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Year 2: Pharmacology for nursing practice > GI Pharmacology > Flashcards

GI Pharmacology Flashcards

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1
Q

Why do patients get constipate? The mechanism behind constipation

A

Decreased peristalsis which could be a result of medication or age etc

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2
Q

Give an example of medication which can contribute to constipation?

A

Opioids

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3
Q

What is senescence?

A

the condition or process of deterioration/downregulate with age

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4
Q

Why are older people more likely to have constipation?

A

process of senescence

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5
Q

What are the 2 forms of laxatives?

A

Bulk laxatives

irritant laxatives

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6
Q

What are the 2 types of bulk laxatives?

A

hydrophillic gels

osmotically active laxatives

alcohol and dissacharide based laxatives

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7
Q

Where in the GI tract are faeces found?

A

colon and rectum

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8
Q

What’s the name of the dehydratable slime in the small intestine?

A

chyme

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9
Q

What are the characteristic of bulk forming laxatives?

A

Insoluble

non-absorbable, cannot permeate through epithelial gut lining

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10
Q

Describe how bulk forming laxatives work

A

contains large macromolecules which increases coloidal pressure in the intestine thus drawing more water into intestine.

Form larger, softer stool which activate stretch receptors in the bowel, causing it to contract and relax moving bolus of faeces forward.

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11
Q

Before administering bulk laxatives to a patient, what must you ensure about the patient’s condition?

A

That they are thoroughly hydrated otherwise, insufficient amount of water will be drawn into the stool

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12
Q

List examples of hydrophilic gell bulk forming laxatives

A

Bran

Ispaghula Husk

Methyl cellulose

Sterculia

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13
Q

What is the name of the nerve fiber network which is solely found in the GI tract and controls it’s motility?

A

Myenteric Plexus

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14
Q

How many muscle layes are in the GI tract and what are they called

A

2 muscle layers,

Circular and Longitudinal

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15
Q

Where is the Myenteric plexus found?

A

In the GI tract, sandwhiched between the circular and longitudinal muscle layers.

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16
Q

What is the Myenteric plexus?

A

nerve fiber network which is solely found in the GI tract and controls it’s motility

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17
Q

What does the efficacy of bulk laxatives (hydrophillic gel) laxatives depend on?

A

Patient being hydrated

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18
Q

What are osmotically active

bulk forming laxatives?

A

Made up of epsom salts or glauber salts which increase osmotic pressure in the bowels.

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19
Q

What are the contraindications for epsom salts for laxative use?

A

Renal Failiure

20
Q

What are the contraindications for Glauber salts?

A

Hypertension

Heart Failiure

Oedema

21
Q

What is the name of the dissacharride found in Macrogol?

A

polyethylene glycol

22
Q

Why does macrogol contain electrolytes aswell?

A

Reduces possibility of electrolyte imbalance and dehydration

23
Q

What is addes to macragol to help reduce possibility of electrolyte imbalance and dehydration?

A

electrolytes

24
Q

Why is Lactulose a useful laxative for those wth hepatic failiure?

A

Acidifies intestine and destroys gut flora to stop production of ammonia gas and ammonium ions.

25
Q

Which laxative should be indicated for someone with hepatic failiure?

A

Lactulose

26
Q

What is the mechanism of stimulant laxatives?

A

Irritates mucosal layer of GI tract causing reabsorbtion of electrolytes resulting in some fluid to enter.

Irritation of mucosal layer also triggers irritation of muscle layer which cause the muscles to contract

27
Q

Why should you not give someone with a bowel obstruction laxative? especilly stimulant laxatives?

A

Forfully contracting the bowels on an obstruction can potentially cause a rupture

28
Q

What are the potential cause for decreased peristalsis?

A

medication -opiods

spinal injury

bowel obstruction

29
Q

What are the two elements for controlling the passing faeces?

A

autonomic and somatic control

30
Q

How long does it normally take for an empty colon to fill?

A

24-48 hours

31
Q

How does a patient develop laxative dependence?

A

Patient takes laxative without allowing time for faeces to move down colon. results in expulsion of material from ascending and transverse colon.

Patient loses water and electrolytes because of this which dehydrates patient.

Retention of sodium due to dehydration results in loss of potassium.

Low potassium (hypokalaemia) means reduces peristalsis since potassium is integral for the contraction of muscle.

This in turn means that the patient will need to take more laxatives

32
Q

Which laxative is less likely to result in laxative dependence?

A

movicol

33
Q

How do we prevent the occurence of laxative dependence on patients?

A

Educate patients on the use of laxatives:

explain it will trake longer for the patient to defecate afterwards.

Ensure that the patient is thoroughly hydrated

awareness that it may take a while to get

34
Q

What are the indication for laxative use?

A

Preperation for surgery/bowel pathology (bowel prep)

constipation

35
Q

Which groups need to be give special consideration before administering laxatives?

A

Older people

young children

36
Q

According to Paediatric guidelines, what should be the first line laxative given to a paeds patient?

A

polyethylene glycol 3350 (movicol) +elecetrolytes.

May be mixed in with a cold drink

37
Q

What should be administered to a paeds pateient if after giving a first line laxative disimpaction does not occur?

A

A stimulant laxative

38
Q

when should a stimulant laxative be administered to a paeds patient if first line laxative does not work?

A

2 weeks if disimpaction does not occur

39
Q

What is the nurse role in terms of caring for a p[atient taking laxatives?

A

Assessing their need for laxatives

Monitoring the patient whilst they are on laxative medication

Evaluate the patients cureent situation to develop care

40
Q

Which cells in the stomach secrete gastric acid?

A

The parietal cells in the inner lining of the stomach

41
Q

What substances are secreted by parietal cells?

A

HCL (gastric acid) and intrinsic factors

42
Q

What is the purpose of gastric acid interms of digestion?

A

activates enzymes required for digestion

43
Q

What is another term (scientific) for indigestion?

A

dyspepsia

44
Q

List the types of acid reducing medications you need to know for the exam

A

Antacids

H-2-receptor anatagonists - HR2 As

Proton pump inhibitors-PPIs

45
Q

What are the consequences of giving acid reducing medication?

A

affects homeostasis of the digestive system

46
Q

Which part of the GI tract is acidic fat-soluble likely to absorbed and why?

A

The stomach because it is an acidic environment

47
Q

How do Antacids work?

A

They are basic and help neutralise the acid in the stomach.

Year 2: Pharmacology for nursing practice (13 decks)

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