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Nurs 5229 Clinical Pharmacotherapeutics > GI deck 2 > Flashcards

GI deck 2 Flashcards

1
Q

antihistamines use with caution in

A

elderly - anticholinergic properties

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2
Q

Antihistamine ADR

A

Drowsiness

Anticholinergic effects of dry mouth, blurred vision, and urinary retention

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3
Q

Phenothiazines ADR

A

Drowsiness
EPS, such as dystonia, akathisia, and tardive dyskinesia
Promethazine: fatal respiratory depression in children younger than 2 years of age

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4
Q

Scopolamine ADR

A

Dry mouth

Withdrawal symptoms

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5
Q

Cnnibinoid dronabionl ADR

A

Euphoria, depression, dizziness, paranoid thoughts, somnolence, and abnormal thoughts
Cardiac effects: palpitations, tachycardia, and hypotension
Seizure and seizure-like activity have been reported

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6
Q

5-HT3 receptor antagonists - ADR

A

Constipation, headache, fatigue, dizziness, and diarrhea

Rare cases of tachycardia, bradycardia, hypotension, and heart rate-corrected QT interval prolongation

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7
Q

Phenothiazines and lithium: may increase

A

eps

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8
Q

Phenothiazines and lithium: may mask

A

LITHIUM TOXICITY

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9
Q

Nausea and vomiting - Drugs used

A

5-HT3 receptor antagonists

Phenothiazines

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10
Q

Phenothiazines are not used in

A

children

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11
Q

Dronabinol is only for use in

A

in chemotherapy-associated nausea and vomiting, and for appetite stimulation.

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12
Q

Motion sickness drug used

A

anti-histamines

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13
Q

vomiting caused by gastroparesis drug used

A

prokinetic drug

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14
Q

Motion Sickness drug is most effective when given

A

prophylactically

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15
Q

Scopolamine patch – very effective but

A

apply approx. 12-24 hours before motion sickness triggering event. This is RX only

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16
Q

Other use for scopolamine can be to prevent

A

nausea from anesthesia apply 12-24 hours before surgery when pts have severe N/V from anesthesia.

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17
Q

Antihistamines are other main group that can help motion sickness- examples

A

examples Bonine (meclizine), Dramamine (dimenhydrinate)

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18
Q

Histamine 2 Receptor Antagonists inhibit

A

acid secretion gastric parietal cells blocks histamine at histamine 2 receptors

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19
Q

Histamine 2 Receptor Antagonists reduce acid by

A

35 - 50 %

20
Q

Histamine 2 Receptor Antagonists examples

A

cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid)

21
Q

H2RA caution in

A

renal and liver impairment, can have CNS adverse reactions – although not common could be serious but is reversible

22
Q

Famotidine approved for

A

infant and children as young as neonates, ranitidine approved for children 1 month to 16 years

23
Q

Cimetidine has the most

A

interactions with foods/drugs
Indications/Clinical use: GERD, Heartburn, PUD - can be used as maintenance therapy after PPI therapy, Ok for longer term use

24
Q

What interferes with absorption of H2RA

A

Smoking does interfere with absorption of this drug

25
Q

Prokinetic agents stimulate

A

motility of the GI tract without stimulating gastric, biliary, or pancreatic secretions

26
Q

only drug in prokinetic class

A

metoclopramide

27
Q

Prokinetic pharmcodynamics

A

Metoclopramide stimulates motility in the upper GI tract.

Metoclopramide also has some actions similar to the phenothiazines and dopamine antagonists.

28
Q

Metoclopramide (reglin) also has some actions

A

similar to the phenothiazines and dopamine antagonists.

29
Q

Metoclopramide has a Black Box warning

A

due to risk of developing tardive dyskinesia

30
Q

Prokinetics are contraindicated in gastrointestinal

A

hemorrhage, mechanical obstruction, new surgery on the GI tract, or perforation.

31
Q

Prokinetic use cautiously in

A

hemorrhage, mechanical obstruction, new surgery on the GI tract, or perforation.

32
Q

Prokinetic ADR

A 
Tardive dyskinesia
Depression, dizziness
Diarrhea 
Hypoglycemia in patients with diabetes
Rare: galactorrhea, amenorrhea, gynecomastia, impotence secondary to hyperprolactinemia
33
Q

Prokinetics Drugs - Interactions

A

Additive CNS depression occurs when used with other CNS depressants.
Increased risk of EPS occurs with other drugs that have the potential for EPS.
Drugs with anticholinergic effects reverse the action of metoclopramide.

34
Q

Prokinetic drug clinical use

A

GERD, diabetic gastroparesis

Monitor – renal function, new-onset movement disorder, depression or suicidal ideation

35
Q

proton pump inhibitors suppress

A

gastric acid secretion, can reduce secretion of acid as much as 90%

36
Q

PPI are all acid-

A

are acid-labile, most formulated as enteric coated capsules

37
Q

PPI are overall safe but

A

safe drug, use with caution in hepatic dysfunction and elderly – no dosage adjustments are recommended

38
Q

PPI are safe in what

A

pregnancy but always weigh risks benefits

39
Q

PPI should only be used

A

short term

40
Q

PPI long term use is not advised due to

A

to PPIs causing nutrient deficiencies with iron, B12 and calcium absorption interference. Long term can lead to increased risk for fracture.

41
Q

PPI long term use increases

A

risk for chronic kidney disease

42
Q

PPI long term use have increased risk of

A

infection from C diff, Salmonella, Campylobacter as the decrease in stomach acid decreases the bodies natural defenses against antimicrobial

43
Q

PPI long term use also shows intrease risk of

A

gastric cancers because of chronic atrophic gastritis

44
Q

All PPIs may interfere with

A

oral administered drugs – see drug interactions table in text

45
Q

PPI clincal indications

A

Duodenal and gastric ulcers, GERD

46
Q

PPI some times are used long term but

A

rarely and usually only with hypersecratory conditions such as Zollinger-Ellison syndrome

47
Q

Average recommended treatment duration for PPI

A

4 to 8 weeks

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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