GI Flashcards
What are the major activities of the GI system?
Secretion of enzymes, acid, bicarb, and mucus; Absorption of water and almost all the essential nutrients needed by the body; Digestion of food into usable and absorbable components; Motility of food and secretions through the system.
What is nausea/vomiting?
The most common and uncomfortable complaint. Vomiting is a complex reflex to various stimuli.
When would we want to induce vomiting?
In the case of an overdose, induce within 60 minutes.
When would we not want a patient to vomit?
Patients who just had surgery, a patient with increased intracranial pressure, and a patient with partial consciousness.
How can we manage N/V?
By using emetics or antiemetics.
What are emetics?
They induce vomiting and they are no longer recommended for at home poison control.
What are antiemetics?
Decrease or prevent N/V. They are centrally or locally acting; if centrally acting, we will see side effects of drowsiness and sedation. They have varying degrees of effectiveness.
What are the groups of centrally acting antiemetics?
Antihistamines, Dopamine agonists, Anticholinergics, Serotonin antagonists, Benzodiazepines, Glucocorticoids, Cannabinoids, Miscellaneous.
What are phenothiazines?
Antiemetic.
What meds are phenothiazines?
Chlorpromazine (Thorazine), Promethazine (Phenergan), Prochlorperazine edisylate (Compazine).
What is the trade name and prototype for phenothiazines?
Promethazine (Phenergan).
What are the indications for Promethazine (Phenergan)?
Treat/prevent motion sickness, N/V.
How do phenothiazines work?
Block H1 receptor sites, and inhibit the chemoreceptor trigger zone.
What pregnancy category is Promethazine (Phenergan)?
Pregnancy category C.
What are the contraindications for Promethazine (Phenergan)?
Hypersensitivity, narrow-angle glaucoma, severe liver disease, intestinal obstruction, bone marrow depression.
When should we take caution when giving Promethazine (Phenergan)?
Cardiovascular disease, liver dysfunction, asthma, respiratory dysfunction, HTN, older adults, debilitated patients.
What are the side effects of Promethazine (Phenergan)?
Drowsiness (significant), confusion, anorexia, dry mouth and eyes, constipation, urinary retention, blurred vision, transient leukopenia, HTN, photosensitivity.
What drug interactions occur with Promethazine (Phenergan)?
Increased CNS depression and anticholinergic effects when taken with alcohol or other CNS depressants.
What are the adverse effects of Promethazine (Phenergan)?
Extrapyramidal syndrome, tardive dyskinesia, akathisia.
What lab results can occur with Promethazine (Phenergan)?
False pregnancy test.
What are nonpharmacologic antiemetics?
Weak tea, flat ginger ale or cola, gelatin, gatorade (cut in half with water), pedialyte, crackers, IV fluids for severe dehydration, cool rag on the forehead/neck, italian ice, ginger.
What is the indication for over the counter antiemetics?
Prevent motion sickness, N/V, dizziness.
What are over the counter antiemetics not effective for?
Severe vomiting related to anticancer agents, radiation, or toxins.
How do over the counter antiemetics work?
Inhibit vestibular stimulation in middle ear.