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Pharmacology 101 > Lecture 12 Nursing 100 > Flashcards

Lecture 12 Nursing 100 Flashcards

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1
Q

GI Assessment

A 
assess normal bowel habits
gather data on diarrhea or constipation
Poor dietary habits
Rx side effects
Interventions to promote normal elimination
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2
Q

Antidiarrheals

A

Reduce fluidity of BM & frequency

Act locally or systemically

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3
Q

Lomotil

A 
related to opiates- systemic, central acintg put intestines to sleep
a synthetic Rx close to Demerol
schedule V
Decreases peristalsis in intestines
combined with Atropine
Used to Tx acute non-specific diarrhea
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4
Q

Lomotil Drug Interactions

A 
Increases effect of:
 barbiturates
 ETOH
narcotics
Sedatives & other CNS depressants
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5
Q

Lomotil Adverse Reactions

A

GI - N/V, discomfort
CNS depression
physical dependence

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6
Q

Lomotil Nursing Implications

A 
Check fluid & electrolyte status
insure adequate fluid volume before Tx
Hold if abdominal distention
no bowel sounds or no flatus
Caution in liver dysfunction
HX of narcotics dependence 
Caution in prostate hypertrophy
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7
Q

Kaopectate

A 
drink it- coats intestines; absorbs irritants
don't give with po meds
mixture of Kaolin & pectin (OTC)
Local acting
Acts as absorbents & protectants
Binds irritants
Used in mild to moderate diarrhea
Interacts to decrease absorption (Digoxin)
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8
Q

Kaopectate Adverse reactions

A

constipation

generally mild and safe

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9
Q

Kaopectate Nursing implications

A

Monitor GI response

Document frequency and consistency of BMs

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10
Q

Laxatives- 4 types

A 
Used to eliminate soft, formed stool
Cathartics
used to cause fluid evacuation
1. hyperosmolar
2.Bulk forming
3. Emollient
4. Stimulants
5. Lubricant
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11
Q

Hyperosmolar laxatives

A

Produces osmotic effect
Causes fluid accumulation & distention
Increases peristalsis

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12
Q

Lactulose (Cephulac)

A

hyperosmolar laxative
Used to decrease ammonia levels
r/t liver dysfunction & encephalopathy
Manages chronic constipation

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13
Q

Milk of Magnesia

A 
hyperosmolar laxative
Can lose a lot of Ca and K loss
eat normal diet
Complete bowel evacuation
Can cause fluid & electrolyte imbalances
N/V, diarrhea, abd. distention, flatus
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14
Q

Milk of Magnesia Nursing Implications

A

Check Fl. & Elec, acid-base, dehyd
check cardiac status
teach proper use of laxatives and bowel training

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15
Q

Bulk-Forming (metamucil)

A 
makes jelly blob in GI tract- pulls in liquid
Most natural
Prevents or Tx constipation
Not absorbed
Act by increasing bulk & H20
promotes peristalsis
Used for simple constipation
r/t low fiber or fluids
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16
Q

Bulk-Forming Laxative Nursing implications

A

Educate patient about
low salt & sugar diet
need for exercise
increase fluids

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17
Q

Emollient (Surfax, Dialose, Colace)

A 
Stool Softeners (reduce surface tension, fluid accumulates)
Usually safe
Used to prevent constipation
Helps pt avoid straining
MI, ICP, rectal surgery, hernia
Interacts w/ ASA, may inc. absorption
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18
Q

Emollient Implications

A 
Made with different salts
Use caution w/ 
K in renal dysfunction
Na in cardiac pt.
Hold if having diarrhea
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19
Q

Stimulants (irritant cathartics) Ducolax and golytly

A

Stimulates peristalsis by irritating mucosa
Stimulates nerve endings in intestinal smooth muscles
Alters fluid & electrolyte absorption
Act on colon

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20
Q

Stimulants uses

A

Empty bowel before surgery/ GI procedures
Constipation r/t bedrest
Neurologic dysfunction of colon
Constipation r/t narcotics

21
Q

Stimulants Adverse Reactions

A 
weakness
Nausea/cramps
Suppository may cause burning
electrolyte imbalance
K & Ca loss
Metabolic Acidosis or Alkalosis
22
Q

Stimulants Nursing Implications

A

Contraindicated in:
abdominal pain
sx appendicitis
rectal bleeding

23
Q

Lubricant Laxative

A 
Mineral oil increases water retention
Used for fecal impaction
Given po or rectally
Treats constipation
softens stool
avoids straining
24
Q

Antiflatulants (mylicon, simethicone

A 
Disperse gas pockets
Antifoaming, Water repellent
Not absorbed, Distributed in intestines
used post op, diverticulitis
spastic colon, peptic ulcer
May increase rectal flatus
25
Q

Antiflatulants Nursing Implications

A 
Obtain pt history
R/O pathologic abdominal problem
Monitor effectiveness
Encourage activity
exercise decreases bloating & Rx need
Make them walk
26
Q

