GI System Drugs Flashcards
Hydrochloric acid
Small concentration in dtomach, aids in digestion
Peptic ulcers education
Avoid NSAIDs!
Histamine-2 antagonists - cimetidine (Tagament)
Lower stomach acid production.
Caution w/liver and kidney dysfunction.
Route: PO, IM , IV
Take with or without food
Antacids lower absorption of H2 antagonist so give after an hour
Avoid: smoking, alcohol, NSAIDs, b/c they can irritate GI
Alert: cimetidine can higher level of warfarin (blood thinner)
Proton Pump Inhibitors (PPIs) - omeprazole (Prylesect), pantoprazole (protonics), lansoprazole (Prevesed), esomeprazole (Nexium)
Lower acid in stomach so ulcer can heal.
Caution in pt with liver dysfunction, pregnancy, and B12 deficiency.
Link between PPIs and B12 deficiency: lower stomach acid, higher risk of B12 deficiency b/c stomach acid helps body absorb B12 from blood!
Route: PO (before breakfast, don’t crush, chew, or break open capsules)
Adv Reac: bone loss
Pt education: weight bearing exercise help keep bone straight, plenty of water.
Alert: monitor closely when giving warfarin, dilating, and digoxin b/c can cause B12 deficiency
Mucosal protestants- sucralfate (Carafate)
Coat stomach (barrier)
Route: PO (empty stomach, 4 times/day, 1 hr before meal and at bed time)
Adv reac: constipation
Pt edu: increase fluids, activity and exercise
Alert: no antacids within 30 mins, no warfarin, diazepam, digoxin, tetracycline within 2 hrs
Antacids - aluminum hydroxide
Neutralize acid in stomach
Route, pt edu, and alert same as mucosal protectants.
Adv reac: constipation and diarrhea
Containdications: severe abdominal pain
Serotonin antagonists - ondansetron (Zofran)
Treat nausea and vomitting
Route: PO, IV (1 hr after post anesthesia)
Caution: children < 3, liver dysfunction, pregnancy, lactation
Safety: Don’t use with apomorphine b/c can cause severe hypotension
Antihistamines/anticolinergics - dimenhydrinate (Dramamine)
Help with vertigo (dizziness)
Can’t see/pee/spit/shit!
Route: PO, IM, IV
Adv reac: very sedating, dry mouth, urinary retention, pomstipation, blurred vision
Pt edu: change positions slowly, take sips of water, increase fluid and fiber and activities
Safety: CNS depressants increase sedative effects, MAOI antidepressant increase anticholinergic effects
Can’t use on new borns!
Dopamine antagonists/prokinetic - metoclopramide (Reglan)
Gastric stimulant
Route: IM, IV, PO
Adv reac: sedation, restless, diarrhea
Pt edu: change position slowly, report diarrhea, increase clear fluids, don’t take this before activity that requires mental alertness!
Safety: CNS depressants increase sedative effects and risk of seizures, opioid and anticholinergics decrease therapeutic effects, absorption decrease in Tylenol, aspirin, Valium, digoxin, lithium
Don’t use if has GI bleeding/obstruction, breast cancer
Bulk-forming agents (fiber supplements) - psyllium/metamucil
Non-digestable, absorb water and form mass.
Forms stool in 1-3 days, not immediate effect.
Route: PO, 3 times/day, given with 8 oz water or juice (b/c esophageal/intestinal obstruction can occur)
Don’t use if have fecal impaction, appendicitis, undiagnosed abdominal pain
Pt edu: take med with 8oz of water or juice, report absence of BM/persistent diarrhea, increase fluid
Surfactant laxatives/stool softeners - docusate sodium (Colace)
Soften stool
Route: PO, with 8oz of fluid
Adv reac: diarrhea throat irritations, rashes, mild abdominal cramps
Don’t use in GI obstructions, fecal impaction, undiagnosed abd pain
Stimulant laxatives - bisacodyl (Senna), Castor Oil
Stimulates colon motility
Treat constipation from opioid use or slow intestinal transit, and colon evacuation before procedures
Route: PO, rectal
Adv reac: abdominal cramps, diarrhea, burning sensation, laxative abuse
Don’t use in GI obstruction, fecal impaction, ulcerated hemorrhoids
Pt edu: increase fluid intake to 2-3 liters/day, report diarrhea, rectal discomfort, and bleeding, do not use repeatedly or extended periods@
Aminosalicylates - sulfasalazine
Anti-inflammatory effects on bowel
Treat Crohn’s disease, ulcerative colitis
Don’t use if allergic, children < 2, intestinal obstruction (b/c can worsen)
This interacts with digoxin!
Herbal consideration: chamomile
Antidiarrheals - diphenoxylate (Lomotil), operative (Immodium)
Decrease flow of fluids and electrolytes into bowel
Use for persistent diarrhea
Route: PO (only several doses, call doctor if diarrhea continues)
Adv reac: constipation
Don’t use in E Coli, C Diff, salmonella, colitis, children < 2, undiagnosed abd pain
Pt edu: fluids!
Antiflatulents - smithicone (Gas-X)
Decrease GI gas bubbles’ surface tension, increase elimination
Relieve pressure and bloating
Route: PO, and chewable
Consult before if pregnant
Pt edu: use a straw for drinking, cut down on carbs, eat less cabbage onions and beans (avoid foods that make you fart, eat them in moderation)
