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Collab Therapies 2 > GI system 2 - Antidiarrheals > Flashcards

GI system 2 - Antidiarrheals Flashcards

1
Q

What are some nursing interventions for pts experiencing diarrhea?

A
  • replace fluid and electrolytes
  • IV hydration
  • do not administer antidiarheal agent if pt is suffering from an organism (we want to let the microbe out)
  • handwashing
  • contact isolation précaution if indicated (if infected)
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2
Q

What are the two main electrolytes lost with diarrhea?

A

Potassium and saline (Na+)

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3
Q

Which laxatives is considered adsorbent?
What is the prototype medication

A

Bismuth subsalicylate (pepto-bismol)

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4
Q

What are some AE associated with bismuth subsalicylate (pepto bismol)?

A

Similar to aspirin:

  • increase bleeding time
  • dark stools
  • black tongue
  • confusion in older adults
  • metallic taste
  • tinnitus
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5
Q

How does bismuth subsalicylate works?

A
  • Works by coating the walls of the GI tract
  • Binds to the causative bacteria which is then eliminated through the stool
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6
Q

What are some contraindications and caution use with bismuth subsalicylate (pepto bismol)?

A
  • KDA
  • major acute GI conditions like obstruction or colitis
  • children under 18 yrs old

Caution use with:
- kids or adolescents recovering from influenza or chicken pox due to increase risk for Rey’s syndrome

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7
Q

How should bismuth subsalicylate (pepto bismol) the adsorbent anti diarrheal should be taken?

A
  • should be chewed thoroughly
  • take with at least 180mls of water
  • DO NOT TAKE QOTH LTHER SALICYLATES (risk of toxicity)
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8
Q

What are some meds interactions with bismuth subsalicylate (pepto bismol)?

A
  • affects absorption of meds from intestine to blood stream
  • decrease effect of : digoxin, quinidine, antihyperglycemics, sulfa
  • increase bleeding time: warfarin, aspirin, NSAIDs
  • binds to vitamin K
  • increase toxicity : other salicylates
  • increase toxicity: methotrexate
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9
Q

Which anti diarrheal is considered anti motility opioid?

A

Loperamide (Imodium)

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10
Q

How does loperamide (Imodium) work?

A
  • decrease bowel motility
  • decreases pain of diarrhea by relief of rectal spams
  • increases absorption of water and electrolytes and other nutrients
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11
Q

How should loperamide (Imodium) be taken?

A
  • take without regard to food
  • take with adequate fluids
  • can be given with simethicone (ovol)
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12
Q

What are some contraindications to anti motility opioid antidiarrheal loperamide (Imodium)?

A
  • KDA
  • ulcerative colitis
  • pseudomembranous colitis
  • pregnancy and breastfeeding
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13
Q

What are some AE with loperamide (Imodium)?

A
  • nausea
  • vomiting
  • constipation
  • resp dépression
  • hypotension
  • urinary retention
  • drowsiness/ dizziness
  • lethargy
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14
Q

What are some meds interactions with loperamide (Imodium)?

A
  • causes CNS depression with: alcohol, opioids, sedatives, antipsychotics, skeletal muscle relaxants
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15
Q

Which anyidiarrheals are used for severe cases of diarrhea?

A
  • loperamide (Imodium) (anti motility opioid)
  • atropine sulphate (anti motility anticholinergic)
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16
Q

Which antidiarrheals are considered anti motility anticholinergic?

A
  • atropine sulphate
  • belladonna alkaloids
17
Q

How do atropine sulphate work?

A
  • slows peristalsis, decrease rhythm and contractions
  • decreases smooth muscle tone in GI tract
  • has drying effects, decreases gastric secretions
18
Q

What are some AE with atropine sulphate the anticholinergic antidiarrheal?

A
  • urinary retention
  • sexual dysfunction
  • headache
  • dizziness
  • dry skin, flushing
  • dry mouth
  • confusion
  • blurred vision
  • hypotension, Brady🤍
19
Q

What are some contraindications to the use of the antidiarrheal atropine sulphate?

A
  • KDA
  • major acute GI conditions (obstruction, colitis)
  • c. Diff
  • after antibiotic use
  • children under 6 yrs old
20
Q

What are some drug interactions with atropine sulphate?

A
  • decrease effect: antacids
  • increased cholinergic effect: amantadine, tricyclic antibiotic, monoamines, opioids, antihistamines
21
Q

A 45 yrs old woman has been diagnosed with IBS and has numerous bowel movements each day. She has been prescribed loperamide. What are the actions the this drug? Select all that apply

A) reduces the daily fecal volume
B) increases viscosity and bulk of the BM
C) reduces the loss of fluids and electrolytes associated with watery bowel movements
D) cures the disease process by eliminating the infection causing IBS
E) reduces the bowel incontinence and urgency

A

a
A, B, C, E

22
Q

A pt calls to ask about giving a medication for diarrhea to his 12 yes old child, who is recovering from the flu. The nurse expects the HCP to recommended which medication?

A) bismuth subsalicylate
B) lactobacillus GG
C) belladonna alkaloid with phenobarbital
D) loperamide

A

D

23
Q

What are some pt teachings about use of antidiarrheals?

A

Teach pt to report any:
- abdominal distension
- firmness of abdomen
- abdominal pain
- worsening or sameness of symptoms
- fever
- rectal bleeds
- unrelieved diarrhea
- n, v or other GI related s&s
- muscle cramping or weakness
- dizziness

24
Q

True or false, bismuth subsalicylate is used to treat constipation?

A

False, it is used to tx diarrhea

25
Q

True or false, bismuth subsalicylate (pepto bismol) should not be given to children?

A

True, should not be given to children under 18

26
Q

Which antodiarrheal does the nurse associate with the development as AE of urinary retention, headache, confusion, dry skin, rash and blurred vision?

A) anticholinergic (atropine)
B) adsorbent (bismuth subsalicylate)
C) probiotics
D) opiates (loperamide)

A

A

27
Q

True or false, simethicone (ovol) can relieve diarrhea?

A

False, it is used to decrease gas formation and belching in the GI TRACT

28
Q

A pt who takes warfarin has been prescribed an adsorbant for diarrhea. It is important for the nurse to assess the pt for bruising because the use of warfarin with adsorbents (bismuth subsalicylate) interferes with the absorption of which vitamin?

A) vitamin A
B) vitamin D
C) Vitamin E
D) Vitamin K

A

D

The oral anticoagulant warfarin is more likely to cause increased bleeding times or bruising when coadministered with adsorbents since the adsorbent binds to vitamin K

29
Q

The anti diarrheal drug Lomotil (combo of diphenoxylate w/ atropine) contains both diphenoxylate, a synthetic opiate antagonist and atropine, an anticholinergic. What is the purpose of the atropine in this combination?

A) to enhance the effects of diphenoxylate
B) to discourage recreational use of the opiate diphenoxylate
C) to counteract the AE of the diphenoxylate
D) to act as an adsorbent for bacteria in the bowel

A

B

Collab Therapies 2 (28 decks)

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