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Med- Math Exam 1 > GI Meds > Flashcards

GI Meds Flashcards

1
Q

Proton Pump Inhibitor prototype

A

Omeprazole

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2
Q

Proton Pump Inhibitor action

A

block basal and stimulated acid production, and reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid

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3
Q

Proton Pump Inhibitor therapeutic use

A

prescribed for gastric and duodenal ulcers, erosive esophagitis, GERD, and hypersecretory conditions such as Zollinger- Ellison syndrome

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4
Q

Proton Pump Inhibitor complications

A

PNEUMONIA, OSTEOPOROSIS and FRACTURES (advise clients to increase vitamin D and calcium intake), REBOUND ACID HYPERSECRETION (take low dose and taper to discontinue), HYPOMAGNESEMIA (tremors, muscle cramps, seizures)

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5
Q

Proton Pump Inhibitor contraindications/ precautions

A

pregnancy risk category C, contraindicated in clients that are hypersensitive and lactating, dysphagia, liver disease, people in high risk for pneumonia including those with COPD

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6
Q

Proton Pump Inhibitor nursing administration

A

Do not crush/break/chew sustained-release capsules
Take once per day prior to eating in the morning
Avoid alcohol and NSAIDS
Active ulcers should be treated for 4-6 weeks
Notify provider for signs of occult GI bleeding (e.g. coffee-ground emesis)
Assess for electrolyte imbalances: hyponatremia & hypomagnesemia
Monitor hepatic enzymes, blood studies

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7
Q

Mucosal Protectant prototype

A

Sulcrafate

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8
Q

Mucosal Protectant action

A

acidic environment of the stomach turns product into a protective barrier that adheres to an ulcer, which protects the ulcer from further injury and from acid and pepsin
able to stick to the ulcer for up to 6 hours

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9
Q

Mucosal Protectant therapeutic use

A

acute duodenal ulcers and those requiring maintenance therapy, it is not absorbed so has no systemic effects, investigational use includes gastric ulcers and GERD

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10
Q

Mucosal Protectant complications

A

CONSTIPATION

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11
Q

Mucosal Protectant contraindications/ precautions

A

pregnancy risk category B, contraindicated in those who are hypersensitive to the meds, use cautiously in clients with CKD

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12
Q

Mucosal Protectant nursing administration

A

Take 4 times a day on an empty stomach, 1 hour before meals, & again at bedtime
Can break/dissolve in water, but should not crush or chew tablet
Can interfere with the absorption of phenytoin, digoxin, warfarin, & ciprofloxacin; allow a 2-hr interval between these medications and sucralfate
Antacids interfere with absorption of sucralfate; take sucralfate 30 minutes before antacid
Increase dietary fiber and drink at least 1500 mL/day
Monitor blood sugar in those with DM because it can cause hypoglycemia

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13
Q

Histamine 2 Receptors prototype

A

Ranitidine

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14
Q

Histamine 2 Receptors action

A

Block H2 receptors, which reduces the volume of gastric acid and lowers the concentration of hydrogen ions in the stomach

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15
Q

Histamine 2 Receptors therapeutic use

A

Gastric and duodenal ulcers, GERD, hypersecretory conditions (Zollinger-Ellison syndrome), aspiration pneumonitis, heartburn, and acid indigestion
Used in conjunction with antibiotics to treat ulcers caused by H. Pylori

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16
Q

Histamine 2 Receptors complications

A

CONSTIPATION, DIARRHEA

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17
Q

Histamine 2 Receptors contraindications/ precautions

A

Pregnancy Risk Category B.
In older adults can cause antiadrenergic effects (impotence) and CNS effects (confusion).
Decrease gastric acidity , which promotes bacterial colonization of the stomach and the respiratory tract. Use cautiously in clients who are high risk for pneumonia, including clients who have COPD

