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3. Nursing Pharmacology > GI Meds Comp 9 > Flashcards

GI Meds Comp 9 Flashcards

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1
Q

Antihistamine action and AE(3)

A
  • acts on vomiting center

- AD: dizziness, drowsiness, urinary retention

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2
Q

Anticholinergic (ACh blockers) example, action and AE(3)

A
  • ex. scopolamine- treat motion sickness
  • blocks transmission of nauseating stimuli to CTZ (chemoreceptor trigger zone)
  • AD: dizziness, drowsiness, urinary retention
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3
Q

Anticholinergic (ACh blockers) contraind

A

glaucoma

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4
Q

Anticholinergic (ACh blockers) patch, who long they last and when to give it

A

lasts 72 hours, give 4 hours before event

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5
Q

phenothiazine drugs action and indication

A
  • blocks dopamine receptors in CTZ

- used for psych disorders, intractable hiccups, LOWER DOSES USED FOR ANTIEMETIC

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6
Q

phenothiazine drugs AE

A
  • OH

- extrapyramidal symptoms EPS (restless, anxiety, spasms of face and neck)

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7
Q

Serotonin blockers (5-HT3) drug prefix, action, indication

A
  • setron
  • block serotonin receptors in CTZ and GI
  • used for NV in PTs RECEIVING CHEMOTHERAPY AND FOR POSTOPERATIVE
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8
Q

cannabinoids example and indication

A
  • dronabinol (Marinol)

- used for NV r/t CHEMOTHERAPY AND ANOREXIA linked to weight loss in AIDS and cancer PTs

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9
Q

cannabinoids AE

A
  • mood changes

- OH

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10
Q

Prokinetic drug example, action, indication

A

-metaclopramide (Reglan)
-cause CTZ to be desensitized to impulses from GI
+ stimulates peristalsis in GI –enhances gastric emptying

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11
Q

Prokinetic drug indication and AE

A
  • used as antiemetic and GERD and delayed gastric emptying

- AE: sedation, diarrhea, EPS

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12
Q

Antiemetic Trimehtobenzamide (Tigan) action and SE

A
  • suppresses impulses to CTZ

- SE: OH and EPS

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13
Q

Antiemetic critical assessments

A

assess complete NV history + precipitating factors

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14
Q

Antiemetic NI(3)

A
  • many drugs cause drowsiness, don’t drive
  • don’t drink alcohol - CNS depression
  • move slowly - HoTN affects
  • for chemo PT, antiemetics given 1-3 hours before chemo
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15
Q

Emetic Ipecac (OTC) use and admin

A
  • induces vomiting after toxic substances

- Admin: take with water, VOMITING OCCURS IN 15-30 min, if no vomit take activated charcoal

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16
Q

acute vs chronic diarrhea time frame

A
  • acute: 3 days - 2 weeks

- chronic: 3 weeks+

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17
Q

non-pharm treatment of diarrhea

A
  1. ID underlying cause
  2. fluid replacement
  3. no milk and fatty foods
  4. wash fruit, no raw veggies and well done meat while traveling
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18
Q

Antidiarrheals : opiates action

A

decrease intestinal motility, decreases peristalsis (more water and electrolytes absorbed)

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19
Q

opiates AE

A
  • drowsiness
  • sedation
  • respiratory depression
  • HoTN
  • urinary retention
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20
Q

Anti-diarrheals: absorbants example

A

bismuth subsalicylate (Pepto-bismol)

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21
Q

Anti-diarrheals: absorbants action

A
  • coat the walls of the GI tract

- bind to the causative bacteria or toxin, is then eliminated through stool

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22
Q

Anti-diarrheals: absorbants AE

A
  • tarry black stools
  • tinnitus
  • metallic taste
  • blue gums
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23
Q

Octeotride (Sandostatin ) treats ….

A

severe diarrhea from cancer

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24
Q

absorbants decrease absorption of…

A
  • digoxin
  • clindamycin
  • quinidine
  • hypoglycemic drugs
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25
Q

absorbants increase …..

A

bleeding time and bruising with anticoagulants

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26
Q

antacids can decrease effects of ….

A

anticholinergic antidiarrheal drugs

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27
Q

antidiarrheals critical assessments

A

Last BM and COCA, abdominal assessment (pain, NV, bowel sounds)

28
Q

antidiarrheals NI

A
  • DO NOT give bismuth subsalicylate to children or teenagers with chicken pox- risk of Reye’s syndrome
  • use with caution in elderly, decreased bleeding time, clotting disorders, recent bowel surgery, confusion
  • avoid fried foods. milk, sedatives
29
Q

Most gentle to strongest laxatives

A
  1. emollient (stool softener)
  2. bulk forming
  3. stimulant (Contact)
  4. Osmotic (Saline)
  5. Chloride channel activators
30
Q

laxative: emollient example and action

A
  • docusate salts (Colace)
  • promote more water and fat in stools
  • gently soften the stool
31
Q

Laxative: bulk-forming example and action

A
  • psyllium (Metamucil)
  • high fiber- absorb water to increase bulk
  • results on 8-12 hrs
  • only L that can be taken long term
32
Q

Laxative: Stimulant examples

A
  • bisacodyl (Dulcolax)
  • senna (Senokot)
  • castor oil
33
Q

Laxative: Stimulant action and AE

A
  • increases peristalsis via intestinal nerve stimulation
  • oral 6-12 hrs, supp 15-60 min
  • AE: reddish brown urine
34
Q

laxatives: osmotic (Saline) examples

A
  • magnesium salts- Milk of Mag, mag sulfate
  • sodium salts-Fleet enema
  • lactulose (reduce ammonia levels)
  • glycerin (supp)
  • Polyethylene glycol (Miralax) -PEG
35
Q

