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Nurs 5229 Clinical Pharmacotherapeutics > GI > Flashcards

GI Flashcards

1
Q

Antacid indications

A

Hyperacidity, Peptic Ulcer Disease, GERD, Hyperphosphatemia, Calcium Deficiency

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2
Q

Antacid precautions/contraindications

A

abdoominal pain of unknown case

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3
Q

renalcalculi avoid

A

calcium containing antacids

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4
Q

renal failure avoid

A

magnesium based antacids

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5
Q

what is strongly cautioned against with renal failue

A

aluminum

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6
Q

sodium content in antacids may affect patients with

A

HTN, CHV, or renal failure

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7
Q

Adverse drug reactions - Antacids aluminum and calcium based

A

consipation

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8
Q

Adverse drug reactions - Antacids magnesium based

A

diarrhea

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9
Q

Antacid administration with other drugs need to be seperated by

A

at least two hours

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10
Q

Antacid you should always do what first

A

find the underlying cause

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11
Q

Combination products have the highest

A

acid neutralizing capcity

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12
Q

docum content of antacid is

A

listed on the lable.

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13
Q

monitoring for antacids

A

Magnesium level in older patients who use magnesium-containing products chronically

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14
Q

provide ___ ___ for people taking antacids

A

Provide lifestyle chainage education - Stop smoking, elevate head while sleeping, and avoid spicy foods, alcohol, or foods that affect lower esophageal sphincter tone (fatty foods, chocolate, caffeine).

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15
Q

Anti-diarrheal three classes

A

absorbent preparations
Opiates
Anti-cholinergics

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16
Q

Kaolin

A

clay like powder that attraches and holds onto bacteria - anti-diarrheal

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17
Q

pectin

A

thinkens stool

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18
Q

bismuth sulfate

A

anti secretory and anti microbial effects

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19
Q

Examples of opiates

A

loperamide (Imodium) (binds to opioid receptors and slows gastric motility), diphenoxin with atropine (Motofen), diphenoxylate (opioid) with atropine (Lomotil)

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20
Q

anti-cholinergics are only useful in

A

IBS

21
Q

Kaolin and pectin are not

A

absorbed and are eliminated in feces.

22
Q

Bismuth subsalicylate dissociates into

A

into salicylate that is absorbed (similar to aspirin), metabolized in the liver, and excreted in urine with the bismuth that is not absorbed.

23
Q

The opioid agents are all absorbed and distributed …

A

systemically, metabolized in the liver, and eliminated in urine and/or feces.

24
Q

Opioids decrease __ and cause __

A

intestinal motility and may cause toxic megacolon.

25
Q

Bismuth subsalicylate is contraindicated

A

contraindicated in children with viral or flu-like illness. similar to given asprin. reyes syndrome

26
Q

Anti-dirrheals use caution in

A

older adults

27
Q

antidiarrheal are contraindicated in the

A

treatment of diarrhea in most children.

28
Q

Most common drug interaction with anti-diarrheals

A

constipation, dark stools with bismuth sulfate (warn patients of this)

29
Q

Diphenoxylate and difenoxin with atropine: have

A

have anticholinergic effects

30
Q

Drug interactions – Anti-diarrheals

A

Aspirin, insulin, CNS depressants

31
Q

Anti-diarrheals - culture stool

A

when appropriate (diarrhea lasting more than 7-10 days) and treat infection appropriately

32
Q

Most infectious diarrhea is

A

self limiting – from viruses or other bacteria. However, severe bacterial infections such as Salmonella, C Diff, Shigella etc. must be treated with antibiotics. Example traveler’s diarrhea.

33
Q

KEY to treatment of diarrhea is to

A

KEY to treatment of diarrhea is to

34
Q

Cytoprotective Agents example

A

sucralfate and misoprostol

35
Q

Sucralfate MOA

A

coats the lining/coats the ulcer to create a barrier to acid, pepsin and bile salts

Technically topical in how it works, very safe, safe in pregnancy

36
Q

Misoprostol – inhibits

A

basal and nocturnal acid secretion also has protective qualities for mucosal lining

37
Q

MIsoprostol is contraindicated in and use with caution in

A

Contraindicated in pregnancy! May cause abortion or premature birth or birth defects.
Caution in renal patients

38
Q

Cytoprotective Agents - ADR

A

Sucralfate: constipation

Misoprostol: diarrhea, menstrual problems (CHECK pregnancy test in women of childbearing age)

39
Q

Cytoprotective Agents - Interanctions

A

Sucralfate: decreases absorption of other drugs

Misoprostol: diarrhea with magnesium-containing antacids

40
Q

Cytoprotective Agents - Clincial indications

A

Ulcers associated with NSAID use (first step stop NSAIDs)

Duodenal ulcers (sucralfate up to 8 weeks t heal ulcer, give up to 4 times a day, 1 hour before meals)

41
Q

Antihistamines (first generation) - MOA

Antiemetic

A

Have strong anti-cholinergic effects and histamine 1 blocking effects
Phenothiazines

42
Q

Phenothiazines MOA

Antiemetic

A

Block dopamine receptors in the chemoreceptor trigger zone

43
Q

Cannabinoids MOA

Antiemetic

A

Work in the central nervous system (CNS) to prevent nausea and vomiting associated with cancer chemotherapy

44
Q

5HT3 Antagonists MOA

Antiemetic

A

Block serotonin on vagal nerve terminals and in the chemoreceptor trigger zone

45
Q

Sustance P/NK receptor antagonist MOA

Antiemetic

A

The emetogenic effects of substance P are mediated through the neurokinin-1 (NK1) receptor, a member of the G protein receptor superfamily

46
Q

Phenothiazines

Produce

A

extrapyramidal symptoms (EPS)

47
Q

Phenothiazines - contraindicated in

A

parkinson’s disease

48
Q

dronabinol use with caution in patients with

A

seizure disorder

49
Q

5-Ht3 receptor antagonists

A

may mask progressive ileus

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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