18
Q

Histamine 2 Receptors nursing administration

A

Report adverse effects to provider.
Cimetidine, ranitidine, and famotidine can be administered IV.
Advise patients to eat meals on a regular schedule, in a relaxed environment, and not to overeat.
Advise to avoid food that cause gastric secretions such as caffeinated beverages including regular and decaf coffee.
Inform that adequate rest can increase healing.
Smoking can delay healing.
Avoid aspirin and other NSAIDs unless taking a low-dose aspirin therapy for the prevention of cardiovascular disease.
Alcohol can exacerbate peptic ulcer disease. Advise clients to avoid drinking alcohol.
Availability of the medication OTC can discourage clients from seeking appropriate health care. Encourage clients to see a provider if manifestations persist.
Encourage clients to adhere to medication regimen, and provide support.
Ranitidine can be taken with or without food.
Treatment of peptic ulcer disease is usually started as an oral dose twice a day until the ulcer is healed, followed by a maintenance dose, which is usually taken once a day at bedtime.
Teach clients to notify provider for and indication of obvious or occult GI bleeding, such as coffee ground emesis.

19
Q

Antiemetics prototype

A 
Ondansetron 
Prochlorperazine
Metoclopramide
Promethazine
Hydroxyzine
20
Q

Antiemetics action

A

Prevents emesis by blocking the serotonin receptors in the chemoreceptor trigger zone (CTZ), and antagonizing the serotonin receptors on the afferent vagal neurons that travel from the upper GI tract to the CTZ
result from blockade of dopamine receptors in the CTZ
muscarinic and histaminergic receptors in nerve pathways that connect the inner ear and VC are blocked

21
Q

Antiemetics therapeutic use

A

treat chemo, radiation, and post operative induced nausea and vomiting
treat motion sickness

22
Q

Antiemetics complications

A 
HEADACHE, DIARRHEA, DIZZINESS, PROLONGED QT INTERVAL can lead to a serious dysrhythmia (torsades de pointes)
EXTRAPYRAMIDAL SYMPTOMS (restlesness, anxiety, spasms of face and neck- treat with anticholinergic such as diphenhydramine or benztropine) HYPOTENSION, SEDATION, ANTICHOLINERGIC EFFECTS such as dry mouth, urinary retention, and constipation (increase fluid intake, increase exercise, client should void every 4 hours  with I&O monitored)
23
Q

Antiemetics contraindications/ precautions

A

Ondansetron should not be given to clients who have a long QT syndrome.
Use dopamine antagonists cautiously, if at all, with children and older adults due to the increased risk of extrapyramidal side effects.
Dopamine antagonists, antihistamines, and anticholinergic antiemitics should be given cautiously in clients who have urinary retention or obstruction, asthma, and and narrow angle glaucoma.
Aprepitant should be used cautiously in children and in clients who have severe liver and kidney disease.
Promethazine is contraindicated in children younger than 2 years old and should be used with extreme caution in older children

24
Q

Antiemetics nursing administrations

A

Treat headache with non-opioid analgesics

Monitor stool pattern

25
Q

Laxatives prototype

A

Docusate Sodium

26
Q

Laxatives action

A

Surfactant laxatives lower surface tension of the stool to allow penetration of water

27
Q

Laxatives therapeutic use

A

Relieve constipation related to pregnancy or opioid use.
Prevent painful elimination in clients who have conditions such as hemorrhoids or following procedure such as episiotomy
prevent straining in clients who have conditions such as cerebral aneurysm or following MI
Decrease risk of fecal impaction in immobile clients and promote defecation in older adults who have decreased peristalsis due to age -related changes in the GI tract

28
Q

Laxatives complications

A

GI IRRITATION, TOXIC MAGNESIUM LEVELS because of magnesium as potential ingredient (advise clients with impaired kidney function to avoid laxatives with magnesium) SODIUM ABSORPTION and FLUID RETENTION with laxatives that contain sodium (careful in patients that have heart disease and those with kidney disease) DEHYDRATION- osmotic diuretics can cause dehydration (monitor I&O, drink 8-10 glasses of water per day)