Digestives

A

Replace specific substances to digest food
May lack in GI tract, Liver or Pancreas
Natural body substances
Action same as substance they replace

27
Q

Pancrease

A 
replaces pancreatic enzymes
act to digest proteins, CHO, fats
Used in pancreatitis, Cystic Fibrosis
Interact with antacids 
Side Effects N/D
28
Q

Pancrease Pt Education

A

Number of BMs will decrease
Consistency of BM improves
Store in air tight case at room temperature
Do not use if allergic to pork or beef
Enc. dietary balance fat/CHO/ Protein
Cystic fibrosis- excessive mucous produced

29
Q

Emetics Syrup of Ipeac

A 
Used to stimulate vomiting
Emergency  Tx acute poisoning
Onset 10 -30 minutes
Action - stimulates vomit center- medulla
local effect on gastric mucosa
OTC
Interacts- milk, charcoal, antacids
30
Q

Antiemetics- antihistamine

A 
Benedryl, Vistaril
Dramamine, Tigan, Antivert
Block Histamine receptors
Decrease Nausea/Vomiting & Vertigo
Also anticholinergic effect (dry mouth, blurred vision, urine retention, constipation)
Used to prevent & treat motion sickness
Best for nausea & vertigo
31
Q

Antiemetics Additive effects

A

anticholinergics
tricyclic antidepressants
antiparkinsons
CNS depressants

32
Q

Antiemetics Adverse reactions

A

r/t antichoilnergic effects
CNS depression
Sedation
Dizziness

33
Q

Antiemetics Nursing Implications

A

Caution with glaucoma, urine retention, ulcer or GI obstruction
Caution with enlarged prostate, asthma (anticholinergic effects)
Caution if sedated, don’t drive, don’t use ETOH

34
Q

Phenothiazines (compazines, phenergan)

A

Blocks dopaminergic receptor in medulla (vomit center)
Controls severe N/V due to disease, anesthesia, chemo
Not as effective in motion sickness
Used in acute cases & short term
Interacts with CNS depressant, narcotics, sedatives, ETOH, Anticholinergics

35
Q

Phenothiazines Adverse Reactions

A 
CNS depression
Lowers threshold for seizures
Low BP, postural hypotension
Decreased muscle tone
Skin effects, photosensitivity
36
Q

Phenothiazines Nursing Implications

A

Not to pt w/ CNS disorders, C-V disease, Liver disease
Caution if convulsive disorder, brain tumor
Use caution in children
Avoid if has dermatitis
Avoid prolonged sun-light
Monitor BP

37
Q

Peptic Ulcer Agents

A

Ulcer- open lesion in mucous membrane (esoph., stom.)
5 -10% US population
Due to stress, diet, acid secretions, infection
Aim of TX- neutralize acid
decrease acid secretions
bind to ulcer

38
Q

Antacids

A

Contains Al, Mg, Ca
Base anion combines with H cation to = H20
Usual pH 1.3 - 2.3 increases to 4.0 or 5.0
Decreases action of pepsin
Decreases acid secretion so ulcer heals
Most effective around the clock schedule (not prn)

39
Q

Antacids Uses

A 
relieve pain & heart burn
promote healing of ulcer
prevent stress ulcer
Aluminum to decrease phosphorus in renal failure
Best 1 hr PC and 3 hr PC & HS
40
Q

Types of Antacids

A

Mylanta- More Mg, laxative effect
Maalox - More Al, constipating effect
Interact to decrease absorption of all med..
Caution with high Na in CHF, HTN, & K in Renal Fail.

41
Q

Antacid Nursing Implications

A

No high Mg in renal disease- can’t excrete
Caution in elderly, decrease bowel motility, fluid retention
May cause constipation or impaction
Monitor color of stools and numbers

42
Q

Histamine 2 receptor antagonists cimetidine and ranitidine

A

Treats duodenal ulcers
Blocks stimulant action of histamine at parietal cells
decreases acid secretion so ulcer can heal

43
Q

Protonix (pantoprazole)

A

gastric acid pump inhibitor

44
Q

Protonix Interactions

A

Antacids decrease absorption of acid

Cimetadine inhibits liver enzyme and changes Rx action

45
Q

Protonix Adverse reactions

A

HA, dizzy, N/D, constipation, skin rash

Loss of libido & impotence (Tagamet)

46
Q

Protonix Nursing Implications

A

decrease dose in elderly
may cause confusion
caution if renal or hepatic impairment

47
Q

Sucralfates (carafate)

A

Short term Tx duodenal ulcers
In acid forms paste & adheres to ulcer
Adverse Reactions- constipation, N, metallic taste

48
Q

Sulcrafates Nursing Implications

A

Give on empty stomach 1 hr ac and HS
DO not give with antacids (won’t work)
Avoid giving aspirin to patient’s with ulcers & GI bleed or irritation

Pharmacology 101 (15 decks)

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