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ABSN > GI pharm - E3 > Flashcards

GI pharm - E3 Flashcards

1
Q

go back and review

A

constipation & diarrhea meds

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2
Q

when treating gerd / PUD, what drugs increase protective factors

A

antacids
sucralfate

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3
Q

when treating gerd / PUD, what drugs decrease aggressive factors

A

H.pylori treatment
H2 blockers
PPIs

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3
Q

how to treat H.pylori

A

several abx + gastric acid inhibitors
-need the combo therapy to minimize resistance & bc H.py thrives in acidic environments and abc hate acidic environments
-take abx for 10 to 14 days (bad adherences bc expensive & lots of pills)

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4
Q

what class are cimedetidine & famotidine

A

H2 receptor antagonists

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5
Q

H2 receptor MOA

A

blocks H2 receptors in the stomach -> reduces gastric acid secretion by 60-70% and increases stomach pH

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6
Q

cimedetidine & famotidine indications

A

Gerd
PUD
Ulcer prophylaxis
Heartburn/dyspepsia

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7
Q

cimedetidine & famotidine SE

A

well tolerated
-CNS effects in elderly
-Slight increased risk for pneumonia in elderly

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8
Q

cimedetidine & famotidine nursing considerations

A

-give at least 1hr apart from antacids
-inhibits CYP 450 enzymes (newer does not so use famotidine when possible)
-give IV form slowly to avoid bradycardia

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9
Q

cimedetidine & famotidine interactions

A

warfarin
phenytoin
theophylline

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10
Q

cimedetidine & famotidine can be used to help prevent what

A

aspiration pneumonia

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11
Q

what class are omoprazole, pantoprazole, & esomeprazole

A

proton pump inhibits (PPIs)

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12
Q

PPIs MOA

A

Binds to proton pump and inhibits the hydrogen potassium ATPase enzyme system -> irreversibly inhibits the secretion of HCl which is the primary driver of gastric acid
more effective than H2RA

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13
Q

omoprazole, pantoprazole, & esomeprazole indications

A

Short term treatment of PUD
GERD

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14
Q

omoprazole, pantoprazole, & esomeprazole SE

A

Short term: relatively safe

Long term: increased risk for pneumonia, bone loss/ hip fx, & stomach cancer

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15
Q

omoprazole, pantoprazole, & esomeprazole nursing considerations

A

try to only use for short term use

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16
Q

what class is sucralfate

A

mucosal protectant

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17
Q

mucosal protectant MOA

A

Drug is altered when exposed to gastric acid and becomes a thick, sticky gel that creates a protective barrier

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18
Q

sucralfate indications

A

Duodenal ulcers
Gastric ulcers

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19
Q

sucralfate SE

A

May cause constipation

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20
Q

sucralfate nursing considerations

A

Always given PO

Decreased drug absorption so take 2 hrs before other meds

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21
Q

major forms of antacids

A

amphojel
tums
milk of magnesia
Maalox
Mylanta

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22
Q

amphojel base & SE

A

aluminum ; constipation

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23
Q

tums base & SE

A

calcium ; constipation

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24
Q

milk of magnesium base & SE

A

magnesium ; diarrhea

25
Q

Maalox and Mylanta base & SE

A

Al + Mg ; balanced

26
Q

antacids MOA

A

neutralizes acid by approximately 50%

27
Q

antacids indication

A

PUD (healing)
GERD (symptoms)
Stress ulcers (prophylaxis)

28
Q

antacids SE

A

Diarrhea or constipation
Acid rebound (can eat tums all day but once stopped sx will come back so avoid triggers vs all med mgt)

29
Q

antacid nursing consideration

A

Alters gastric absorption when taken w/ other drugs (chelation) -> separate from other meds by 1 to 2 hrs

30
Q

what class is Ondansetron

A

serotonin blocker

31
Q

serotonin blocker MOA

A

Blocks serotonin receptors in the trigger zone in the brain and in the afferent vagal nerves in the stomach and small intestines

