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Pharm > GI disorder drugs > Flashcards

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
Q

antacids therapeutic use

A

used to treat PUD and GERD

26
Q

antacids ADRs

A

calcium based (Tums): constipation
Magnesium-based (milk of magnesia): diarrhea
Aluminum based (Amphojel): hypophosphatemia

27
Q

antacids contraindications and interactions

A

Decreased absorption of tetracyclines, digoxin, fluroquinolones, aspirins (do not admin within 1-2 hours of taking these meds!!!)

28
Q

antacids RN intervention and client education

A

Monitor bowel function for constipation or diarrhea
Monitor phosphorus levels for aluminum based

29
Q

5-hydroxytryptamine or serotonin receptor antagonist prototype and other drug names

A

ondansetron (Zofran)
Others: granisetron (Sancuso)

30
Q

5-hydroxytryptamine EPA

A

block 5-HRT3 serotonin receptors in chemoreceptor trigger zone (CTZ) of brain; minimizes nausea and vomiting

31
Q

5-hydroxytryptamine administration

A

PO - disintegrating tablet or IV

32
Q

5-hydroxytryptamine therapeutic use

A

tx nausea/vomiting secondary to chemo/radiation therapy and in postoperative recovery

33
Q

5-hydroxytryptamine ADRs

A

torsades de point, stevens johnson syndrome, headache, dizziness

34
Q

5-hydroxytryptamine contraindications and interactions

A

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
Q

5-hydroxytryptamine RN intervention and client education

A

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
Q

antihistamine/anticholinergic prototype and other drug names

A

dimenhydrinate
Other: diphenhydramine (Benadryl)

37
Q

antihistamine EPA

A

prevents vertigo, nausea, vomiting by blocking release of histamine (h1) receptors in inner ear and those connected to CTZ

38
Q

antihistamine administration

A

PO, IV, IM

39
Q

antihistamine therapeutic use

A

tx nausea/vomiting secondary to chemo/radiation therapy and in postoperative recover

40
Q

antihistamine ADRs

A

anticholinergic effects (dry mouth, constipation, urinary retention, dec bladder tone); sedation, drowsiness, dizziness

41
Q

antihistamine contraindications and interactions

A

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
Q

antihistamine RN intervention and client education

A

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
Q

dopamine antagonist/prokinetic prototype

A

metoclopramide (Reglan)

44
Q

dopamine antagonist EPA

A

dopamine receptor blocker. Increases threshold of CTZ in the brain

45
Q

dopamine antagonist administration

A

PO, IV, IM. Admin IV slowly

46
Q

dopamine antagonist therapeutic use

A

tx nausea, vomiting associated with chemotherapy, opioids, radiation therapy. Can be used to increase GI motility in GERD

47
Q

dopamine antagonist ADRs

A

sedation, extrapyramidal reactions (incontrollable repetitive movements of tardive dyskinesia), restlessness, neuroleptic malignant syndrome

48
Q

dopamine antagonist contraindications and interactions

A

Gastrointestinal obstruction, hemorrhage or perforation
Parkinsons disease
Many drug reactions

49
Q

dopamine antagonist RN intervention and client education

A

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
Q

bulk forming laxatives prototype

A

psyllium (Metamucil)

51
Q

bulk forming laxatives route

A

PO

52
Q

bulk forming laxatives therapeutic use

A

relief from constipation within 8-72 hours

53
Q

stool softener prototype

A

docusate sodium (colace)

54
Q

stool softener route

A

PO

55
Q

stool softener EPA

A

changes surface tension of stool, inc water absorption into stool

56
Q

cathartics prototype

A

bisacodyl (Dulcolax)

57
Q

cathartics route

A

PO and rectal

58
Q

cathartics use

A

treats constipation, neurogenic bowel or for bowel prep

59
Q

cathartics therapeutic use

A

PO usually produces a BM in 6-12 hours. Rectal produces a BM within 15 min to 1 hour

60
Q

similarities for all constipation meds

A

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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