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GI disorder drugs Flashcards

1
Q

Histamine-2 receptor antagonists prototype and other drug names

A

cimetidine (Tagamet)
Other: famotidine (pepcid)

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2
Q

histamine-2 receptor antagonist EPA

A

decreases amount, acidity and pepsin content of gastric juices by inhibiting histamine 2 receptors

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3
Q

histamine-2 receptor antagonist administration

A

PO, IV, IM

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4
Q

histamine-2 receptor antagonist therapeutic use

A

treats PUD, GERD, GI bleeding and Zollinger-Ellison syndrome

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5
Q

histamine-2 receptor antagonist ADRs

A

impotence, gynecomastia, decreased libido, confusion, arrhythmias, agranulocytosis, aplastic anemia

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6
Q

histamine-2 receptor antagonist contraindications and interactions

A

Can increase blood levels of warfarin, phenytoin, lidocaine, ketoconazole, and theophylline
Avoid NSAIDs, aspirin, alcohol or other GI irritants

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7
Q

histamine-2 receptor antagonist RN intervention and client education

A

Monitor for delirium
Education related to what medications to avoid
Admin IV slowly to prevent bradycardia
Avoid antacids with 1hr of admin

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8
Q

Proton pump inhibitors (PPI) prototype and other drug names

A

omeprazole (Prilosec)
Other drugs: pantoprazole (protonix), lansoprazole (Prevacid), esomeprazole (nexium)

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9
Q

PPI EPA

A

inhibitrs hydrogen potassium ATPase in the stomach thereby inhibiting gastric acid production

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10
Q

PPI administration

A

PO (immediate or ER) and IV

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11
Q

PPI therapeutic use

A

treats PUD and GERD with esophageal erosion and Zollinger-Ellison syndrome. GERD prophylaxis in the hospital setting 2/2 intubation or decreased mobility

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12
Q

PPI ADRs

A

risk for bone density loss with long term use; abdominal pain, nausea, vomiting, diarrhea; hypomagnesemia

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13
Q

PPI contraindications and interactions

A

Caution in pregnancy and lactation
Avoid ketoconazole
Increased warfarin, phenytoin, diazepam levels
St Johns wort decreases omeprazole levels

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14
Q

PPI RN intervention and client education

A

Should only take for 8 weeks at a time
Risk for osteoporosis increases with length of therapy
- Result of dec absorption of calcium 2/2 dec gastric acid
Take adequate amount of calcium, vit D, magnesium
Monitor for rebound acid hypersecretion when stopping medication
Maintain lowest dose possible for shortest amount of time
Report any diarrhea immediately (risk for cdiff)

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15
Q

mucosal protectant prototype

A

sucralfate (Carafate)

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16
Q

mucosal protectant EPA

A

causes chemical reaction in the stomach thereby creating a gel that coats ulcers and creates barrier between stomach and gastric secretions

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17
Q

mucosal protectant admin

A

orally on empty stomach; four times a day (QID); 1 hour before mealtime and at bettime (hs). Do not give within 30 minutes of antacids

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18
Q

mucosal protectant use

A

treats peptic ulcers 4-8 week treatment, may bind to ulcer and form a protective barrier from gastric acid

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19
Q

mucosal protectant ADRs

A

low incidence, not absorbed systemically, constipation and dry mouth

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20
Q

mucosal protectant contraindications and interactions

A

Decreased absorption of antibiotics: ciprofloxacin, tertracycline, and fluoroquinolones
Decreased absorption of digoxin, phenytoin, diazepam, and warfarin

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21
Q

mucosal protectant RN intervention and client education

A

Admin 2 hours before or after drugs above
Increase fluids and fiber intake
Report severe constipation or diarrhea

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22
Q

antacids prototype and other drug names

A

aluminum hydroxide (Amphojel)
Other drugs: magnesium hydroxide (Milk of Magnesia); calcium-carbonate (Tums)