29
Q

Laxatives contraindications/ precautions

A

Contraindicated in clients who have fecal impaction, bowel obstruction, and acute surgical abdomen to prevent perforation.
Contraindicated in clients who have nausea, cramping, and abdominal pain.
Contraindicated in clients with diverticulitis and ulcerative colitis; w/ the exception of bulk-forming laxatives
Use cautiously during pregnancy and lactation. Bisacodyl and docusate are Pregnancy Risk Category C

30
Q

Laxatives nursing administration

A

Obtain complete history of laxative use, and provide teaching.
Teach clients that chronic laxative use can lead to fluid and electrolyte imbalances.
to promote defecation and resumption of normal bowel function, instruct clients to increase high-fiber foods and to increase amounts of fluids. Recommend at least 2 - 3 L/day from beverages and food sources.
Encourage clients to maintain a regular exercise regimen to improve bowel function.
Instruct clients to take bulk-forming and surfactant laxatives with 8 oz. water

31
Q

Prokenetic Agents prototype

A

Metoclopramide

32
Q

Prokenetic Agents action

A

IF the CTZ is activated (e.g., by chemotherapy) the CTZ in turn activates the vomiting center to expel gastric contents. Metoclopramid controls nausea and vomiting by blocking dopamine and serotonin receptors in the CTZ.
Metoclopramide augments action of acetylcholine, which causes an increase in upper GI motility, increasing peristalsis

33
Q

Prokenetic Agents therapeutic use

A

Control postoperative and chemotherapy-induced nausea and vomiting, as well as the facilitation of intubation and examination of the GI tract.
The oral form is used for diabetic gastroparesis (delayed stomach emptying with gas and bloating) and management of GERD through its ability to increase motility

34
Q

Prokenetic Agents complications

A

EXTRAPYRAMIDAL SYMPTOMS:
Inform clients of the possible adverse effects such as restlessness, anxiety, and spasms of the face and neck.
Administer and antihistamine, such as diphenhydramine, to minimize EPSs.
SEDATION
Inform clients of the potential of sedation.
Advise clients to avoid activities that require alertness, such as driving.
DIARRHEA
Monitor bowel function and indications of dehydration

35
Q

Prokenetic Agents contraindications/ precautions

A

Contraindicated in clients who have GI perforation, GI bleeding, bowel obstruction, and hemorrhage.
Contraindicated in clients who have seizure disorder due to an increased risk for seizures.
Use cautiously in children and older adults due to the increased risk for EPS

36
Q

Prokenetic Agents nursing administration

A

Monitor the CNS depression and EPSs.
Medication can be given orally or IV. If the IV dose 10 mg or less, it may be administered IVP undiluted over 2 min. If the dose is greater than 10 mg, it should be diluted abd infused over 15 min. Dilute the medication in at least 50 mL dextrose 5% in water, sodium chloride, and lactated Ringer’s

37
Q

Aminosalicylates prototype

A

Sulfasalazine

38
Q

Aminosalicylates action

A

Decrease inflammation by inhibiting prostaglandin synthesis

39
Q

Aminosalicylates therapeutic use

A

IBS, Crohn’s dz, ulcerative colitis

IBD is controlled, rather than cured, by these medications, which often are used in combination therapy

40
Q

Aminosalicylates complications

A

BLOOD DISORDERS
Include agranulocytosis, hemolytic and macrocytic anemia
NAUSEA, CRAMPS, RASH, ARTHRALGIA
Notify provider if adverse effects persist.

41
Q

Aminosalicylates contraindications/ precautions

A

Women who are pregnant, plan to become pregnant, or who are breastfeeding should consult provider about continued use of sulfasalazine.
5-aminosalicylates are contraindicated in clients who have sensitivity to sulfonamides, salicylates, or thiazide diuretics.
Use cautiously in older adults.
Use cautiously in clients who have liver or kidney disease or blood dyscrasias

42
Q

Aminosalicylates nursing administration

A

Ensure that controlled-release and enteric-coated are not crushed or chewed

Med- Math Exam 1 (3 decks)

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