GI Drugs Flashcards
OTC anti-emetics
Diphenhydrinate
Meclizine
Bisthmuth subsalicylate
Ginger
Nursing implications for anti-emetics
Do not drink alcohol Do not take while pregnant Do not take while breastfeeding Take before vomiting begins No operation of heavy machinery until effects are known
Antihistamines used as antiemetics
Hydroxyzine
Promethazine
Anticholinergics used as anti-emetics
Scopolamine
Contraindications for scopolamine
Glaucoma
How should Promethazine (Phenergan) not be administered and why?
IV
Can cause tissue necrosis
Use of antihistamine/anticholinergic anti-emetics
Treatment of nausea and vomiting
Side effects of antihistamine/anticholinergic anti-emetics
Dryness
Use of promethazine
Motion sickness, vertigo, perioperative nausea and vomiting
Side effects of promethazine
Drowsiness, restlessness, hypotension, constipation, urinary retention
Route of administration for promethazine
PO, PR, IM, IV
Example of dopamine antagonist anti-emetics
Phenothiazines such as prochlorperazine and promethazine
Examples of phenothiazines
Prochlorperazine
Promethazine
Action of dopamine agonist anti-emetics
Suppress emesis by blocking dopamine 2 receptors in CTZ
Use of dopamine antagonist anti-emetics
Prevents vomiting
Reduce anxiety
Tx psychosis
Side effects of dopamine antagonist anti-emetics
EPS (tardive dyskinesia and akathesia)
Nursing implications for dopamine antagonist anti-emetics
Teach pts taking prochloroperazine of reddish-brown urine
Routes of administration of prochlorperazine
PO, IM, IV, rectal
Side effects of prochlorperazine
Drowsiness Dizziness Hypotension Photosensitivity Constipation Tardive dyskinesia
Examples of benzodiazepine ant-emetics
Lorazepam
Diazepam
Use for benzodiazepines
Tx for anxiety
N/V that occurs with chemotherapy
Examples of serotonin receptor antagonist
Dolasetron
Odansetron
Serotonin receptor drugs end in
-setron
Side effects of serotonin receptor antagonist
HA (severe requiring pain meds)
Diarrhea
Dizziness
Fatigue
Glucocorticoids end in
-one
Examples of glucocorticoid anti-emetics
Dexamethasone
Methylprednisolone
Use of glucocorticoids
Suppress emesis with chemotherapy
Example of cannabinoid anti-emetics
Dronabinol
Use of cannabinoids
Tx of N/V with cancer
Stimulate appetite for AIDs pts
Side effects of cannabinoids
Drowsiness, dry mouth, impaired thinking
Contraindication for using cannabinoids
Psych pts
Use of Metoclopramide (Reglan)
N/v, vertigo, increase gastric emptying
Side effects of metoclopromide
Drowsiness, EPS, anticholinergic symptoms
Use of emetics
Stimulate vomiting to expel ingested toxic substances
Contraindications for emetics
Not to be given if a caustic agent was ingested
Not be if substance is unknown
Nursing implications for emetics
Instruct to call poison control Use activated charcoal if vomiting is contraindicated Always know the substance Follow w/ 8 ounces of water Repeat doses 20-30 min apart
Examples of anti-diarrheals
Loperamide (Imodium) Diphenoxylate HCl (Lomotil) w/ atropine sulfate
Opium derivative antidiarrheal
Diphenoxylate HCl (Lomotil)
Action of diphenoxylate HCl (lomotil)
Slows GI motility
Contraindications for antidiarrheals containing atropine sulfate (lomotil & imodium)
Due to atropine contraindicated in pts with glaucoma
classifications of antidiarrheals
Opiates-opiate related agents
Octreotide
Absorbents
Examples of opiate/ opiate-related agents
Atropine/Diphenyloxylate
Action of opiates/opiate-related agents
Decreases intestinal motility
Side effects of opiate/opiate-related antidiarrheal agents
Drowsiness, constipation, dry mouth, weakness, urinary retention
Contraindications for opiate/opiate-related agents
Liver & kidney disease
Glaucoma
Use of octreotides
Severe diarrhea due to metastatic cancer
Route of administration for octreotides
SQ
Action of octreotides
Inhibits gastric acid, pepsinogen gastric, cholecystokinin, serotonin & intestinal fluid
Example of absorbents
Bismuthsubsalicylate (pepto & kaopectate)
Action of absorbents
COATs the GI tract & absorbs the bacterial/toxins that cause diarrhea
Nursing implications of absorbents
Check for allergies to aspirin
Tablets must be chewed
Shake suspensions
May cause black, furry tongue & tarry stools if taken in excess
4 types of laxatives
Osmotic (saline)
Stimulants
Bulk-forming agents
Emollients (stool softeners)
Examples of osmotic (saline) laxatives
Glycerine Mag citrate MOM Fleet phosphasoda Fleet enema
Use of osmotic laxatives
Relieves constipation, bowel prep, elimination of ammonia in liver disease (lactulose)
Action of osmotic laxatives
Pulls water into colon & increases water in feces
Contraindication for osmotic laxatives
Renal disease
Side effects of osmotic laxatives
Flatulence, abdominal cramping, vomiting
Action of MOM
Cover stomach lining, decreasing burning
When should MOM be given?