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23
Q

antacids EPA

A

alkaline compounds that neutralize gastric acid

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24
Q

antacids administration

A

PO up to QID; take with full glass of water

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25
antacids therapeutic use
used to treat PUD and GERD
26
antacids ADRs
calcium based (Tums): constipation Magnesium-based (milk of magnesia): diarrhea Aluminum based (Amphojel): hypophosphatemia
27
antacids contraindications and interactions
Decreased absorption of tetracyclines, digoxin, fluroquinolones, aspirins (do not admin within 1-2 hours of taking these meds!!!)
28
antacids RN intervention and client education
Monitor bowel function for constipation or diarrhea Monitor phosphorus levels for aluminum based
29
5-hydroxytryptamine or serotonin receptor antagonist prototype and other drug names
ondansetron (Zofran) Others: granisetron (Sancuso)
30
5-hydroxytryptamine EPA
block 5-HRT3 serotonin receptors in chemoreceptor trigger zone (CTZ) of brain; minimizes nausea and vomiting
31
5-hydroxytryptamine administration
PO - disintegrating tablet or IV
32
5-hydroxytryptamine therapeutic use
tx nausea/vomiting secondary to chemo/radiation therapy and in postoperative recovery
33
5-hydroxytryptamine ADRs
torsades de point, stevens johnson syndrome, headache, dizziness
34
5-hydroxytryptamine contraindications and interactions
Prolonged QT syndrome (cardiac) Caution with pregnancy and lactation Avoid SSRIs/SNRIs, tricyclic antidepressants, MAOI, lithium, buspirone and triptans due to risk of serotonin syndrome
35
5-hydroxytryptamine RN intervention and client education
Monitor QT interval on telemetry/EKG If giving IV push, must push slowly over 1-2 minutes Can be given every 8 hours as needed Educate client to report severe/persistent headaches Increased risk for falls
36
antihistamine/anticholinergic prototype and other drug names
dimenhydrinate Other: diphenhydramine (Benadryl)
37
antihistamine EPA
prevents vertigo, nausea, vomiting by blocking release of histamine (h1) receptors in inner ear and those connected to CTZ
38
antihistamine administration
PO, IV, IM
39
antihistamine therapeutic use
tx nausea/vomiting secondary to chemo/radiation therapy and in postoperative recover
40
antihistamine ADRs
anticholinergic effects (dry mouth, constipation, urinary retention, dec bladder tone); sedation, drowsiness, dizziness
41
antihistamine contraindications and interactions
BPH or who are at greater risk for urinary retention Closed angle glaucoma, hyperthyroidism, cardiovascular disease, pregnancy and lactation Increased risk for sedating effects w/ other CNS depressants
42
antihistamine RN intervention and client education
Increased risk for falls Educate on the importance of frequent sips of water or hard candy High fiber foods Laxative support if needed Monitor BP and pulse when giving via IV (risk for hypotension/bradycardia) Monitor for urinary retention
43
dopamine antagonist/prokinetic prototype
metoclopramide (Reglan)
44
dopamine antagonist EPA
dopamine receptor blocker. Increases threshold of CTZ in the brain
45
dopamine antagonist administration
PO, IV, IM. Admin IV slowly
46
dopamine antagonist therapeutic use
tx nausea, vomiting associated with chemotherapy, opioids, radiation therapy. Can be used to increase GI motility in GERD
47
dopamine antagonist ADRs
sedation, extrapyramidal reactions (incontrollable repetitive movements of tardive dyskinesia), restlessness, neuroleptic malignant syndrome
48
dopamine antagonist contraindications and interactions
Gastrointestinal obstruction, hemorrhage or perforation Parkinsons disease Many drug reactions
49
dopamine antagonist RN intervention and client education
Increased risk for falls Lowest dose possible for shortest duration Monitor for s/sx of EPS or tardive dyskinesia: - Lip smacking, writhing motions, involuntary movements, involuntary spasm to face and neck; anxiety Monitor for neuroleptic malignant syndrome: - Muscle rigidity, hyperthermia, tachycardia, diaphoresis and altered consciousness
50
bulk forming laxatives prototype
psyllium (Metamucil)
51
bulk forming laxatives route
PO
52
bulk forming laxatives therapeutic use
relief from constipation within 8-72 hours
53
stool softener prototype
docusate sodium (colace)
54
stool softener route
PO
55
stool softener EPA
changes surface tension of stool, inc water absorption into stool
56
cathartics prototype
bisacodyl (Dulcolax)
57
cathartics route
PO and rectal
58
cathartics use
treats constipation, neurogenic bowel or for bowel prep
59
cathartics therapeutic use
PO usually produces a BM in 6-12 hours. Rectal produces a BM within 15 min to 1 hour
60
similarities for all constipation meds
ADRs: GI effects Nursing implications: can affect absorption of drugs, assess bowel function, last BM Contraindicated: esophageal or GI obstruction, dysphagia

Pharm (13 decks)

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