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NUR 326 > GI Pharm > Flashcards

GI Pharm Flashcards

1
Q

go look at basic GI meds

A

;)

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2
Q

for upper GI disorders we try to

A
  • inc the protective factors –> antacids, sucralfate
  • dec aggressive facotrs –> treat h pylori, H2 blockers, proton pump inhibitors
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3
Q

treating h pylori

A

several antibiotics and gastric acid inhibitors

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4
Q

why use combo therapy for h pylori

A

minimizes resistance
lots of abx dont work the best in acidic env
confirm case before treating

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5
Q

what are the problems with h pylori treatment

A

10-14 days of abx
$200 for 12 pills a day so low adherence

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6
Q

decreasing gastric acid drugs

A

block H2 receptors
inhibit proton pump inhibitor
the two ways that inc acidity

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7
Q

cimetidine and famotidine class

A

H2 receptor antagonists

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8
Q

cimetidine and famotidine moa

A

block H2 receptors in the stomach and reduce acid secretion by 60-70%
- ultimately inc stomach pH

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9
Q

cimetidine and famotidine routes

A

PO, IV

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10
Q

cimetidine and famotidine nursing considerations

A

give at least 1 hour apart from antacids
lessens likelihood of aspiration pneumonia
IV give slowly bc risk of bradycardia

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11
Q

cimetidine and famotidine indications

A

GERD
PUD
ulcer
prophylaxis –> dec risk for aspiration pneumonia
heartburn/dyspepsia

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12
Q

cimetidine and famotidine adverse effects

A

well tolerated
CNS effects in elderly
slight inc risk for pneumonia in elderly (kinda a stretch)

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13
Q

cimetidine and famotidine interactions

A

cimetidine –> CYP450 inhibitor
famotidine –> no interactions, when possible 1st choice
can inc levels of warfarin, phenytoin, theophylline

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14
Q

omeprazole
pantoprazole
esomeprazole class

A

proton pump inhibitor

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15
Q

omeprazole
pantoprazole
esomeprazole moa

A

bind to H/K ATPase pump to inhibit the secretion of HCl

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16
Q

omeprazole
pantoprazole
esomeprazole indications

A

short term treatment of GERD, PUD

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17
Q

omeprazole
pantoprazole
esomeprazole adverse effects

A

short term: safe
long term: inc risk of pneumonia, bone loss, hip fracture, stomach cancer –> typically benefits out weight these

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18
Q

omeprazole
pantoprazole
esomeprazole interactions

A

few, but defs less than older H2 receptor antagonist

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19
Q

omeprazole
pantoprazole
esomeprazole nursing considerations

A

short term use only
- long term will typically be rx

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20
Q

sucralfate class

A

mucosal protectant

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21
Q

sucralfate is composed of

A

sucrose base and aluminum hydroxide

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22
Q

sucralfate moa

A

alters into sticky thick gel that adds the protective barrier when exposed to stomach acid

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23
Q

sucralfate indications

A

duodenal ulcers
gastric ulcers
sometimes given for chronic gastritis

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24
Q

sucralfate route

A

only PO, tablet or suspension

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25
sucralfate adverse effects
nothing major, maybe C
26
sucralfate interactions
dec drug absorption take 2 hours after other drugs
27
major forms of antacids
aluminum calcium magnesium Al + Mg
28
aluminum and calcium antacid se
constipation
29
magnesium antacid se
D
30
al + mg antacid se
balanced approached
31
antacid moa
neutralize acid by approximately 50% - undergoes chemical change
32
antacids indications
PUD (healing) GERD (symptoms) stress ulcers (prophylaxis) heartburn and indigestion for some
33
antacids se
C or D depending on form rebound secretion of acid --> heartburn comes back
34
antacids interactions
cause chelation of other drugs --> antacids will hold onto drugs preventing them from getting digested and absorbed *separate taking with other drugs by 2 hours*
35
antiemetics
serotonin blockers antihistamines anticholinergics dopamine antagonists prokinetics
36
ondansetron class
serotonin blockers
37
ondansetron moa
blocks 5HT receptors in the trigger zone of the brain and afferent vagal nerves in the stomach and small intestine
38
ondansetron route
IV, PO
39
ondansetron indications
NV, esp. chemo induced
40
ondansetron se
mild ha D dizzy pretty well tolerated serious: serotonin syndrome so be aware of other drugs that affect 5HT like SSRIs, SNRIs, TCAs, MAOis, buspirone, tramadol
41
dimenhydrinate hydroxyzine meclizine class
antihistamines
42
dimenhydrinate hydroxyzine meclizine moa
block the release of H1 receptors in inner ear
43
dimenhydrinate hydroxyzine meclizine indications
treat dizziness and N - antiemetic, antivertigo associated with motion sickness
44
dimenhydrinate hydroxyzine meclizine adverse effects
sedation drowsy dizzy anticholinergic effect (drying effect) *fall risk*
45
what to know about hydroxyzine
never given IV bc can result in significant tissue damage, thrombosis and gangrene can be given IM
46
metoclopramide class
dopamine antagonist or prokinetic agent
47
metoclopramide moa
blocks dopamine receptors to inc the tone of LES inc peristalsis in both stomach and intestine --> diabetic gastroparesis
48
metoclopramide indications
NV --> chemo radiation, opioids GI motility issues --> for dec peristalsis, CF paralytic ileus
49
metoclopramide adverse effects
sedation - severe: extrapyramidal symptoms, restlessness, neuroleptic malignant syndrome
50
what are extrapyramidal symptoms
drug induced movements cause by taking metoclopramide, especially with anti psychotics - akathisia - acute dystonia - parkinsonism - tardive dyskinesia - neuroleptic malignant syndrome
51
akathisia
restlessness, tense, constant desire to move
52
acute dystonia
involuntary muscle distractions
53
parkinsonism
tremors rigid muscles in the limbs
54
tardive dyskinesia
facial movements like tongue twisting, chewing motions, cheek puffing, grimacing
55
neuroleptic malignant syndrome
rigid muscle, fever, drowsy, confusion - can lead to seizures
56
diphenoxylate with atropine loperamide class
anti D
57
diphenoxylate with atropine loperamide moa
dec intestinal peristalsis, reduce the intestinal effluent
58
diphenoxylate with atropine loperamide adverse reactions
drowsiness and constipation - fall and driving precautions especially with CNS depressants - anti cholinergic effects with atropine - serious cardiac arrest, arrythmias
59
sulfasalazine class
5 aminosalicylate
60
sulfasalazine indications
mild to moderate IBD
61
sulfasalazine moa
sulfasalazine is a sulfonamide abx that converts the intestine into 5 aminosalicyclic acid and sulphapyridine - sulphapyridine has no therapeutic effect
62
sulfasalazine se
N, fever, rash, headache, hematologic disorders
63
sulfasalazine nursing considerations
do not give to pts with sulfa allergies or have types of anemias - caution if pts has diseases, comorbities
64
infliximab class
DMARDS disease modifying anti-rheumatic drugs
65
infliximab moa
monoclonal antibodies which neutralize TNF alpha, an inflammatory mediator *turns TNF off*
66
infliximab indications
lots, but for here IBD
67
infliximab side effects
immune suppression - infection, cancer, heart failure, infusion rxns, neutropenia
68
infliximab nursing considerations
often require therapeutic drug monitoring and biomarker monitoring for inflammation (CRP) pre screening before starting to ensure safety

NUR 326 (20 decks)

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