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Pharmacology > GI System > Flashcards

GI System Flashcards

1
Q

Antacids Adverse Effects

A

Aluminum, calcium- constipation
Calcium- kidney stones
Magnesium- Diarrhea, magnesium toxicity if kidneys impaired
Sodium- Fluid retention, alkalosis

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2
Q

Histamine-2 Receptor Blockers (H2RBs) Action

A

Block H2 receptor of parietal cells —> reduce hydrogen ion secretion —> increase PH in stomach

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3
Q

H2RBs Therapeutic use

A

Treatment of acid-related disorders
Adjunct therapy to control upper GI bleed
Management of urticaria (rash)

Available forms: PO, IV. Nizatidine PO only

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4
Q

H2RBs Adverse Effects

A

Cimetidine: confusion, disorientation in the elderly, impotence, gynecomastia.
Famotidine: Thrombocytopenia
Ranitidine: Thrombocytopenia
Nizatidine: Cough or hoarseness, chest pain

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5
Q

Proton Pump Inhibitors (PPIs) Examples

A

Omeprazole
Lansoprazole
Pantoprazole

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6
Q

PPIs Adverse Effects

A

Pneumonia
Osteoporosis (long term effect)
Hypomagnesemia
Wrist, spine, hip fracture
C. Diff-associated diarrhea

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7
Q

PPIs therapeutic use (temporary use)

A

Ulcers
Esophagitis
GERD
NSAID induced ulcers
Prevention of stress ulcer (can be b/c of someone w/ an NG tube)

Available forms: PO and IV

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8
Q

Nursing Implications on H2RBs

A

Take H2RBs 1-2 hours before antacids (antacids decrease its absorption)
Not given alone (works as an additional medication for GI bleed)
Caution in clients with COPD, pneumonia, and kidney impairment.
Cimetidine: increases anticoagulant effects of warfarin and theophylline levels
Smoking decreases effectivemess of H2RBs

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9
Q

PPIs nursing implications

A

Food can decrease absorption of PPIs (take medication an hour before or after)
Make sure Don’t bite medications
Do not open PPI capsule and sprinkle contents over food: capsule contents may be opened and mixed with apple juice but not in food.
Take omeprazole once a day before breakfast
Take before meals if prescribed more than once a day

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10
Q

Nursing implications

A

Shake liquid formulations of antacids
Administer medications at least 1 hour before or after an antacid
Alternate use of aluminum or calcium and magnesium antacids to normalize bowel pattern
Consume high-fiber foods and drink adequate fluids if taking magnesium hydroxide
Avoid antacids with sodium if positive for HTN or heart failure
Avoid antacids with magnesium if positive for renal dysfunction
Chew tablets throughly and drink at least 8 oz of water or milk
Maintain adequate intake of calcium and vitamin D
Notify provider of GI bleed symptoms of if symptoms of hyper acidity are not relieved .

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11
Q

Sucralfate - cytoprotective Adverse Effects

A

May cause dry mouth, nausea, constipation
May impair absorption of other drugs

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12
Q

Sucralfate implications

A

Increase fiber and fluid intake
Give 30 min before or after antacids and maintain 2-hr interval when giving other drugs
Take 1-hour before meals and at bedtime

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13
Q

Misoprostol- prostaglandin analogue symptoms

A

Therapeutic doses may cause abdominal cramps and diarrhea

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14
Q

Simethicone therapeutic effect

A

Anti-flatulent
Reduces the discomfort when passing gas

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15
Q

Antidiarrheals

A

Adsorbents- Bismuth salicylate, activated charcoal
Anticholinergic- Belladonna
Opiates- OTC loperamide, Diphenoxylate/atropine
Probiotics-Lactobacillus acidophilus

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16
Q

Adsorbents Adverse Effects

A

Increased bleeding times
Confusion
Tinnitus, metallic taste

17
Q

Anticholinergics Adverse effects

A

H/A, dizziness, blurred vision
Urinary retention
Dry skin, flushing

18
Q

Opiates

A

Dizziness, drowsiness
Urinary retention, constipation

19
Q

Probiotics

A

Flatulence, bloating

20
Q

Laxatives examples

A

Bulk-forming
Emollient
Hyperosmotic
Saline
Stimulant

21
Q

Bulk-forming action and examples

A

Absorb water to increase bulk
- psyllium
-methylcellulose

22
Q

Emollient actions and examples

A

Lubricate and soften stool
-lubricant: mineral oil
-stool softener: docusate sodium

