GI Meds

Question 1

Primaxin

Answer 1

Antibiotic - miscellaneous penicillin

Assess penicillin allergy

Watch: allergic reactions (rash, urticaria, pruritus, chills, wheezing, laryngeal edema, fever, joint pain; angioedema) -> epiNEPHrine, resuscitation equipment should be available for anaphylactic reaction

Monitor: seizure, severe diarrhea (w/ blood or pus - pseudomembranous colitis), bleeding, bruising, joint pain, vaginal itching furry tongue

Question 2

Cytotec

Answer 2

Antiulcer - Prevention of NSAID-induced gastric ulcers

NO: pregnancy, Aspirin, extreme temp. food, caffeine, alcohol, spices

Watch: hematemesis, occult or frank blood in stools, severe abdominal pain, cramping, severe diarrhea, menstrual disorders

Question 3

Vasopressin (Pitressin)

Answer 3

Pituitary hormone - Promotes reabsorption of water by action on renal tubular epithelium (decreases urine output in DM); causes vasoconstriction on muscles in the GI system

NO: chronic nephritis, Pregnancy, breastfeeding, CAD, asthma, renal/vascular disease, migraines, seizures

Monitor: Monitor pulse, B/P, ECG

SE: nausea, congestion, cramps, headache, water intoxication in DM (lethargy, behavioral changes, disorientation, neuromuscular excitability)

Question 4

Nitroglycerin

Answer 4

Coronary vasodilator, antianginal - decreases preload & afterload -> increases systemic BP + tissue perfusion

NO: alcohol, severe anemia, increased ICP, cerebral hemorrhage, closed-angle glaucoma, cardiac tamponade, cardiomyopathy, constrictive pericarditis

Monitor: orthostatic B/P, pulse, pain, drug tolerance

SE: Headache, flushing, dizziness, Postural hypotension, tachycardia, collapse, syncope, palpitations

Question 5

Lasix

Answer 5

Loop diuretic - Decreased edema in lung tissue, peripherally; decreased B/P

NO: Anuria, hypovolemia

Watch: hearing loss, F&E, hypokalemia (tachycardia, weak pulse; muscle weakness, altered LOC, drowsiness, apathy, lethargy, confusion, anorexia, nausea, cramps), hyponatremia (increased B/P, cold, clammy skin), hypovolemia (anorexia, nausea, vomiting, diarrhea, abdominal cramps; lethargy, increased ICP, confusion, headache, seizures, coma, fatigue, tremors, hyperreflexia), hyperchloremia (weakness, lethargy, coma; deep rapid breathing)

Serious rash: Monitor for skin rash often, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme may occur and is life-threatening

Question 6

Morphine sulfate

Answer 6

Opioid analgesic - Moderate to severe pain

NO: addiction (opioid/alcohol), pregnancy, hemorrhage, bronchial asthma, increased ICP, paralytic ileus, hypovolemic shock, MAOI therapy

Monitor CNS changes: dizziness, drowsiness, hallucinations, euphoria, LOC, pupil reactions. Allergic reactions: rash, urticaria

**Assess respiratory depression, character, rate, rhythm; notify prescriber if respirations are <12/min

Question 7

Zantac

Answer 7

H2 histamine receptor antagonist (H2 blocker) - Healing of duodenal ulcers or gastric ulcers, gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, or heartburn

NO: alcohol, smoking,

Watch: coffee-grounds emesis, black tarry stools, abdominal pain, cramping, sore throat, rash, dizziness, confusion, or delirium report to prescriber immediately

Teach: Gynecomastia (breast enlargement in men) is reversible, take med at bedtime

Question 8

Reglan

Answer 8

Cholinergic, antiemetic - Prevention of nausea, vomiting induced by chemotherapy, radiation; delayed gastric emptying, gastroesophageal reflux

Watch: Sedation, fatigue, restlessness, headache, sleeplessness, dystonia, dizziness, drowsiness, suicidal ideation, seizures, EPS, neuroleptic malignant syndrome; tardive dyskinesia (hyperthermia, change in B/P, pulse, tachycardia, sweating, rigidity, altered consciousness)

Question 9

Iron sulfate (Ferrous Sulfate)

Answer 9

Hematinic - Prevention and correction of iron deficiency

NO: Sideroblastic anemia, thalassemia, hemosiderosis/hemochromatosis

**avoid use with blood transfusions (iron overload may occur), dairy products, calcium supplements, vit C

Watch: toxicity: nausea, vomiting, diarrhea (green, then tarry stools) hematemesis, pallor, cyanosis, shock, coma

Question 10

Pro-Banthine

Answer 10

Peptic ulcer, Zollinger-Ellison Syndrome

NO: paralytic ileus, intestinal atony of elderly/debilitated pt, obstructive uropathy, toxic megacolon, GI obstruction

SE: Constipation, Dry mouth, Dry skin, Decreased sweating, Blurred vision, Sedation, Tachycardia, Dysphagia, Urinary retention

Question 11

Pepto Bismol (bismuth subsalicylate)

Answer 11

Antidiarrheal/weak antacid - for travelers’ diarrhea

NO: pregnancy, breastfeeding, children

**Anticoagulants (oral): increased effect of anticoagulants
Quinolones: decreased absorption of quinolones
Salicylates: increased risk of salicylate toxicity

Watch: dehydration, F&E, Hearing loss, tinnitus, metallic taste, blue gums, black tongue (chew tabs)

Question 12

GoLYTELY

Answer 12

Laxative solution - clean the bowel before colonoscopy, a barium x-ray, or other intestinal procedures.

