GI meds Flashcards
cimetidine (Tagamet) class
Histamine-2 Receptor Antagonists
cimetidine (Tagamet) EPA
decreases amount, acidity, and pepsin content of gastric juices by inhibiting histamine 2 receptors
cimetidine (Tagamet) therapeutic use
peptic ulcer disease
GERD
GI bleeding
Zollinger-Ellison syndrome
cimetidine (Tagamet) ADRs
impotence
gynecomastia
decreased libido
confusion
arrhythmias
agranulocytosis
aplastic anemia
cimetidine (Tagamet) contraindications and interactions
increases levels of warfarin, phenytoin, lidocaine, ketoconazole, and theophylline
avoid NSAIDs, Aspirin, alcohol or any other GI irritants
cimetidine (Tagamet) interventions and education
monitor for delirium
educate on what meds to avoid
slow IV administration to prevent bradycardia
avoid antacids within an hour of administration
omeprazole (Prilosec) class
Proton Pump Inhibitors
omeprazole (Prilosec) EPA
Inhibits hydrogen potassium ATPase in the stomach thereby inhibiting gastric acid production
omeprazole (Prilosec) therapeutic use
peptic ulcer disease
GERD
Zollinger- Ellison syndrome
prophylaxis for extubation
omeprazole (Prilosec) ADRs
osteoporosis
abdominal pain
nausea
vomiting
diarrhea
hypomagnesemia
omeprazole (Prilosec) contraindications and interactions
pregnancy and lactation
ketoconazole
increase levels of warfarin, phenytoin, diazepam
st johns wort decreases effectiveness
omeprazole (Prilosec) interventions and education
do not take longer than 8 weeks
osteoporosis due to decreases calcium absorption
supplement calcium, magnesium, vitamin D
monitor for rebound acid hypersecretion
lowest dose for shortest amount of time
report diarrhea due to cdiff risk
sucralfate (Carafate) class
mucosal protectant
sucralfate (Carafate) EPA
chemical reaction in the stomach creates gel that coats ulcers and creates barrier between stomach and gastric secretions
sucralfate (Carafate) therapeutic use
peptic ulcers
4-8 week treatment course
sucralfate (Carafate) administration
must be given on empty stomach, can be given QID
sucralfate (Carafate) ADRS
constipation and dry mouth
sucralfate (Carafate) interactions
decreased absorption of antibiotics
decreased absorption of digoxin, phenytoin, diazepam, and warfarin
sucralfate (Carafate) interventions
administer 2 hours before or after interactive drugs
increase fluid and fiber itake
report severe constipation or diarrhea
aluminum hydroxide (Amphojel) class
antacid
aluminum hydroxide (Amphojel) EPA
alkaline compounds neutralize gastric acid
aluminum hydroxide (Amphojel) therapeutic use
peptic ulcer disease
GERD
aluminum hydroxide (Amphojel) ADR
hypophosphaatemia
magnesium antacid ADR
diarrhea
calcium antacid ADR
constipation
aluminum hydroxide (Amphojel) interactions
decreases absorption of tetracyclines, digoxin, fluoroquinolones, aspirin
do not administer antacid within 2 hours of these meds
aluminum hydroxide (Amphojel) interventions and education
monitor bowel function
monitor phosphorus levels for aluminum based antacids
ondansetron (Zofran) class
5-HT3 serotonin receptor antagonist
ondansetron (Zofran) EPA
Block 5-HT3 serotonin receptors in chemoreceptor trigger zone of brain; minimizes nausea and vomiting
ondansetron (Zofran) therapeutic use
treat nausea and vomiting secondary to chemo or radiation therapy and postop recovery
ondansetron (Zofran) ADRs
torsades de point
SJS
headache
dizziness
ondansetron (Zofran) contraindications and interactions
prolonged QT syndrome
caution with pregnancy and lactation
avoid SSRIs, SNRIs, tricyclic antidepressants, MAOIs, lithium, buspirone, and triptans due to risk for serotonin syndrome
ondansetron (Zofran) interventions and education
monitor QT on EKG
give IV push over 2 minutes
can be given Q8hrs PRN
report severe headaches
increased risk for falls
dimenhydrinate class
Antihistamine/Anticholinergic
dimenhydrinate EPA
prevents vertigo, nausea, vomiting by blocking release of histamine receptors in the inner ear
dimenhydrinate therapeutic use
treat nausea and vomiting secondary to chemo, radiation, and post-op recovery
dimenhydrinate ADRs
anticholinergic effects:
dry mouth
constipation
urinary retention
decreased bladder tone
sedation
drowsiness
dizziness
dimenhydrinate contraindications and interactions
BPH or risk for urinary retention
closed angle glaucoma
hyperthyroidism
cardio disease
pregnancy and lactation
increased risk for sedating effects with other CNS depressants
dimenhydrinate interventions and education
increased risk for falls
drink water frequently
high fiber foods
laxative support
monitor BP and pulse for hypotension and bradycardia when giving IV
monitor urinary output
metoclopramide (Reglan) class
Dopamine Antagonist/Prokinetic
metoclopramide (Reglan) EPA
dopamine receptor blocker
Increases threshold of chemoreceptor trigger zone in the brain
metoclopramide (Reglan) therapeutic use
treat nausea and vomiting due to chemo, opioids, radiation
can increase GI motility in GERD
metoclopramide (Reglan) ADRs
sedation
extrapyramidal - incontrollable repetitive movements
restlessness
neuroleptic malignant syndrome
metoclopramide (Reglan) contraindications and interactions
GI obstruction
hemorrhage or perforation
parkinson’s disease
metoclopramide (Reglan) interventions and education
increased risk for falls
monitor for EPS or tardive dyskinesia - lip smacking, writhing, spasms
monitor for neuroleptic malignant syndrome - rigid, hyperthermia, tachycardiaa, sweating
psyllium (Metamucil) class
bulk-forming laxative
psyllium (Metamucil) EPA
adds bulk and stimulates peristalsis
psyllium (Metamucil) therapeutic effect
relief from constipation within 8-72 hours
docusate sodium (Colace) class
stool softener
docusate sodium (Colace) EPA
changes surface tension of stool, increases water absorption
bisacodyl (Dulcolax) class
cathartics
bisacodyl (Dulcolax) therapeutic use
treats constipation, neurogenic bowel, bowel prep
PO produces BM in 6-12 hours
Rectal produces BM in 15 mins - 1 hour
