acid production)= decreased acid production

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12
Q

What are the indications of famotidine (Pepcid)?

A
  • PUD
  • GERD
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13
Q

What are the interactions associated with famotidine (Pepcid)?

A

Can affect absorption of meds that require acidic environment for absorption

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14
Q

What are the available dosages of famotidine (Pepcid)?

A
  • 20 mg and 40 mg pills
  • 40 mg/5 mL susp
  • IV
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15
Q

What is the drug class of pantoprazole (Protonix)?

A

PPI - proton pump inhibitor

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16
Q

Describe the MOA of pantoprazole (Protonix)

A
  • Bind irreversibly with the proton pump of the parietal cells
  • Reduce the production of acid by blocking the enzyme in the wall of the stomach
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17
Q

What are the indications of pantoprazole (Protonix)?

A
  • Duodenal ulcer treatment / maintenance
  • Gastric ulcers
  • GERD
  • Zollinger-Ellison syndrome
  • H. pylori
  • Stress ulcer prophylaxis
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18
Q

What are the side effects of pantoprazole (Protonix)?

A
  • Nausea
  • Diarrhea
  • Long-term use may lead to C. diff infection
  • Osteoporosis (decreased Ca absorption)
  • Pneumonia

B12 / magnesium depletion

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19
Q

What are the interactions associated with pantoprazole (Protonix)?

A
  • Clopidogrel (Plavix) must be 12 hours apart
  • May reduce levels of medications that require gastric acid for absorption
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20
Q

Describe the monitoring associated with pantoprazole (Protonix)

A
  • Vitamin B12
  • Magnesium
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21
Q

What are the available dosages of pantoprazole (Protonix)?

A
  • 20 and 40 mg pills (cannot be crushed)
  • IV
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22
Q

What is the drug class of sucralfate (Carafate)?

A

Mucosal protectant

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23
Q

Describe the MOA of sucralfate (Carafate)

A

Covers, adheres to, and protects ulcer site – won’t prevent an ulcer but can help heal an existing one

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24
Q

What are the indications of sucralfate (Carafate)?

A
  • Stress ulcers
  • Esophageal erosions
  • Peptic ulcers
  • Prevention of gastric mucosal injury from drug-induced ulcers
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25
Q

What are the side effects of sucralfate (Carafate)?

A

Not systemically absorbed - constipation

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26
Q

What are the available dosages of sucralfate (Carafate)?

A

1 gm PO QID one hour before meals and at bedtime

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27
Q

Describe the nursing considerations associated with sucralfate (Carafate)

A
  • Not widely used due to multi dosing a day
  • Must wait 2 hours prior to administering other drugs
28
Q

What is the drug class of misoprostol (Cytotec)?

A

Prostaglandin E analog

29
Q

Describe the MOA of misoprostol (Cytotec)

A
  • Decreases acid secretion
  • Increases bicarb & protective mucus secretion
  • Vasodilation to maintain submucosal blood flow
  • Prevention of gastric ulcers by replacing prostaglandins lost by NSAID use
30
Q

What is the primary indication of misoprostol (Cytotec)?

A

Prevention of NSAID-induced gastric ulcers

31
Q

What is the primary contraindication of misoprostol (Cytotec)?

A

Pregnancy

32
Q

What are the side effects of misoprostol (Cytotec)?

A
  • Abdominal pain
  • Diarrhea may occur when taken with magnesium antacids
  • Dysmenorrhea or spotting may occur in women – birth-control measures important
33
Q

Describe the nursing considerations associated with misoprostol (Cytotec)

A
  • Take with meals
  • Take at bedtime
34
Q

What is the therapeutic range of misoprostol (Cytotec)?

A

100 - 200 mcg

35
Q

Describe the physiological process of nausea / vomiting

A
  • Vomiting center is responsible for the physiologic events that lead to nausea & vomiting
  • Neurotransmitters are sent to the chemoreceptor trigger zone (CTZ) (near the medulla) where nausea & vomiting are induced
  • These signals then alert the brain = nausea & vomiting
  • Vomiting induced by chemotherapy or post operatively are much more intense and treated more aggressively
36
Q

What is the drug class of ondansetron (Zofran)?

A

Serotonin antagonist / antiemetic of choice

37
Q

Describe the MOA of ondansetron (Zofran)

A

Blocks serotonin receptors in CTZ & vomiting center

38
Q

What is the primary indication of ondansetron (Zofran)?

A

Nausea / vomiting

39
Q

What is the primary contraindication of ondansetron (Zofran)?

A

QT prolongation

40
Q

What are the side effects of ondansetron (Zofran)?

