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Pharmacology > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

common disorders with Upper GI

A

Heartburn, GERD, Peptic Ulcer Disease, Duodenal ulcer

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2
Q

Nursing Assessment for GI secretion drugs

A

baseline H&P including allergies and medications
focus: GI and abdominal assessment related to disorder and AE
Follow administration protocol

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3
Q

Nursing Education for GI secretion drugs

A

non-pharm interventions for disorder
proper administration
shortest duration to reduce risk for AE

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4
Q

Common AE for GI secretion drugs

A

nausea
vomiting
diarrhea
constipation
abdominal discomfort
rash

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5
Q

Sodium Bicarbonate class

A

antacids

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6
Q

Sodium Bicarbonate MoA

A

neutralize stomach acid by direct chemical reaction

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7
Q

Sodium Bicarbonate Indications

A

relief of upset stomach r/t hyperacidity

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8
Q

Sodium Bicarbonate Route

A

PO: rapid onset, short duration, give PRN to treat symptoms
also used IV for metabolic acidosis and cardiac emerg. (more severe AE profile and urgent nursing)

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9
Q

Sodium Bicarbonate AE

A

gastric acid rebound, belching, fluid retention, hypokalemia, metabolic alkalosis (headache, confusion, irritability, nausea, weakness, tetany) if overdosed

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10
Q

Sodium Bicarbonate nursing considerations

A

give other meds 1-2 hours after oral antacid; chew tab and give with 8 oz of water; do not take with milk; electrolyte disturbances; teach- not to take 2 wks; OTC

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11
Q

Cimetidine (Tagamet) class

A

Histamine 2 (H2) antagonists

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12
Q

Cimetidine (Tagamet) MoA

A

blocks histamine-2 receptor sites to reduce gastric acid secretion and pepsin production

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13
Q

Cimetidine (Tagamet) Indications

A

GI ulcers; GERD; hyper-secretory conditions; heartburn and acid indigestion

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14
Q

Cimetidine (Tagamet) AE

A

headache, dizziness; severe: cardiac arrhythmias

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15
Q

Cimetidine (Tagamet) Nursing

A

Teach: smoking diminishes effectiveness of med; extended duration (greater than 6 months) risk for vitamin B12 malabsorption; OTC

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16
Q

Omeprazole (Prilosec) class

A

proton pump inhibitors (PPI)

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17
Q

Omeprazole (Prilosec) MoA

A

blocks secretion hydrochloric acid in the stomach; ALL gastric acid secretion is temporarily blocked

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18
Q

Omeprazole (Prilosec) indications

A

GERD, GI ulcers; prevention ulcers in acute care

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19
Q

Omeprazole (Prilosec) cautions

A

long term use risk: atrophic gastritis (malabsorption of vitamin B 12- pernicious anemia), osteoporosis related fracture (decreased Ca absorption); associated with C diff.

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20
Q

Omeprazole (Prilosec) AE

A

headache, dizziness, upper respiratory infection (URI)

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21
Q

Omeprazole (Prilosec) nursing

A

administer on an empty stomach (30-60 min before a meal);
Teach- shortest duration, report s/s severe diarrhea; monitor h/h; OTC

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22
Q

Sucralfate (Carafate) class

A

gastrointestinal protectant

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23
Q

Sucralfate (Carafate) MoA

A

binds to base of ulcers and erosions forming protective barrier from pepsin

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24
Q

Sucralfate (Carafate) indications

A

GI ulcer; chronic renal failure/hyperphosphatemia

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25
Q

Sucralfate (Carafate) AE

A

constipation, dry mouth, dizziness

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26
Q

Sucralfate (Carafate) nursing considerations

A

administer med on an empty stomach, 1 hour before or 2 hours after meals and at bedtime; admin other meds at least 2 hours before (impairs absorption)

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27
Q

Assessment for Laxatives

A

baseline H&P including allergies and medications
focused assessment: bowel sounds, I&O, electrolytes
contraindicated in acute bowel disorders such as ileus, obstruction, ischemia, perforation

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28
Q

Monitoring for Laxatives

A

loose stools (diarrhea), nausea, vomiting, abdominal pain, dehydration, electrolyte imbalance
achievement of soft bowel movement within 24 hours of administration

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29
Q

implementation for laxatives

A

hold if loose stools
encourage 3 L of water daily, high fiber diet, increase activity
for multiple PRN softener/laxative orders (first use docusate if no results try bisacodyl or polyethylene glycol- may need multiple drugs for result

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30
Q

teaching for laxatives

A

teach not to take a laxative if experiencing nausea, vomiting, abdominal pain. contact provider if experiencing severe abdominal pain, muscle weakness, cramps, and or dizziness
long term use of laxatives results in decreased bowel tone and may lead to dependency; use for no more than 7 days.

