GI Meds

Question 1

Antacids

Answer 1

• albuminum hydroxide (Constipation)
• Sodium bicarbonate (Constipation)
• magnesium hydroxide/sulfate (milk of magnesia) (Diarrhea)

Facts:
- neutralize gastric acid
- used for PUD and GERD
- prolonged use can cause hypophosphatemia and decrease absorption of other meds
- other meds should be taken 1 hour before antacids
- do not use daily for longer than 2 weeks
- magnesium sulfate can cause respiratory paralysis

Question 2

Antisecretory Agents

Answer 2

Proton Pump Inhibitors (PPIs): suppresses gastric acid production
(“-zoles”)
- Omeprazole
- Lansoprazole
- Rabeprazole sodium
- Esomeprazole

Histamine2 Receptor Antagonists (H2 Blockers): (“-dines”)
- Ranitidine Hydrochloride
- Cimetidine
- Nizatidine
- Famotidine

Facts:
-treat gastric and duodenal ulcers, GERD, and Zollinger-Ellison syndrome (too much gastric acid)
- do not give to patients with COPD or breast feeding
- report juandice immediately
- can increase risk for osteoporosis, pneumonia in COPD patients, and acid rebound
- H2 can cause decreased libido, lethargy, confusion, and depression
- do not crush, chew, or break tablets
- avoid NSAIDs
- take 1 hour before meals
- eat more dairy
- monitor for hypomagnesia (disorientation)

Question 3

Mucosal Protectants

Answer 3

• Sucralfate

Facts:
- adheres to ulcers upon contact and protects for up to 6 hours (“line the stomach”)
- treats GERD and gastric/duodenal ulcers
- do not give to chronic renal failure patients
- give 1 hour before meals on empty stomach
- do not take within 30 mins of antacids

Question 4

Antiemetics

Answer 4

• Promethazine
• Metoclopramide
• Ondansetron
• Scopolamine

Facts:
- act upon the “vomiting center” of the brain and reduce nausea and vomiting
- can cause EPS (movement disorder), drowsiness, anticholinergic effects (DRY), respiratory depression, restlessness, diarrhea, headache, and tardive dyskinesia)

Question 5

Antidiarrheals

Answer 5

• Diphenoxylate plus Atropine
• Loperamide
• Paregoric

Facts:
- manage diarrhea
- can cause increase risk of megacolon for clients with IBS, constipation, drowsniess, dry mouth, and blurred vision
- do not give to clients with COPD
- avoid caffeine

Question 6

Stool Softeners

Answer 6

• Psyllium (bulk forming to decrease diarrhea)
• Docusate Sodium/Senna (Surfactant to relieve constipation)
• Magnesium hydroxide (promote rapid evacuation and prevent painful elimination)

Facts:
- do not give to patients with fecal impaction or bowel obstruction
- can cause hypermagnesia
- can cause fluid retention
- eat more fiber and fluids