GI Medications Flashcards
Aggressive Gastritis factors
H. Pylori NSAIDS Acid Pepsin Smoking
Defensive Factors
Mucus
Bicarbonate
Blood flow
Prostaglandins
Antacids MOA
MOA: reacts with gastric acid to produce neutral salts
By neutralizing acid, antacids decrease destruction of the gut wall
Reduce pepsin activity, enhances mucosal protection by stimulating production of prostaglandins
Antacids ( medication )
Calcium carbonate ( tums) Sodium bicarbonate (alka-seltzer) Aluminum hydroxide Magnesium hydroxide ( milk of magnesia) - diarrhea Magnesium oxide ( mag-Ox)- constipation
Combo : maalox, mylanta,
Antacid ( admin and precaution, contra, preg)
Pt should take 1-2 hours after a meal or when symptom occur
Take 1 hour before or 2 hours after medication
Preacaution: kidney stones, geriatrics, renal impairment
Contraindications: hypercalcemia or hypophosohatemia
Preg: generally safe
Antacids ( adverse)
Sodium loading
Acid rebound
Milk-alkali syndrome - high blood calcium and metabolic alkalosis
Antacids with aluminum and calcium = constipation
Antacids with mag = diarrhea
Bulk Laxatives
Anti diarrhea
MOA: increases bulk and moisture content of stool, stimulates peristalsis
Adverse: bloating, cramping, flatulênce
Precaution : poor fluid intake
Safe in preg
Lomotil
Anti-diarrhea
MOA: slow GI motility and propulsion, allow fluid to be absorbed, decreasing fecal volume
Precautions: toxic megacolon
Scheduled V controlled substance
Low potential for physical dependence and abuse
Imodium
Anti-diarrhea
Best drug
MOA: slow GI motility and propulsion, allow fluid to be absorbed , decreasing fecal volume
Adverse : drowsiness dizziness, headache
Precaution: fluid rentention, and toxic megacolon
Bismuth Subsalicylate
MOA: anti-secretory antimicrobial
Adverse: darkening of stool and tongue
Precaution : caution in pt taking anticoagulation medication
Contra: 3rd trimester preg, allergy ASA, severe GI bleeding
Antidopaminergics
Compazine, Phenergan, Reglan
MOA: block D2 receptors in CTZ and other areas of brain
Adverse: extrapyramidal reactions ( tar dive dyskinesia)
Contraindications : Reye’s syndrome ( do not give in kids)
Preg: not reccomended
Reglan ( metoclopramide)
MOA: blocks D2 receptors, stimulates upper GI tract, increases peristalsis of Duodum and jejunem
Lowers sz control
Adverse: tardive dyskinesia
PrecautionL geriatrics increased risk for confusion
Contraindication : GI obstruction
Anticholinergics
Meclizine ( vertigo)
Dramamine ( motion sickness)
Scopolamine
MOA: reduce sensitivity of vestibular apparatus
Lots of side effects
NK1 Receptor Antagonist
Given ahead of chemo to prevent N/V. Will not treat N/V
Decreases effectiveness of oral contraceptives
5HT3 receptor antagonists
Zofran, Anzemet, Kytril, Aloxi
MOA: work peripherally intestinal wall by blocking 5HT3, work centrally in CTZ by blocking 5HT3 receptors
Zofran okay for < 4
Can give in pregnancy
Acute vomiting treatment
N = PO antiemetic
N/V : PR for short term period then switch to oral once vomiting is under control
Anticipated Vomiting treatment
Premedication, antidopinergics : start low and increase PRN for symptom control
Anticholinergics for motion sickness and vertigo
NK1 and 5HT3 for Chemo emesis
Stool softeners
MOA: lowers surface tension, permits easier defecation
Adverse: intestinal obstruction, diarrhea
Colas
Osmotic Laxatives
MOA: cause water the tissue into the bowel, increases peristalsis
Miralax
Amitiza
For opiod induced constiption and IBS in women
Not approved for children
Stimulants
MOA: directly stimulates sensory nerves in intestinal mucosa
Bulcolax, senna
Precaution: fluid and electrolyte abnormalities
Saline laxatives
Mag citrate
MOA: attract and retain water in bowel, índice contractions
Precautions: edema and HTN
Do not give to infants
Constipation short term management
Start with bulk laxative or saline agent
Stimulants are third line
Long term constipation management
- Bulk laxative and saline agent
- Opioid prophylaxis
- Add another stool softener
Do not take stimulants or saline laxatives long term
