GI/GU Meds Flashcards
Why do peptic ulcers need to avoid NSAIDs?
Because they might irritate stomach lining causing worse GI problems
What do histamine h2 blockers do?
Decrease stomach acid production
Histamine h2 blockers adverse reactions
Gynecomastia
Agranulocytosis
Aplastic anemia
Histamine h2 blockers ex?
Cimetidine (Tagamet)
Cimetidine (Tagamet) class?
Histamine h2 blockers
What to avoid when giving histamine h2 blockers?
Avoid antacids within 1 hr
Avoid smoking, alcohol, and NSAIDs, anything that might increase GI irritation
Proton pump inhibitors (PPIs) ex?
Omeprazole (Prylesect)
Pantoprazole (Protonics)
Lansoprazole (Prevesed)
Esomeprazole (Nexium)
What does PPIs do?
Decrease acid in stomach so ulcers can heal
Omeprazole (Prylesect) class?
PPIs
Pantoprazole (Protonics) class?
PPIs
Lansoprazole (Prevesed) class?
PPIs
Esomeprazole (Nexium) class?
PPIs
What’s the effect of PPIs on vitamin B12?
Stomach acid helps absorb B12
PPIs reduce stomach acid
So less stomach acid = less B12
What electrolyte do you need to monitor when pt is on PPIs?
Magnesium
Prolonged use of PPIs can lead to?
Bone loss b/c less intestinal absorbed Calcium!
Risk for fractures
When in the day should pt take PPIs?
Before breakfast
What can pt do to prevent bone loss while taking PPIs?
Weight bearing exercise
What do mucosal protectants do?
Coat your stomach, creat a barrier
Mucosal protectant ex?
Sucralfate (Carafate)
Sucralfate (Carafate) class?
Mucosal protectant
Should nucosal protectants be taken with or without food?
Without
When should you give mucosal protectants?
1 hr before meal and at bedtime
Can mucosal protectants and antacids be taken together?
No
How long should you wait to give antacids after giving mucosal protectants?
30 min
How long should you wait before giving warfarin, theophylline, phenytoin, digoxin, tetracycline, and diazepam after giving mucosal protectants?
2 hr
Antacids ex?
Aluminum hydroxide
What do antacids do?
Neutralize gastric acid
How should you give antacids?
Empty stomach, 1 hr before meals and at bedtime
What adverse reactions can antacids cause?
Constipation and diarrhea
Can antacids be given with any other drugs?
No b/c gastric acid needs time to be neutralized
What does serotonin antagonists do?
Block serotonin receptors
Treat nausea and vomiting
Serotonin antagonist ex?
Ondansetron (Zofran)
Ondansetron (Zofran) class?
Serotonin antagonist, antiemetics
What drug does ondansetron have to avoid?
Apomorphine b/c they may cause severe hypotension when used together
What to always do before throwing meds at pt?
Collect data, assess
Ondansetron adverse reactions?
Serotonin syndrome
Headache
Dizziness
Constipation
Diarrhea
What do antihistamines/anticholinergics help with?
Vertigo/dizziness
How does antihistamine/anticholinergic help with vertigo?
By blocking the release of histamine h1 receptors in the inner ear
Adverse reactions of antihistamine/anticholinergic
Can’t see/pee/spit/shit
Sedation
What happens if using MAOIs with antihistamine/anticholinergic?
Increase anticholinergic effects
Antihistamine/anticholinergic ex?
Dimenhydrinate (Dramamine)
Dimenhydrinate (Dramamine) class?
Antihistamine/anticholinergic
Dopamine antagonist action?
Increase GI motility
Adverse reaction of dopamine antagonists
Sedation, diarrhea, restlessness
What should you educate pt on dopamine antagonists?
Change position slowly
Increase fluid intake
Do not drive or operate machines
Dopamine antagonist ex?
Metoclopramide (Reglan)
Metoclopramide (Reglan) class
Dopamine antagonist
What is bulk-forming agents used for?