32
Q

Ondansetron indication

A

Nausea & vomiting

33
Q

Ondansetron SE

A

Mild HA
Diarrhea
Dizziness

34
Q

Ondansetron nursing consideration

A

Monitor for serotonin syndrome -> beware if pt is on SSRIs, SNRIs, TCAs, MAIs, buspirone, tramadol

35
Q

what class are Dimenhydrinate, Meclizine & Hydroxyzine

A

antihistamines

36
Q

antihistamines MOA

A

Blocks the release of histamine H1 receptors in the inner ear

37
Q

Dimenhydrinate, Meclizine & Hydroxyzine indications

A

Treatment of dizziness & nausea
(antiemetic & antivertigo associated w/ motion sickness)

38
Q

Dimenhydrinate, Meclizine & Hydroxyzine SE

A

Sedation
Drowsiness
Dizziness
Anticholinergic effects

39
Q

Dimenhydrinate, Meclizine & Hydroxyzine nursing considerations

A

Fall risk in elderly

Hydroxyzine cannot be given IV

40
Q

what class is metoclopramide

A

dopamine antagonists

41
Q

dopamine antagonists

A

Blocks dopamine receptors, increases the tone of the lower esophageal sphincter (GERD), increases peristalsis in both the stomach & the intestines (diabetic gastroparesis)

42
Q

metoclopramide indication

A

N/v associated w/ chemo/radiation/opioids
GI motility issues
paralytic ileus

43
Q

metoclopramide SE

A

Sedation
Severe: extrapyramidal symptoms, restlessness, neuroleptic malignant syndrome

44
Q

metoclopramide nursing considerations

A

extrapyramidal symptoms (drug induced movement disorders) usually occurs when given w/ antipsychotic meds

45
Q

extrapyramidal symptoms (ESP)

A

-Akathisia: may feel restless, tense, constant desire to move
-acute dystonia: involuntary muscle contractions
-parkinsonism
-tardive dyskinesia (repeated abnormal facial movements)
-neuroleptic malignant syndrome: life threatening, 1st sign is rigid muscle, fever & drowsiness and can lead to seizures

46
Q

what drug class is Diphenoxylate w/ atropine &
Loperamide

A

antidiarrheal

47
Q

antidiarrheal MOA

A

Decrease intestinal peristalsis, reduce the intestinal effluent

48
Q

Diphenoxylate w/ atropine & Loperamide indication

A

diarrhea

49
Q

Diphenoxylate w/ atropine & Loperamide SE

A

drowsiness
constipation

50
Q

Diphenoxylate w/ atropine & Loperamide nursing consideration

A

Dip + At can cause bradycardia & anticholinergic effects

Fall risk and driving precautions

51
Q

what class is sulfasalazine

A

5-aminosalicylates

52
Q

5-aminosalicylates MOA

A

Sulfasalazine is a sulfonamide antibiotic that converts the intestine into 5- aminosalicyclic acid & sulphapyridine

53
Q

sulfasalazine indication

A

mild to moderation IBD

54
Q

sulfasalazine SE

A

Nausea
Fever
Rash
H/a
Hematologic disorders

55
Q

sulfasalazine nursing considerations

A

Do not give to patients who are allergic to sulfa drugs or who have certain types of anemias

Not the best drug for patients with many diseases d/t lots of interactions

56
Q

what class is infliximab

A

Disease modifying antirheumatic drug (DMARD)

57
Q

Disease modifying antirheumatic drug (DMARD) MOA

A

Monoclonal antibody which neutralizes TNF alpha (inflammatory mediatory)

58
Q

infliximab indication

A

IBD

59
Q

infliximab SE

A

Immune suppression ->
Infection, cancer, heart failure, infusions

60
Q

infliximab nursing considerations

A

Often require therapeutic drug monitoring and biomarker monitoring for inflammation (CRP)

Needs lots of prescreening: vaccines, tifers, TB screen

ABSN (161 decks)

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