GI drugs Flashcards
rotation 2 - week 1
The histamine receptors in the stomach secrete stomach acid when they are stimulated, which histamine antagonist is given to decrease amount of acid produced and increase the pH of the acid that is in there, to help treat things like ulcers, GERD and heartburn?
think cimet. cement is alkaline, and this drug is trying to make your stomach more alkaline to reduce discomfort
Cimetidine
what are the 3 side effects of cimetidine related to hormones + sexual function?
-impotence
-gynecomastia
-decreased libido
you should not give antacids within at least one hour of giving other GI medications because? which 2 drug classes do you especially need to wait?
it can decrease the absorption, therefore the effectiveness, of the medication that was given prior, especially histamine antagonists + mucosal protectants
What drug class does omePrazole fall into, that’s used to treat ulcers, GERD + erosive esophagitis by inhibiting ATPase, which is responsible for gastric acid secretion?
Proton Pump Inhibitors
Which electrolyte should you monitor if your patient is taking Omeprazole for longer than 3 months?
Magnesium + calcium - it reduces absorption - may need to supplement
how can you monitor for bone loss in your patient while they’re taking omeprazole, and how should they try to prevent it from happening?
bone density scans and by taking calcium/ vitamin D supplements and performing weight bearing exercises
Sucralfate is a mucosal protectant used to treat duodenal ulcers, how does it protect your stomach from gastric secretions?
this medication forms a gel in the stomach that coats the ulcers, to protect them from the gastric acid
constipation is a side effect of a lot of GI meds, what can you give and what should you teach the patient?
give laxatives PRN and have the patient increase fluid + fiber intake
true or false ? mucosal protectants decrease the absorption of other medications.
true
What are antacids used to treat?
PUD + GERD
What are 4 examples of antacids?
Sam Ate Mints + Caffeine, and has horrible acid reflux
-sodium bicarbonate
-aluminum hydroxide
-magnesium hydroxide
-calcium carbonate
Antacids work by neutralizing the ____ ____ in the stomach.
gastric acid
Which antacids cause diarrhea?
Magnesium Antacids - because they pull more water into the GI tract
which antacids cause constipation because they slow GI motility?
Aluminum and Calcium Antacids
PROSTaglandins are used to prevent gastric ulcers in patients who use NSAIDs long term, which drug is the protype for this drug class?
misoPROSTol
why should you make sure that your patient isn’t pregnant prior to administering Misoprostol?
this drug can cause:
-spontaneous abortion
-spotting
-uterine cramps
-dysmenorrhea
-painful menstruation
it can also be used to induce labor, soften the cervix + stimulate contractions
How do serotonin antagonists, like ondansetron, work to relieve N/V chemo/ radiation or post op?
blocks the serotonin receptors in the Chemo Trigger Zone in the brain, that innervate the stomach to minimize N/V
Metoclopramide is a nonphenothiazine drug used to treat N/V after chemo/radiation/opioids, GERD and diabetic gastroparesis by
-increasing the tone of the lower esophageal sphincter
-increases peristalsis and
-increases the threshold in the _______.
Chemoreceptor Trigger Zone
When a patient is taking metoclopramide, why should you monitor and report for restless, anxiety, spasms of the face and neck, lip smacking, writhing motions and other involuntary movements?
this could be signs that this drug has caused tardive dyskinesia
How do osmotic laxatives, like magnesium citrate, work to relieve constipation?
this drug brings water into the intestines which enlarges and softens the stool + increases peristalsis
Which medication is a (bulk forming) fiber supplement used to treat constipation, diarrhea, diverticulosis, IBS, and to help patients with ostomies with stool regulation?
psyllium
True or False?
Psyllium works by pulling water from the intestines to form a glutinous mass to add bulk to the stool to increase peristalsis.
true
Docusate is a stool softener used to treat constipation, impaction, reduce straining and help with painful stools. How does this soften the stools?
docusate decreases the absorption of water in the intestine and increases water absorption in the stool
Which 2 therapies can be used together to produce a softer stool and enhance intestinal motility?
**DOCta + nurse Senna are going to help you poop **
Docusate + Senna
Stimulant Laxatives are given by nurse Senna to treat opioid induced constipation or for colon prep for a procedure
How does senna work?
-stimulates motility by effecting the nerve endings in the Gi tract
-decreases absorption through the intestinal wall which increases secretion to move stool out
Why should you not give antacids together with a stimulant laxative?
because it can dissolve the enteric coating too early before it gets to the colon, where its supposed to be dissolved
Loperamide is an opioid used to treat diarrhea + reduce the volume with an ileostomy, Why would an opioid be used to treat diarrhea?
because opioids do the opposite and usually cause constipation because they decrease peristalsis - this allows for water absorption to increase + firm up stool
Alosetron decreases visceral pain, slows peristalsis, increases water absorption to treat diarrhea in which specific kind of patient?
only Alyssa can take ALosetron
female patients who have IBS-D
What does Pancrelipase help digest + absorb?
fats, proteins and carbs
Which drug protype is a digestive enzyme administered to replace the natural enzymes produced from the pancreas?
pancrealipase
Methylnaltrexone Bromide is used to treat constipation induced by?
the METH head came into the ER because he hasn’t pooped in 2 weeks from all the opioids
opioids
Prochlorperazine is specifically used to treat N/V associated with anesthesia + motion sickness by blocking what receptors in the CTZ in the brain?
dopamine receptors
Aprepitant directly blocks receptors in the CNS that are associated N/V caused by emetogenic chemotherapy. Why should you monitor for pregnancy and ask about breastfeeding with this medication? (besides the fact that they shouldn’t be pregnant or BF while getting chemo either)
because this drug can cross into the placenta and enter human milk
sucralfate is a GI protectant and you have to monitor blood sugar because it can cause __________.
hyperglycemia