NO: perforated bowel, a bowel obstruction, severe constipation, colitis, toxic megacolon

**Avoid eating + taking other medications, vitamins, or mineral supplements within 1 hour before drinking GoLYTELY

Watch: severe stomach pain or bloating; nausea, vomiting, headache, trouble drinking liquids, little or no urinating; or fever, severe diarrhea, rectal bleeding or bright red bowel movements.

Question 13

Carafate

Answer 13

Antiulcer - Duodenal ulcer, oral mucositis, stomatitis after radiation of head and neck

SE: Dry mouth, constipation, bezoar (stones - critically ill patients)

Teach: take on empty stomach, report bloody stool, avoid antacids, milk alkalotics, water within 2 hr of the product

Question 14

Aldactone

Answer 14

​Potassium-sparing diuretic

NO: Pregnancy, breastfeeding, hypersensitivity, anuria, severe renal disease, hyperkalemia

Watch: F&E (Hypokalemia: assess for polyuria, polydipsia, dysrhythmias. • Hyperkalemia: weakness, fatigue, dyspnea, dysrhythmias, confusion)
cramps, diarrhea, lethargy, thirst, headache, skin rash, menstrual abnormalities, deepening voice, breast enlargement

Teach: take in AM (avoid nocturia), take with food or milk, avoid foods high in potassium should be avoided: oranges, bananas, salt substitutes, dried apricots, dates

Question 15

Prevacid

Answer 15

Proton-pump inhibitor - Suppresses gastric secretion -> Reduction in gastric pain, swelling, fullness

NO: breastfeeding

Watch: Pseudomembranous colitis (bowel sounds q8hr, abdomen for pain, swelling, anorexia, blood in stool, cramping, fever)

**avoid alcohol, salicylates, ibuprofen

Question 16

Pepcid

Answer 16

​H2-histamine receptor antagonist, antiulcer agent

SE: Headache, dizziness, paresthesia, depression, anxiety, somnolence, insomnia, fever, Thrombocytopenia, aplastic anemia

***Renal impaired: seizures, Dysrhythmias, QT prolongation

NO: driving, aspirin, alcohol, smoking, extreme temp. food, caffeine, alcohol, spices,

Report diarrhea, black tarry stools, sore throat, rash, dizziness, confusion, or delirium

Question 17

Creon

Answer 17

Digestant - Pancreatic enzyme -> Increases protein, fat, carbohydrate digestion

**Assess Allergy to pork. Allergic reactions: abdominal pain, cramping, or hematuria

SE: Hyperglycemia, hypoglycemia, Anorexia, nausea, vomiting, diarrhea, cramping, bloating. Hyperuricuria, hyperuricemia

Watch: steatorrhea (signifies undigested fat content)

Teach: take with food, not to crush, chew product

Question 18

Aciphex

Answer 18

PPI - Suppresses gastric secretion -> Reduction in gastric pain, swelling, fullness

Watch: C.difff colitis (CDAD), low magnesium level (tremors, muscle soreness, spasms, anxiety, change in heart rate, palpitations), Headache, dizziness, anorexia, abd pain, N&V

Report severe diarrhea, pregnancy, black, tarry stools,
NO alcohol, salicylates, NSAIDs
Use sunscreen, protective clothing to prevent burns

Question 19

Amphojel

Answer 19

Antacid - Decreased acidity, healing of ulcers, decreased phosphate levels in chronic renal failure

NO allergic to aluminum

Watch: Constipation, anorexia, obstruction, fecal impaction, Hypophosphatemia (anorexia, weakness, fatigue, bone pain, hyperreflexia), hypercalciuria, hypomagnesemia, aluminum toxicity

Avoid phosphate-containing foods (most dairy products, eggs, fruits, carbonated beverages)

Report black tarry stool (normal: white, speckled)

Question 20

Ursodiol

Answer 20

Gallstone dissolution agents - treat biliary cirrhosis production of cholesterol and by dissolving the cholesterol in bile to prevent stone formation

NO eso. varices pt, pregnancy, bile duct blockage

SE: diarrhea, constipation, indigestion, N&V, dizziness

Report: frequent urination or pain when urinating

Question 21

Flagyl

Answer 21

Antibiotic

NO Pregnancy (1st trimester), breastfeeding

Watch: allergic reactions (rash, urticaria - hives, pruritus), overgrowth of infection (perineal itching, fever, malaise, redness, pain, swelling, drainage, rash, diarrhea, change in cough, sputum), severe diarrhea

Teach trichomoniasis patient that both partners need to be treated, dry mouth (use sips of water, sugarless gum, candy, normal: metallic taste, dark urine

Question 22

Eliquis

Answer 22

Anticoagulant

NO aspirin, NSAID, warfarin, heparin, SSRIs, SNRIs

Watch: coffee ground vomits, severe bleeding, pink/red/brown urine, black tarry stool, Unexpected pain, swelling, or joint pain, Tingling, Numbness, Muscle weakness

Question 23

Lactulose

Answer 23

Laxative - Decreased constipation, decreased blood ammonia level

SE: Nausea, vomiting, anorexia, cramping, rectal bleeding, Hepatic encephalopathy, electrolyte imbalances (muscle cramps, pain, weakness, dizziness, excessive thirst)

Question 24

Xifaxan

Answer 24

Antibiotic - treat E. coli

NO allergic to rifamycins, diarrhea with fever, blood in stool, pregnancy (1st trimester)

Report: diarrhea persists for more than 24-48 hr

Take full course of med, without regard to food.