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Pharmacology FINAL EXAM > GI Medications > Flashcards

GI Medications Flashcards

1
Q

Antacids

A
  1. Work by neutralizing stomach acid & increasing gastric pH
  2. Given between meals and before bedtime
  3. Reducing acidity can promote healing of ulcers, reduce ulcers, or treat hyperacidity
  4. Does nothing to reduce the underlying cause of hyperacidity
  5. Contain Calcium, aluminum, and magnesium
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2
Q

Antacids

-Interactions

A

Changes the pH of the stomach and can effect the absorption of medications

  1. Decreases effectiveness of anti-infectives, and H2 blockers
  2. Increases effectiveness of diazepam, enteric coated drugs
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3
Q

Antacids and Anti-infectives

A
  1. Antaids decrease effectiveness of anti-infectives, and H2 blockers
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4
Q

Antacids and Diazepam

A

Antacids increase effectiveness of diazepam & enteric coated drugs

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5
Q

Antacids

-Pt teaching

A
  1. Don’t take w/in 2 hrs of other meds

2. Watch for electrolyte changes

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6
Q

H2 Blockers

A
  1. Used to treat ulcers and gastroesophageal reflux
  2. Works by blocking H2 (histamine) in the parietal cells
  3. SHORT term fix for hyperacidity
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7
Q

H2 Blockers

-Examples

A
  1. Cimetidine
  2. Famotidine**
  3. Ranitidine
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8
Q

H2 Blockers

-Adverse Effects

A
  1. Diarrhea
  2. Dizziness
  3. Mental confusion
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9
Q

Proton Pump Inhibitors

-Action

A
  1. Gastric anti secretory agent, works by inhibiting the proton pumps, not allowing the secreting of HCL most likely irreversible
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10
Q

Proton Pump Inhibitors

-Used For

A
  1. Used for ulcers
  2. GERD
  3. Hypersecretory conditions
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11
Q

Proton Pump Inhibitors

-Examples

A
  1. Lansoprazole (Prevacid)

2. Pantoprazole (Protonix)

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12
Q

Proton Pump Inhibitors

-Adverse effects

A
  1. Abdominal upset
  2. Headache
  3. Dizziness
  4. Well TOlerated
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13
Q

Proton Pump Inhibitors

-Drug Interactions

A
  1. H2-blockers
  2. Warfarin (increases effectiveness)
  3. Antibiotics
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14
Q

Proton Pump Inhibitors

-Teaching points

A
  1. do NOT crush or chew sustained release tablets or capsules
  2. Long term, regular use can cause Vitamin B12 deficiency
    - leads to anemia
  3. Take on empty stomach - 30 minutes prior to meal
  4. Teach pt ways to reduce gastric acidity or irritation
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15
Q

Mucosal Protectant

-Action

A
  1. Works by reacting w/ the HCL and proteins to form a paste at the ulcer site
  2. Used in duodenal (and gastric) ulcers
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16
Q

Mucosal Protectant

-sucralfate (Carafate)

A
  1. Used for the treatment of duodenal ulcers
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17
Q

Mucosal Protectant

-Adverse Effects

A
  1. Constipation **
  2. GI upset and drowsiness

Also, 90% of the aluminum from carafate is not absorbed, but watch pt’s w/ renal disease when the remaining aluminum cannot be removed via kidneys

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18
Q

Mucosal Protectant

-Teaching and Nursing Implications

A
  1. Administer on an empty stomach, 1 hr before or 2 hrs after food or other meds
  2. Watch for renal failure pt’s
  3. Make sure you flush the NG or feeding tube before and after giving it, if giving through tubes
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19
Q

Prostaglandins

-Action

A
  1. Works by increasing prostaglandins, which decrease gastric acid, protecting the mucosa
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20
Q

Prostaglandins

-Example

A
  1. Misoprostol (Cytotec)
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21
Q

Prostaglandins

-Indication

A
  1. Given when Pt’s are chronically taking NSAIDs, will also produce cervical softening and uterine contractions
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22
Q

Prostaglandins

-Adverse Effects

A
  1. Commonly diarrhea and abd pain

2. Contraindicated w/ pregnancy

23
Q

Prostaglandins (Cytotec)

-Pt teaching

A
  1. Take w/ meals and bedtime

2. Discuss contraceptives w/ women on this medication

24
Q

Antiemetics & Emetics

-Examples

A
  1. Prokinetic Agent (Reglan)
  2. Phenothiazine
  3. Seotonin Antagonist
25
Q

Antiemetics

-Action

A
  1. Antiemetics treat N/V. Also can treat gastric motility disorders
    - (prokinetic such as metoclopramide (reglan)
26
Q

Antiemetics

-2 Groups

A
  1. Phenothiazine (Dopamine Blocker)
  2. Serotonin Blocker

Work to decrease activating the CTZ (vomiting center)

27
Q

Antiemetics (dopamine blockers)

  • Prochlorperazine (Compazine)
  • Promethazine (Phenergan)

Adverse Effects

A
  1. Drowsiness
  2. Hypotension
  3. Anticholinergic
  4. Extrapyramidal symptoms
28
Q

Antiemetics (dopamine blockers)

  • Prochlorperazine (Compazine)
  • Promethazine (Phenergan)

Implication and teaching

A
  1. Watch for adverse effects
    - hypotension, EPS, drowsiness
  2. ID and treat underlying cause of nausea
29
Q