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31
Q

Docusate (colace) class

A

lubricant/stool softener

32
Q

Docusate (colace) MoA

A

promotes electrolyte and water absorption into colon, promotes incorporation of water into the stool (results in stool softening)

33
Q

Docusate (colace) indications

A

relief and prevention of constipation, prevent straining

34
Q

Docusate (colace) route

A

PO or suppository

35
Q

Docusate (colace) AE

A

well tolerated, low risk for dehydration and electrolyte imbalance

36
Q

Docusate (colace) nursing considerations

A

first-line pharmacologic therapy for prevention of constipation

37
Q

bisacodyl (dulcolax) class

A

bowel chemical stimulant

38
Q

bisacodyl (dulcolax) MoA

A

chemical irritant that directly stimulates GI tract motility

39
Q

bisacodyl (dulcolax) indications

A

constipation, evacuate the bowel for diagnostic procedures

40
Q

bisacodyl (dulcolax) route

A

PO or suppository

41
Q

bisacodyl (dulcolax) AE

A

see nursing role

42
Q

bisacodyl (dulcolax) nursing considerations

A

admin PO with water (interact milk, juice, antacids)

43
Q

polyethylene glycol (Miralax) class

A

bulk stimulants; hyperosmotic laxative

44
Q

polyethylene glycol (Miralax) MoA

A

increase water absorption into the colon and GI tract (water follows polyethylene glycol; which stays in the colon and GI tract)

45
Q

polyethylene glycol (Miralax) indications

A

constipation, evaluate bowel for diagnostic procedure (high dose)

46
Q

polyethylene glycol (Miralax) AE

A

see nursing role

47
Q

polyethylene glycol (Miralax) nursing considerations

A

mix with 4-8 oz of water; acute care fall risk

48
Q

antidiarrheal contraindications

A

diarrhea caused by poisoning or by bacterial toxins
acute abdominal disorders including GI obstructions

49
Q

antidiarrheal assessment

A

baseline H&P including allergies and medications
I&Os and elimination patterns, electrolytes, hydration, bowel sounds and abdomen
TE: decrease number of bowel movements

50
Q

antidiarrheal teaching

A

teach to take medications exactly as prescribes
notify HCP if symptoms persist after 2 days and or s/s dehydration
do not use for infectious diarrhea
keep hydrated 3L/day

51
Q

loperamide (imodium) class

A

antidiarrheals

52
Q

loperamide (imodium) MoA

A

slow the motility of GI tract through direct action on lining of GI tract

53
Q

loperamide (imodium) indications

A

non-infectious diarrhea

54
Q

loperamide (imodium) AE

A

constipation, abdominal distension, abdominal discomfort, nausea, dry mouth

55
Q

loperamide (imodium) nursing considerations

A

admin drug after each loose stool; not to exceed recommended daily maximum dose.

56
Q

antiemetic agent assessment

A

baseline H&P including allergies and medications
focus: GI, I&O, neuro/LOC
document emesis: output amount, color, frequency
s/s dehydration, electrolyte imbalance from vomiting
fall risk
drug-drug CNS depressants

57
Q

antiemetic agent implementation

A

give PRN medication as appropriate
consider appropriate route, use least invasive
verify route-wrong route can be dangerous
Preventative therapy: admin 30-60 prior to chemotherapy dose or end of surgery

58
Q

how patient situation affects antiemetic routes

A

oral preferred, but if vomiting, select alternate route (contact provider)
suppository often used in hospice care

59
Q

antiemetic teaching

A

timing of administration
no heavy machinery

60
Q

antiemetic evaluation

A

TE: absence of nausea and vomiting- document response
AE: drowsiness, dizziness, cardiovascular
lifespan older adults: poly-pharmacy, anticholinergic effects, CNS effects- falls

61
Q

ondansetron (zofran) class

A

serotonin blockers

62
Q

ondansetron (zofran) MoA

A

blocks serotonin peripherally, centrally and small intestine; blocks chemoreceptor trigger zone

63
Q

ondansetron (zofran) indications

A

n/v (post op, chemotherapy, illness)

64
Q

ondansetron (zofran) caution

A

cardiac arrhythmias, CNS depression

65
Q

ondansetron (zofran) AE

A

drowsiness, dizziness, headache, diarrhea, prolonged QTc/dysrhythmias

66
Q

ondansetron (zofran) nursing considerations

A

see general nursing

67
Q

acute acetaminophen overdose

A

leads to acute liver failure: nausea, vomiting, jaundice, malaise, confusion

68
Q

acute acetaminophen overdose treatment

A

acetylcysteine- use within 24 hours of toxicity

69
Q

hepatic encephalopathy

A

liver cirrhosis, increased ammonia levels

70
Q

hepatic encephalopathy treatment

A

lactulose- excretes ammonia in stool
loose stools are expected TE

71
Q

lactulose (enulose) class

A

hyperosmotic laxative

72
Q

lactulose (enulose) MoA

A

pulls fluid out of venous system and into lumen of small intestine; inhibits diffusion of ammonia back to blood, excreting more ammonia in stool

73
Q

lactulose (enulose) indications

A

hepatic encephalopathy, constipation

74
Q

lactulose (enulose) route

A

oral or enema

75
Q

lactulose (enulose) AE

A

n/v/d; electrolyte imbalance

76
Q

lactulose (enulose) nursing

A

titrate as directed (# of loose stools) or scheduled dose; monitor ammonia levels I&O, electrolytes, mental status, skin rectal area; use caution w/additional laxatives; teach: bad taste; compliance.

Pharmacology (6 decks)

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