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NUR 326 - GI and Endocrine > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

Which upper GI drugs INCREASE protective factors

A

antacids and sucralfate

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2
Q

Which upper GI drugs DECREASE aggressive factors

A

treat H. Pylori
H2 Blockers
PPI

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3
Q

how do you treat h. pylori?

A

several antibiotics plus a gastric acid inhibitor for 10-14 days
must have positive test to treat due to high resistance

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4
Q

why do you use combination therapy to treat h. pylori?

A

minimize resistance, H.pylori like acidic environment

adherence low due to cost

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5
Q

what are two drug classes target gastric production

A

Blocks H2 receptors, inhibits proton pump

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6
Q

what role does histamine play in gastric acid production?

A

causes the production of gastric acid

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7
Q

what role does the proton pump play in gastric acid production?

A

makes gastric acid

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8
Q

Which medications are H2 receptor agonists?

A

cimetidine

famotidine

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9
Q

what is the MOA of H2 receptors?

A

block H2 receptors
reduces gastric acid
increases stomach pH

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10
Q

indications of use for H2 receptors

A 
GERD
PUD
ulcer prophylaxis
heartburn
dyspepsia
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11
Q

nursing considerations for H2 receptors

A

give at least 1 hour apart from antacids
can increase warfarin, phenytoin, theophylline levels
give IV slowly to avoid bradycardia
can increase CNS effects and pneumonia risk in elderly

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12
Q

which meds are PPI’s

A

omeprazole
pantoprazole
esomeprazole magnesium

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13
Q

What is the MOA of PPI’s

A

binds to proton pump

irreversibly inhibits the secretion of HCl
turns off the pump

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14
Q

indications of use for PPI’s

A

short term tx of PUD and GERD

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15
Q

adverse effects of PPI’s

A

short term- safe

long term- increased risk of pneumonia, BONE LOSS, hip fx, stomach cancer

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16
Q

nursing considerations for PPI’s

A

short term use only

if used long term usually good outweighs the bad

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17
Q

which meds are mucosal protectant’s?

A

sucralfate

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18
Q

what is the MOA of mucosal protectants?

A

alters gastric acid and makes sticky, thick gel to form protective barrier
composed of sucrose-base, and aluminum hydroxide

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19
Q

what are the indications for mucosal protectants?

A

duodenal ulcers
gastric ulcers
chronic gastritis

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20
Q

nursing considerations for mucosal protectants

A

decreased drug absorption, take 2 hours apart ( take last) Always given PO suspension or tablet

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21
Q

what are the major forms of antacids and their side effects?

A

aluminum- constipation (amphojel)
calcium- tums (tums)
magnesium- diarrhea (milk of mag)
aluminum + magnesium- balanced approach (maalox, mylanta)

22
Q

what is the MOA of antacids?

A

neutralizes acid

23
Q

indications of use for antacids?

A

PUD
GERD
Stress Ulcers

24
Q

adverse effects of antacids

A

diarrhea or constipation (depends on base)

acid rebound

25
Q

nursing considerations with antacids

A

chelation (dont take antacids with other meds, take 2 hours apart)
altered gastric absorption
separate from other drugs by 1-2 hours

26
Q

what meds are serotonin blockers

A

ondansetron

27
Q

what is the MOA for serotoin blockers?

A

blocks serotonin receptors in trigger zone in brain and afferent vagal nerves in stomach and small intestine
used to treat chemo/rad induced vomiting but can be used for all

28
Q

side effects of serotonin blockers? (ondansetron)

A

HA, dizziness, diarrhea, serotonin syndrome

use caution with psych meds

29
Q

which meds are antihistamines

A

dimenhydrinate
meclizine
hydroxyzine

30
Q

MOA of antihistamines

A

blocks release of histamine H1 in the inner ear

31
Q

side effects of antihistamines

A

sedation, drowsiness, dizziness, nausea

32
Q

nursing considerations for antihistamines

A

treat motion sickness
fall risk due to sedation
NEVER give hydroxyzine IV can cause gangrene

33
Q

what meds are dopamine antagonists? (prokinetic agent)

A

metoclopramide

34
Q

MOA of dopamine antagonists

A

blocks dopamine receptors, increases tone of lower esophageal sphincter, increases peristalsis in stomach and intestine

35
Q

indications of use for dopamine antagonists

A

n/v associated with chemo/rad/opioids
increases GI motility
paralytic ileus

36
Q

Side effects of dopamine antagonists (metoclopramide)

A

sedation
extrapyramidal symptoms
restlessness
neuroleptic malignant syndrome

37
Q

what is extrapyramidal symptoms

A

akathisia - restless, tense, constant need to move
acute dystonia - involuntary muscle contractions
parkinsonism
tardive dyskinesia
neuroleptic malignant syndrome ( very rare but deadly rigid muscles)

38
Q

dystonia

A

spasms of tongue, neck, back, and legs
causes unnatural positioning or neck
abnormal eye movements and excessive salvation

39
Q

akathisia

A

continuous restlessness, inability to sit still, constant movement

40
Q

pseudoparkinsonism

A

muscle tremors
cogwheel rigidity
shuffling gate
slow movements

41
Q

tardive dyskinesia

A

abnormal lip smacking, tongue darting, chewing movements, slow and aimless arm and leg movements

42
Q

what drugs are 5-aminosalicylates

A

sulfasalazine

43
Q

MOA of 5-aminosalicylates

A

sulfonamide antibiotic that converts the intestine into 5-aminosalicylic acid and sulphapyridine
sulphapyridine has no therapeutic effect for IBD
*reduces symptoms of uc and crohns flares

44
Q

what are 5-aminosalicylates used for?

A

Mild to moderate IBD

45
Q

side effects of sulfasalazine

A

nausea, fever, rash, ha, hematologic disorders

46
Q

nursing considerations for 5-aminosalicylates (sulfasalazine)

A

do not give to patients allergic to sulfa, or certain types of anemia

47
Q

what meds are DMARDS

A

infliximab

48
Q

what are DMARDS used for

A

IBD

49
Q

MOA of DMARDS (infliximab)

A

monoclonal antibody that neutralizes TNF-alpha

turns off inflammatory response

50
Q

side effects of infliximab

A

immune suppression
requires therapeutic monitoring and biomarker (CRP) monitoring
pt must be prescreened for infections, TB, HIV, AIDS, ETC

NUR 326 - GI and Endocrine (6 decks)

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