GI elimination

Question 1

What is ondensatron?

Answer 1

5HT3 agonist or serotonin receptor agonist

Question 2

What is the MOA of ondensatron?

Answer 2

Blocks serotonin receptors to prevent vomiting

Question 3

What is ondensatron used for?

Answer 3

Acute moderate to severe vomiting due to chemo

First line choice for post op nausea and vomiting

Question 4

Who can ondensatron be used on?

Answer 4

Children older than 6 months
Older adults tolerate it well

Question 5

Adverse effects of ondensatron?

Answer 5

Dizziness, headache, prolonged QT, torsades de pointes

Question 6

Ondensatron assessment?

Answer 6

Headache, dizziness, diarrhea

Feeling better?

Question 7

Ondensatron teaching?

Answer 7

Don’t take with St. John’s wort
It’s a sedation med
Avoid alcohol when taking this

Question 8

What drug class is Bisacodyl?

Answer 8

Stimulant cathartic

Question 9

What is bisacodyl used for?

Answer 9

Constipation
Bowel prep
Neurogenic bowel

Question 10

Special population considerations for Bisacodyl?

Answer 10

Not for under 6 years old for occasional constipation

Can be used in under 6 years for treatment resistant constipation

Common bowel regiment in the ICU

Question 11

Adverse effects of Bisacodyl?

Answer 11

Abdominal pain/cramping
Nausea
Diarrhea
Weakness

Question 12

Contras for Bisacodyl?

Answer 12

Undiagnosed abdominal pain due to risk of obstruction

Question 13

Bisacodyl nursing considerations?

Answer 13

Don’t take within an hour of drinking milk
Take on empty stomach
Lowered calcium and potassium levels
Anticholinergic interaction=more constipation

Question 14

Bisacodyl assessment?

Answer 14

Bowel patterns

Question 15

Bisacodyl caution?

Answer 15

Older adults and children due to dehydration and electrolyte imbalances

Question 16

Psyllium drug class?

Answer 16

Bulk forming laxative

Question 17

Uses for psyllium?

Answer 17

Occasional constipation
Diarrhea
Lowers cholesterol with good diet

Question 18

Contras for psyllium?

Answer 18

Undiagnosed abdominal pain
Fecal impaction

Question 19

Psyllium nursing considerations?

Answer 19

Take 1 hr before or 2-4 hours after meals
Take with 8 oz of liquid to prevent obstruction

Question 20

Psyllium caution?

Answer 20

Diabetics
Hypertension
Renal disease
Phenylketonuria

Question 21

Diphenoxylate/atropine drug class?

Answer 21

Opiate related anti-diarrheal agent

Controlled substance

Question 22

What is the MOA of Diphenoxylate/atropine?

Answer 22

Slows peristalsis by acting on the stomach’s smooth muscles

Question 23

Diphenoxylate/atropine uses?

Answer 23

Moderate to severe diarrhea

Question 24

Adverse effects of Diphenoxylate/atropine?

Answer 24

Atropine related: anticholinergic effects

Opioid related: hypotension and respiratory depression

Question 25

Contras for Diphenoxylate/atropine?

Answer 25

Diarrhea due to a toxin or microorganism

Question 26

Diphenoxylate/atropine caution?

Answer 26

Children- higher risk of atropine overdose OA: causes constipation Critically ill: caution in hepatorenal disease

Question 27

Diphenoxylate/atropine assessment?

Answer 27

Fluid/electrolyte balance Urine output Skin turgor

Question 28

PUD symptoms?

Answer 28

Bloating Indigestion Heartbeat Nausea

Question 29

Causes of PUD?

Answer 29

H pylori NSAIDS

Question 30

Heartburn teaching?

Answer 30

Elevate HOB/sit upright for 1-2 hours after eating small meals Avoid chocolate, fats, citric juices, coffee, alcohol 4-8 weeks high dose treatment

Question 31

Cimetidine drug class?

Answer 31

H2 receptor agonist

Question 32

MOA of Cimetidine?

Answer 32

Lowers volume, pepsin, and acidity of gastric juices

Question 33

Cimetidine uses?

Answer 33

Prevention/treatment of PUD, GERD, Zollinger-Ellison syndrome

Question 34

Cimetidine caution?

Answer 34

Liver disease Mental confusion in renal impairment Older adults more likely to experience confusion, agitation, and disorientation

Question 35

Cimetidine contras?

Answer 35

Not for children under 12 Pregnant/lactating women Hepatic or renal failure

Question 36

Adverse effects of cimetidine?

Answer 36

Diarrhea Drowsiness Headache Confusion Gynecomastia

Question 37

Gastric and DD ulcer healing time on Cimetidine?

Answer 37

6 to 8 weeks

Question 38

Esophagitis healing time on cimetidine?

Answer 38

12 weeks

Question 39

Cimetidine assessment?

Answer 39

CNS Gynecomastia Abdominal pain/GI upset

Question 40

Cimetidine teaching?

Answer 40

Take at bedtime or with meal before bedtime Antacids decrease absorption Interacts with a lot of drugs

Question 41

Omeprazole drug class?

Answer 41

Proton pump inhibitor

Question 42

What is special about omeprazole?

Answer 42

It is the strongest inhibitor of gastric acid secretion

Question 43

Omeprazole uses?

Answer 43

Drug of choice with PUD GERD with erosive esophagitis Zollinger Ellison syndrome

Question 44

GERD healing time on omeprazole?

Answer 44

1-2 weeks

Question 45

Esophagitis healing time on omeprazole?

Answer 45

8 weeks

Question 46

Gastric and DD ulcers healing time omeprazole?

Answer 46

2 weeks

Question 47

How are H pylori ulcers treated?

Answer 47

PPI + 2 antimicrobial drugs

Question 48

Population considerations for omeprazole?

Answer 48

Popular for children Drug of choice for GERD in those over 60 Used in the ICU a lot to prevent stress ulcers (IV)

Question 49

Omeprazole adverse effects?

Answer 49

Long duration/higher doses= risk of bone fractures Nausea, diarrhea, headache

Question 50

Omeprazole nursing considerations?

Answer 50

Take PO before food swallow whole

Question 51

Cimetidine critically ill uses?

Answer 51

Prevention of stress related gastric ulcers in the ICU