23
Q

Hyperosmotic actions and examples

A

Increase fecal water content
- polyethylene glycol (PEG)
- Sorbitol
- Lactulose

24
Q

Saline actions and examples

A

Increase osmotic pressure causing more water to enter the intestines
- magnesium hydroxide
- magnesium citrate

25
Q

Stimulant actions and examples

A

Increase peristalsis via intestinal nerve stimulation
- senna
- Bisacodyl

26
Q

Laxative adverse effects

A

Dehydration, electrolyte imbalance
GI irritation
Diarrhea, rectal burning sensation

27
Q

Nursing implications

A

Obtain history of symptoms, bowel elimination patterns, and laxative use
Assess fluid and electrolyte status before initiating therapy
Client teaching
— increase fiber intake ( bran, fresh fruits, veggies, and fluid intake 2-3L/day)
— Use laxatives occasionally if needed
— Do not use laxatives if experiencing N/V and abdominal pain
— Take laxatives with 6-8 oz of water
Take bisacodyl at bedtime for results in 6-12 hrs
; suppositories are effective within one hour

28
Q

Antiemetics therapeutic use

A

Prevent of relieve Nausea and vomiting
Action: block neurological stimulus that induces vomiting

29
Q

Antiemetics examples

A

Antidopaminergic: Prochlorperazine (PO, PR, IM, IV)
Serotonin blocker: Ondansetron (PO, IM, IV)
Prokinetic: Metoclopramide (PO, IM, IV)
Cannabinoid: Dronabinol (PO)

30
Q

Antidopaminergic- Prochlorperazine Adverse Effects

A

Extrapyramidal symptoms (EPS)
Tardive dyskinesia
Sedation
Hypotension
Anticholinergic effects

31
Q

Serotonin blocker - Ondansetron Adverse Effects

A

Headache, dizziness
Dysrhythmia
Diarrhea

32
Q

Prokinetic- Metoclopramide Adverse Effects

A

EPS
Tardive dyskinesia
Sedation
Diarrhea

33
Q

Cannabinoid- Dronabinol Adverse Effects

A

Hypotension
Tachycardia
Dysphoria

34
Q

Antiemetics Contraindications

A

Caution in clients with asthma, narrow angle glaucoma, and urinary retention or GI obstruction
Caution in children and older adults

35
Q

Antiemetic Interactions

A

Antiemetics and opioids or alcohol —> increased CNS depression
Antiemetics and antihypertensives —> increased hypotensive effects

36
Q

Nursing implications for antiemetics

A

Assess precipitating factors for N/V, medical history, and current medications
Give antiemetics 30-60 min before chemotherapy
Assess for Anticholinergic effects and EPS

37
Q

Client teaching for antiemetics

A

Avoid driving and performin hazardous tasks due to sedations
Do not combine alcohol and antiemetics due to CNS depression
Change positions slowly due to orthostatic hypotension
Stop the medication and notify the provider if positive for EPS.
Increase fluid intake, engage in physical activity, and suck on hard candy or chew gum to help relieve Anticholinergic effects

38
Q

What is gonna be on our test

A

Question on fimetidine
When shouldn’t you give certain medications.. remember contraindications
Do not give Laxatives, antidiarrheals, antacids (can stimulate the GI tract as well), and antiemetics with someone with GI obstructions
Evaluate the effectiveness of a medication: need to know if the medication is working
A lot of questions on antacids
Different GI medications address different GI issues
Know specific contraindications for each specific antacid
Lactulose will give you diarrhea : remember that if you are inducing diarrhea you are concerned about electrolyte imbalance. (Electrolytes include Sodium, magnesium, potassium.)
Laxatives don’t usually work right away. Baseline they take 1-3 days exception would be per rectum or saline
Almost all laxatives are PO example saline is PO but bisocodyl are PR and PO there are saline that can also be used as PR as well
A lot of questions on constipation use and diarrhea use
Know mechanism of action for each antiemetics…. Example Metoclopramide helps empty stomach contents faster
Bisocodyl and senna : if someone stops taking them the body is gonna withdraw (it stimulates GI effects) so body will depend on it gonna be worried about dependency
Remember dehydration for laxatives

Pharmacology (5 decks)

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