A
  • Headache
  • Constipation
41
Q

What are the adverse effects of ondansetron (Zofran)?

A

Prolonged QT interval- can lead to fatal dysrhythmias

42
Q

Describe the nursing considerations associated with ondansetron (Zofran)

A
  • Caution when administering with other QT prolonging drugs
  • Safe for pregnancy
43
Q

What is the drug class of meclizine (Antivert)?

A

H1 receptor blocker - first generation antihistamine

44
Q

Describe the MOA of meclizine (Antivert)

A
  • MOA-Prevent cholinergic stimulation in vestibular & reticular systems
  • N / V occur when vestibular & reticular systems are stimulated Block nerve pathways that connect inner ear and vomiting center
45
Q

What are the indications of meclizine (Antivert)?

A
  • Nausea / vomiting
  • Motion sickness
  • Dizziness
  • Vertigo
46
Q

What are the side effects of meclizine (Antivert)?

A
  • Dizziness
  • Drowsiness
  • Confusion
  • Blurred vision
  • Dilated pupils
  • Dry mouth
  • Urinary retention
47
Q

What is the route of meclizine (Antivert)?

A

PO

48
Q

What is the drug class of metoclopramide (Reglan)?

A
49
Q

Describe the MOA of metoclopramide (Reglan)

A

Blocks dopamine receptors in CTZ - desensitized impulses from GI tract AND stimulates peristalsis to empty GI tract

50
Q

What are the indications of metoclopramide (Reglan)?

A
  • Delayed gastric emptying
  • GERD
  • Nausea / vomiting
  • Gastroparesis associated with diabetes
51
Q

What are the adverse effects of metoclopramide (Reglan)?

A
  • Hypotension
  • Tardive dyskinesia with long-term use
52
Q

Avoid ______ use with metoclopramide (Reglan)

A

Alcohol / CNS depressants

53
Q

What is the drug class of promethazine (Phenergan)?

A

Phenothiazine / antidopaminergic

54
Q

Describe the MOA of promethazine (Phenergan)

A
  • Block dopamine receptors in CTZ to prevent nausea & vomiting
  • Also has antihistamine and anticholinergic properties
55
Q

What are the indications of promethazine (Phenergan)?

A
  • Psychotic disorders
  • Intractable hiccups
  • Nausea / vomiting
  • Motion sickness
56
Q

What are the side effects of promethazine (Phenergan)?

A
  • Orthostatic hypotension
  • EPS
  • Respiratory depression
57
Q

Describe the nursing considerations associated with promethazine (Phenergan)

A
  • IV route = use with extreme caution
  • Intraarterial administration instead of IV causes severe tissue damage which may require amputation
  • Needs diluted in at least 10 ml fluid, administered with running IV at port farthest away from patient or through a large bore IV (16-18 gauge)
  • Discontinue administration if patient reports burning or pain
58
Q

Describe the physiological process of constipation

A
  • Decrease in frequency of BMs or hard or
    difficult to pass stools
  • Usual time span from ingestion to defecation
    is 24-36 hours
  • Peristalsis is stimulated once feces enters the
    rectum leading to a bowl movement
  • Based on normal bowel pattern
  • Can range from 3X per day or every 3rd day
59
Q

What are the causes of constipation?

A
  • Drug induced
  • Laxative abuse
  • Neurological dysfunction
  • Metabolic dysfunction
  • Bowel disease
  • Lifestyle
60
Q

Describe management of constipation

A
  • If obstruction suspected - X-ray or other diagnostic tests, no laxatives
  • Lifestyle changes - increase fiber and fluids, do not delay defecation, void laxative abuse
  • Laxatives or Enemas - do not give laxatives if undiagnosed abdominal pain
61
Q

What is the drug class of psyllium (Metamucil)?

A

Fiber supplement / Bulk-forming laxative

62
Q

Describe the MOA of psyllium (Metamucil)

A
  • Soften fecal mass & increase bulk (similar to what dietary fiber does) by drawing water into the intestine and promoting peristalsis
  • Non-digestible and non-absorbed so excreted in stool
63
Q

What are the indications of psyllium (Metamucil)?

A
  • Acute / chronic constipation
  • IBS
  • Diverticulosis
  • Diarrhea - bulking
64
Q

Describe the nursing considerations associated with psyllium (Metamucil)

A
  • 1 tsp in 8 ounces of water or juice 1-3 times per day
  • Follow with a full glass of water
  • Onset of action 12-24 hours
65
Q
A

NURS 305 - Exam 5 (4 decks)

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