In the AM for a BM in the PM
Side effects of MOM
Abdominal cramping
Diarrhea
Dehydration
Examples of stimulate laxatives
Bisacodyl (Docalax)
Senna glycoside
Castor oil
How would you position a patient when administering bisacodyl suppository?
Lying down on left side with leg flexed
Side effects of bisacodyl
Fluid and electrolyte imbalance
Abdominal discomfort
Loss of potassium
Cramping
Examples of Bulk forming laxatives
Metamucil
Citrucel
Fibercan
Action of bulk-forming laxatives
Natural fiber substance absorbs water and softens stools
Increases peristalsis
Side effects of bulk-forming laxatives
Abdominal cramping
Flatus
Nausea
Types of anti ulcer drugs
Tranquilizers Anticholinergics Antacids H2 blockers PPI's (Proton pump inhibitors) Pepsin Prostglandid E1 Analog
Example of tranquilizers
Chlordiazepoxide
Action of tranquilizers
Minimal effects in treating ulcers; reduce vagaries stimulation & decreases anxiety
Example of anticholinergic for ulcers
Glycobarium bromide
Use of anticholinergics for ulcers
Often given prior to surgery to dry everything up
Action of anticholinergics for ulcers
Relieves ulcer pain by reducing GI motility & secretions
Side effects of anticholinergics for ulcers
Dry mouth, urinary retention, drowsiness
Examples of antacids
Sodium bicarbonate
Calcium carbonate
Aluminum hydroxide
Magnesium hydroxide
Action of antacids
Promote ulcer healing by neutralizing acid
Side effects of sodium bicarbonate
Metabolic acidosis
Side effects of calcium carbonate
Hypercalcemia, alkalosis, crystalluria
Side effects of aluminum hydroxide/magnesium carbonate
Magnesium compounds cause diarrhea
Calcium causes constipation
Examples of H2 blockers
Climetidine
Ranitidine
Famotidine
Niztidine
H2 blockers end in
-dine
Action of H2 blockers
Prevents acid reflux in esophagus
Blocks H2 receptors of parietal calls of the stomach thus reducing gastric secretions
Side effects of H2 blockers
HA, confusion, vertigo, diarrhea, constipation, decreased libido & impotence
Contraindications for H2 blockers
Cimetidine cannot be used with impaired renal fx; if taken w/ antacids, effective is decreased
Examples of proton pump inhibitor (PPI)
Lansopraxole
Pantoprazole
Esomepraxole
Omeprazole (Prilosec)
PPI drugs end in
-xole or -zole
Action of proton pump inhibitors
Suppress gastric acid secretions
Example of pepsin inhibitor
Sucralfate
Action of pepsin inhibitor
Non-absorbable & combines w/ protein to form a viscous substance that covers the ulcer & protects it from acid and pepsin
Side effects of pepsin inhibitor
Rash, dizziness, insomnia, diarrhea, constipation
Nursing implications of pepsin inhibitor
Dosing 1 g AC/HS (before meals/before bed)
Example of prostaglandin analogue
Cytotec
Use of prostaglandin anologue
Prevent and treat peptic ulcers
Action of prostaglandin anologue
Suppress gastric acid secretions & increase cytoprotective mucus in the GI tract