Nondigestible, absorb water to form a mass
The mass stimulates peristalsis, form stool in 1-3 days
How long does it take for bulk-forming agents to see affect?
1-3 days
How should pt take bulk-forming agents?
1-3 times/day, take with 8+ oz of water or juice
Buil-forming agents ex?
Psyllium/Metamucil
Psyllium/Metamucil class?
Bulk-forming agents
what is another name for stool softeners?
Surfactant laxatives
Surfactant laxatives ex?
Docusate sodium (Colace)
Docusate sodium (Colace) class
Surfactant laxatives
Surfactant laxatives action?
Change the surface tension of stool to increase water absorption and soften stool
How should pt take surfactant laxatives?
With 8 oz of water
Pt education for surfactant laxasives
Stop med when diarrhea happens
2-3 L of fluid per day
High fiber foods
Can any laxatives be taken everyday?
No!
Stimulant laxatives ex?
Bisacodyl (Senna), castor oil
Bisacodyl (Senna) class?
Stimulant laxatives
Stimulant laxatives action?
Stimulate intestinal motility
What pt use stimulant laxatives?
When experiencing constipation due to opioid use
When evacuating colon prior to surgery
Can stimulant laxatives be used repeatedly?
No
Aminosalicylates uses?
Inflammation in GI tract
Aminosalicylates ex?
Sulfasalazine
Sulfasalazine class?
Aminosalicylates
Contraindications of sulfasalazine?
Digoxin, chamomile
Antidiarrheals ex?
Diphenoxylate (Lomotil)
Loperamide (Immodium)
Loperamide (Immodium) class
Antidiarrheals
Diphenoxylate (Lomotil) class
Antidiarrheals
Antidiarrheals action?
Decrease flow of fluids and electrolytes into bowel
Can antidiarrheal be used for acute diarrhea?
No, only for chronic
Antiflatulents ex?
Smithicone (Gas-X)
Smithicone (Gas-X) class
Antiflatulents
Antiflatulents action?
Decrease surface tension of GI gas bubbles to eliminate them
Pt education for antiflatulents
Avoid foods that make you fart (cabbage, onion, beans)
Use a straw for drinking
Cut down on carbs
If pt is on female hormone replacement therapy, what should you educate them on?
Monitor for vaginal bleeding
Have a yearly pelvic exam
Is estrogen used by itself?
No it’s used with progestin to reduce the risk of endometrial cancer
Estrogen’s affect on warfarin?
It decreases the effects of warfarin
Estrogen’s affect on tricyclic antidepressants?
It increases the effects of them
LH and FSH stimulant ex?
Clomid
Clomid class
LH and FSH stimulant
Clomid action
Stimulates the ovary to produce mature follicles
Pt education on clomid
Take with food
Expect hot flashes
Report pelvic pain
Can take OTC anti-inflammatory drugs PRN
Benign prostatic hypertrophy drug ex?
Finasteride (Proscar)
Finasteride (Proscar) class?
BPH drug
BPH drugs action?
Shrink prostate size
Is BPH med PRN or rountine?
Routine!
Pt education on BPH meds
Will take several months before symptoms (ex: painful urination) will get better
Do not stop taking even if symptoms got better b/c will reoccur
Erectile dysfunction med ex?
Sildenafil (Viagra)
Tadalafil (Cialis)
Tadalafil (Cialis) class
Erectile dysfunction
Sildenafil (Viagra) class
Erectile dysfunction meds
Erectile dysfunction meds action
Dilate vessels, increase blood flow to penis
Erectile dysfunction meds contraindications
Nitrates for chest pain b/c both can cause hypotension
What do you need before treating UTI?
Culture and sensitivity
Can kind of juice can pt with UTIs take?
Cranberry, prevent bacteria from sticking to bladder walls
Urinary analgesics ex
Phenazopyridine (Pyridium)
Phenazopyridine (Pyridium) class?
Urinary analgesics
How long can pt take phenazopyridine (Pyridium) for?
No longer than 2 days, if symptoms continue, cannot take another round!
An expected finding of phenazopyridine (Pyridium)
Brown-orange color urine