Antiemetics (serotonin blockers)
-Ondansetron (Zofran)

Action

A
  1. Blocks Serotonin, reducing triggering the vomit center via CTZ
30
Q

Antiemetics (serotonin blockers)
-Ondansetron (Zofran)

Adverse Effects

A
  1. Generally well tolerated
  2. Headache
  3. Diarrhea
  4. Dizziness
31
Q

Antiemetics (serotonin blockers)
-Ondansetron (Zofran)

Pt teaching and implications

A
  1. Watch for liver damage (Increased AST, ALT)

2. Monitor I&O and BP

32
Q

Laxatives

-Different types

A
  1. Stimulant Laxative
  2. Bulk-forming Laxative
  3. Lubricant Laxative
  4. Hyperosmotic Laxative
  5. Stool softener
33
Q

Laxatives

-Different kinds

A
  1. The best laxative i snot a medication
    - Water, fiber, activity
  2. Next best is bulk
  3. Stimulant laxatives can become addicting
  4. Saline enemas are used infrequently and as last resort
  5. Hyperosmotic is used for quick acting laxative, when medical tests are ordered
34
Q

Best Laxative

A
  1. Water, fiber, and activity
35
Q

Saline enemas

A
  1. Used infrequently and as last resort
36
Q

Hypoosmotic laxatives

A
  1. Used for quick acting laxative when medical tests are ordered.
37
Q

Cytotec (misoprostol)
-Prostaglandins

Adverse Effects

A
  1. Abdominal pain
  2. Diarrhea
  3. Constipation
38
Q

Cytotec (misoprostol)
-Prostaglandins

Pregnancy

A
  1. Misoprostol will cause spontaneous abortion
  2. Women of childbearing age must be informed of this effect through verbal and written info and must use contraception throughout therapy
39
Q

Lifestyle changes for GERD and Ulcers?

A
  1. Avoid aspirin and similar pain meds
  2. avoid alcohol & Caffeine
  3. avoid tobacco
  4. avoid oily and spicy meals
  5. Avoid acidic fruits & sweets
40
Q

H1 Histamine receptor

-Location

A
  1. Found on smooth muscle, endothelium, and CNS
  2. Causes bronchoconstriction (lungs)
    - Primary receptors involved in allergic rhinitis
41
Q

H2 Histamine Receptors

-Location

A
  1. Located on Parietal cells and Vascular Smooth muscle cells
  2. Primarily involved in Vasodilation
  3. Also STIMULATE GASTRIC ACID SECRETION
42
Q

Bulk-forming laxatives

A
  1. Preferred drugs for the treatment and prevention of chronic constipation
  2. May be taken on a regular basis w/out ill effects
  3. Slow onset
    - not used when rapid and complete bowel evacuation is needed
43
Q

Stool Softeners

A
  1. Used to Prevent Constipation

- used especially in patient who have undergone recent surgery

44
Q

Stimulant Laxative

A
  1. Rapid acting
  2. Cause diarrhea and cramping
  3. Only use occasionally because they may cause laxative dependence and depletion of electrolytes
45
Q

Hyperosmotic Laxative

A
  1. Can produce a bowel movement very quickly

2. DO NOT use on a regular basis because of the possibility of fluid and electrolyte depletion

46
Q

Lubricant Laxative

A
  1. includes mineral oil, which lubricates stool and colon mucosa
  2. Mineral oil should be discouraged
    - it may interfere w/ the absorption of fat-soluble vitamins
  3. Serious adverse effects
47
Q

H2 Blockers vs. PPI’s

A
  1. PPI’s are the most effective
  2. PPI’s
    - inhibit proton pumps, not allowing the secreting of HCL most likely irreversible
  3. H2 blockers:
    - works by blocking H2 (histamine in the parietal cells)
48
Q

sucralfate (Carafate)

-Administration

A
  1. Administer on an empty stomach 1 hr before or 2 hours after food or other medications
  2. Flush the NG or feeding tube before and after giving it, if giving through these tubes
49
Q

Constipation

-Causes

A
  1. Inadequate water and fiber intake
  2. Inadequate activity
  3. Resisting urge to have bowel movement
  4. Overuse of laxatives
  5. Hypothyroidism
  6. Medications
50
Q

Constipation

-Treatment

A
  1. A high-fiber diet
  2. Adequate fluid intake
  3. Regular exercise
  4. Don’t ignore urge for BM’s
51
Q

Antacids

-w/ other medications

A
  1. Don’t take antacids w/in two hours of other medications
52
Q

Vitamin B12 and Intrinsic Factor

A
  1. Intrinsic factor is release by parietal cells (stomach surface)
  2. W/out intrinsic factor the body can only absorb 1% of ingested vitamin B12.
  3. Pernicious anemia can result from B-12 deficiency
53
Q

Vitamin B-12 Deficiency

-S/S

A
  1. Fatigue & weakness
  2. Rapid HR and breathing
  3. Pale skin & sore tongue
  4. Easy bruising or bleeding, including bleeding gums
  5. Nerve damage that affects cognitive and muscle function
54
Q

Extrapyramidal symptoms (EPS)

A
  1. Can be an adverse effect of Compazine
  2. EPS include:
    - Muscular rigidity, tremor, bradykinesia and difficulty walking
    - induced by neuroleptic meds; drug-induced parkinsonism

Pharmacology FINAL EXAM (9 decks)

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