PEG with electrolyte solution (GoLYTELY) used for.. and how much…

A

bowel evacuation prior to GI procedures (colonoscopy) or GI surgery
-2-3 L

36
Q

laxatives: osmotic (Saline) action and AE

A
  • more water enters intestine >bowel distention>peris. and BM
  • AE: magnesium toxicity (with renal insufficiency)
37
Q

All Laxatives AE

A
  • rectal irritation
  • diarrhea
  • electrolyte imbalances
38
Q

laxatives contraindications

A
  • undiagnosed abdominal pain
  • inflammatory disorders of the GI tract
  • spastic colon
  • bowel obstruction
  • pregnancy
39
Q

laxatives critical assessments

A
  • last BM and COCA

- abdominal assessment (bowel sounds, pain, NV)

40
Q

laxatives NI

A
  • assess PT history: allergies, BM pattern, fluid and electrolytes before therapy
  • do not take if experiencing NV, abdom. pain, suspected acute abdom.
  • high fiber, lots of fluid in diet
  • **PT should take all lax tablets with 6-8oz of water- esp. bulk-forming
41
Q

Laxatives, call doc if….

A
  • severe abdominal pain
  • muscle weakness
  • cramps
  • dizziness

(fluid and electrolyte loss)

42
Q

HCL secretion triggered by….

A
  • food
  • large fatty meals
  • a lot of alcohol
  • emotional stress
43
Q

acid-related diseases caused by..

A

imbalance of the three cells of the gastric gland and their secretions
- most common hyperacidity (indigestion, sour stomach, heart burn)

44
Q

Acid-related disorders

A
  • Peptic Ulcer disease (PUD)
  • gastroesophageal reflux disease (GERD)
  • Helicobacter pylori (treat with proton-pump inhibitors and antibiotics)
45
Q

proton pump inhibitors (216)

A

completely block production of acid , alters absorption of drugs

46
Q

Peptic ulceration patho

A
  • mucosal lining erosion (esophageal, gastric, duodenal)

- hypersecretion (HCL, Pepsin, pH of 2-5)

47
Q

Peptic ulcer risk factors and symptoms

A
  • H. pylori
  • mechanical
  • genetic
  • environment
  • drugs
  • symptom: aching pain
48
Q

antiulcer drugs

A
  • tranquilzers
  • anticholinergic drugs
  • histamine 2 blockers
  • proton pump inhibitors
  • antacids
  • prostaglandin E analog
  • pepsin inhibitor
49
Q

tranquilizer glycopyrrolate (Robinul) action

A

reduces vagal stimulation , decreases anxiety

50
Q

anticholinergic Propantheline (Pro-Banthine) action

A

inhibits release if HCL by blocking ACh and histamine

51
Q

antacids action

A
  • neutralize stomach acid and reduces pain
  • DO NOT prevent overproduction of acid
  • DO neutralize the acid once it is in stomach
52
Q

antacids can be used with..

A
  • aluminum salts
  • calcium salts
  • magnesium salts
  • sodium bicarbonate
53
Q

Antacid : Aluminum salt use and AE

A
  • have constipating effect, used with Mg to reduce
  • used for PT with renal disease, easy excrete
  • AE: constipation, hypercalcemia
54
Q

Antacid: Calcium salt example and SE

A
  • Tums (calcium carbonate)
  • may cause constipation, kidney stones
  • not recom. for PT with renal disease- toxic
55
Q

Antacid: Magnesium Salts SE and caution

A
  • commonly cause DIARRHEA, use with other drugs to counter

- dangerous with renal failure, accumulates

56
Q

Antacids: Sodium Bicarbonate caution

A

-sodium content may cause problems in PT with HF, HTN, or renal insufficiency

57
Q

Critical assessments for Antacids

A

appropriate electrolyte level

58
Q

Antacids NI

A
  1. assess for allergies, contrandications
  2. not for PT with HF or HTN
  3. MOST MEDS SHOULD BE GIVEN 1-2 HOURS AFTER GIVING ANTACID
  4. may cause premature dissolve of enteric coated meds
59
Q

histamine type 2 H2 blockers examples

A
  • most popular:
  • cimetidine (Tagamet)
  • famotidine (Pepcid)
  • ranitidine (Zantac)
60
Q

histamine type 2 H2 blockers action and SE

A
  • reduce gastric acid by blocking H2 receptors of parietal cells in stomach
  • SE: HA, dizziness
61
Q

H2 blockers NI

A
  • smoking decreases effect
  • All H2 antagonists may inhibit the absorption of drugs that require an acidic GI environment for absorption
  • contact doc if prolonged HA occurs
  • 1 hour before or after meals
  • caution with PT who are confused, disoriented, or elderly
62
Q

Proton pump inhibitors (PPI) suffix and action and result and

A

-“prazole”
-reduce gastric acid by
inhibiting hydrogen/K+ ATPase
-result: achlorhydria- ALL gastric acid secretion is temporarily blocked

63
Q

PPI SE

A
  • HA
  • insomnia
  • dizziness
64
Q

PPI NI

A
  1. works best taken 30-50 min before meals
  2. capsules swallowed whole
  3. may open and mix with apple sauce, eat immed
  4. may increase levels of DIAZEPAM, PHENYTOIN, and more bleeding with WARFARIN
65
Q

Sucralfate (Carafate) action and admin

A
  • attracted to ulcer base, and forms a protective barrier
  • give 30 min before meals and bedtime
  • impairs other drug absorption ( give 2 hrs before sucra.)

3. Nursing Pharmacology (22 decks)

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