GI Medication: Class & Types Inflo Flashcards
What are the 6 types of acid controlling agents?
- Antacids
- H2 Receptor blockers
- Proton Pump Inhibitors
- Mucous barrier
- Prostaglandin like substances
- Prokinetic agents
What is the function of antacids?
- Antacids help to treat heartburn/indigestion/acid reflux/GERD
- They work by neutralizing the stomach acid that causes heartburn
Patients with renal failure should avoid what kind of antacids?
• Magnesium based
Patients w/ heart failure or HTN should be advised to avoid what kind of antacids?
• Sodium based
How long before other oral medications should you take antacids?
• 2hrs
When taking an antacid, what is the guidance for food?
• Take with food or w/in 1hr (or <3hrs)
When taking an antacid, what is the guidance regarding before sleep?
• Take w/in 1hr of bedtime (or <3hrs)
What is better, a liquid or solid antacid and why?
• Liquid, as it absorbs faster
When taking antacids, it will decrease the absorption rate of what drugs?
- Digoxin
- Tetracycline
- Aspirin
- Iron
- Inderol
How do H2 Receptor (H2) Blockers work?
• They bind to histamine type 2 receptors on the basolateral (antiluminal) surface of gastric parietal cells, interfering with pathways of gastric acid production and secretion.
When should H2 blockers and other meds be taken in relation to antacids?
• Take 1hr before or after antacids
Should H2 blockers be taken before or after meals?
• Before
True or False
The HCP should be notified of significant diarrhea when taking H2 receptors.
• True
True or False
It is permitted to crush, break or chew H2 receptors
• False
When taking H2 receptors, what should be avoided as to not cause gastric discomfort?
- Smoking
- Alcohol
- Spicy/acidic foods
When should a once-a-day dose of H2 blockers be taken and why?
- At bedtime
- It is likely to enhance nocturnal gastric pH control and decrease nocturnal gastric acid breakthrough.
What side effects may be experienced with the use of H2 blockers?
- HA/Dizziness
- N/V, abdominal discomfort
- Constipation
What is the function of Proton Pump Inhibitors?
• Deactivates the enzyme system that pumps H+ ions from the parietal cells, thus inhibiting gastric acid secretion
Should PPIs be taken before, with or after meals?
• Before
True or False
It is ok to chew, divide or crush PPI’s
• False
True or False
PPI’s may be administered with antacids
• True
If ordered twice a day, when should PPIs be given?
• Before breakfast and at bedtime
How do PPIs interact with digoxin?
- PPIs can increase blood levels by changing gastric pH resulting in increased absorption of digoxin
- This can potentially lead to digoxin toxicity which can trigger fatal arrhythmias
How do PPIs interact with iron?
- Supresses iron absorption through the inhibition of duodenal ferroportin (transport protein that allows for cellular passage in/out of the cell
- Puts pt @ risk for iron deficiency
How do PPIs interact with Warfarin?
- Increase the effect of warfarin
- Will require careful monitoring of international normalized ratio (INR) when initiating PPI among warfarin users
What are the side effects of PPIs?
- HA, Dizziness
- N/V/D/C
Prokinetic agents are known as GI _____.
• Stimulants
What is the function of Prokinetic agents?
• Rather than neutralizing acid, prokinetic agents increase both gastric emptying and lower esophageal sphincter pressure
When should prokinetic agents be administered?
• 30 mins before meals and bedtime
What is the function of Anticholinergics (antispasmatics)?
• Inhibits secretion of gastric acid in large doses.
We do NOT give anticholinergics to patients with…
- Paralytic ileus
- Hiatal hernia
- GERD
How do laxatives work?
• Laxatives ease the passage of softened, fully formed fecal matter from the rectum
How does mineral oil help with bowel movements?
- Mineral oil is used to treat constipation.
- It is a lubricant laxative and works by keeping water in the stool and intestines.
