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MSII Medication Review > Lewis 47 - Lower GI Problems > Flashcards

Lewis 47 - Lower GI Problems Flashcards

1
Q

MOA/Class

hycosamine
dicyclomine

A

Decreases stomach and intestinal motility and the secretion of stomach fluids, including acid.

Anticholinergic

Tucker 33

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2
Q

Side Effects

hycosamine
dicyclomine

A

drowsiness, dizziness, dry mouth, urinary retention, tachycardia

Tucker 33

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3
Q

Nursing Considerations

hycosamine
dicyclomine

A

Additive effects with other anticholinergics.

Tucker 33

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4
Q

Indications

hycosamine
dicyclomine

A

IBS-D

Tucker 33

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5
Q

MOA/Class

alosetron

A

Decreased perception of pain and discomfort and decreased GI motility

Serotonin (5-HT3) receptor antagonist

Tucker 58

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6
Q

Side Effects

alosetron

A

Severe constipation; ischemic colitis

Tucker 58

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7
Q

Nursing Considerations

alosetron

A

Last resort due to potential for significant side effects.

Tucker 58

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8
Q

Indications

alosetron

A

IBS-D

Tucker 58

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9
Q

MOA/Class

loperamide

A

Inhibits GI motility

Synthetic opiate

Tucker 58

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10
Q

Side Effects

loperamide

A

Constipation

Tucker 58

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11
Q

Nursing Considerations

loperamide

A

Use cautiously with history of GI obstruction. Monitor for dehydration with persistent diarrhea.

Tucker 58

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12
Q

Indications

loperamide

A

Diarrhea / IBS-D

Tucker 58

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13
Q

MOA/Class

linaclotide

A

Increases secretion of sodium, chloride, and bicarbonate (and fluid) into intestinal lumen

Guanylate cyclase-C receptors agonist

Tucker 58

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14
Q

Side effects

linaclotide

A

Diarrhea, altered electrolyte levels

Tucker 58

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15
Q

Nursing Considerations

linclotide

A

Contraindicated with possibility of bowel obstruction

Tucker 58

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16
Q

Indications

linaclotide

A

IBS-C

Tucker 58

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17
Q

MOA/Class

sulfasalazine
mesalamine

A

Antiinflammatory

Salicylate/DMARD

Tucker 16

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18
Q

Side Effects

sulfasalazine
mesalamine

A

GI upset

Tucker 16

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19
Q

Nursing Considerations

sulfasalazine
mesalamine

A

Monitor for salicylate toxicity (tinnitus, headache, dizziness, acidosis).
Wear sunscreen (photosensitivity).
Increase folic acid intake with sulfasalazine.

Tucker 16

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20
Q

Indications

sulfasalazine
mesalamine

A

irritable bowel disease (IBD)
rheumatoid arthritis (RA)

Tucker 16

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21
Q

MOA/Class

adalimumab

A

Blocks action of TNF - a proinflammatory mediator

Tumor necrosis factor (TNF) blocker

Tucker 16

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22
Q

Side Effects

adalimumab

A

infection, increased risk for lymphomas/cancers (immunosuppression)

Tucker 16

23
Q

Nursing Considerations

adalimumab

A

No live vaccines. Get tested for TB prior to beginning medication. Cancer screenings.

Tucker 16

24
Q

Indications

adalimumab

A

UC/Crohn’s
(also RA, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis)

Tucker 16

25
# MOA/Class prednisone, hydrocortisone, methylprednisolone
Inhibits inflammatory mediators / immunosuppressant | Corticosteroid/glucocorticoid ## Footnote Tucker 36
26
# Side Effects prednisone, hydrocortisone, methylprednisolone
Fluid retention, weight gain, immunosuppression, amenorrhea, impaired wound healing, fragile skin, hyperglycemia, osteoporosis, peptic ulcers, growth suppression, increased IOP ## Footnote Tucker 36
27
# Nursing Considerations prednisone, hydrocortisone, methylprednisolone
Taper dose to discontinue. Avoid live-virus vaccines. Infection control measures. Encourage calcium/vit D with long-term use. Reduced efficacy of antidiabetics. Additive GI problems with NSAIDS/ASA. ## Footnote Tucker 36
28
# Indications prednisone, hydrocortisone, methylprednisolone
Management of inflammatory, autoimmune, or allergic disorders. Usually used for flare-up/exacerbation; not maintenance therapy due to adverse effects. ## Footnote Tucker 36
29
# MOA/Class azathioprine cyclosporine
Suppresses cell-mediated immunity | Immunosuppressant ## Footnote Tucker 17
30
# Side Effects azathioprine cyclosporine
Bone marrow suppression. Hepatotoxicity. ## Footnote Tucker 17
31
# Nursing Considerations azathioprine cyclosporine
Increased risk for infection and cancers. Avoid live-virus vaccines. Good infection control implementation. Avoid grapefruit juice. ## Footnote Tucker 17
32
# Indications azathioprine cyclosporine
Crohn's disease/UC (also transplant rejection, RA) ## Footnote Tucker 17
33
# MOA/Class methotrexate
Anti-metabolite. (Interferes with folic-acid metabolism - inhibits cell replication.) Suppresses immune response. | Immunosuppressant/DMARD ## Footnote Tucker 14
34
# Side Effects methotrexate
Bone marrow suppression. Hepatotoxicity. ## Footnote Tucker 14
35
# Nursing Considerations methotrexate
Supplement folic acid intake ## Footnote Tucker 14
36
# Indications methotrexate
Crohn's disease/UC (also psoriasis, RA) ## Footnote Tucker 14
37
# MOA/Class omeprazole pantoprazole
Suppresses gastric acid secretion by blocking the proton pump of the parietal cells. | Proton pump inhibitor ## Footnote Tucker 57
38
# Side Effects omeprazole pantoprazole
Headache, dizziness, abdominal pain. Bone density loss, c. diff, pneumonia (with long-term use). ## Footnote Tucker 57
39
# Nursing Considerations omeprazole pantoprazole
May alter absorption of other drugs. Self-medication with OTC drugs may mask underlying problems. ## Footnote Tucker 57
40
# Indications omeprazole pantoprazole
Hypersecretory conditions. GERD. Stress ulcer prevention. ## Footnote Tucker 57
41
# MOA/Class cimetidine famotidine
Blocks H2 receptors on parietal cells preventing the release of HCl acid. | Histamine (H2) receptor blocker ## Footnote Tucker 57
42
# Side Effects cimetidine famotidine
Headache, somnolence, confusion, hallucinations, gynecomastia. ## Footnote Tucker 57
43
# Nursing Considerations cimetidine famotidine
Cimetidine has higher profile for adverse side effects than famotidine. ## Footnote Tucker 57
44
# Indications cimetidine famotidine
Hypersecretory conditions. GERD. Stress ulcer prevention. ## Footnote Tucker 57
45
# MOA/Class * Bisocodyl, senna * Psyllium * Magnesium formulations, lactulose, polyethylene glycol * Docusate
* Bisocodyl, senna - stimulant laxative * Psyllium - bulk-forming laxative * Magnesium formulations, lactulose, polyethylene glycol- osmotic laxative * Docusate - lubricant laxative ## Footnote Tucker 58
46
# Side Effects * Bisocodyl, senna * Psyllium * Magnesium formulations, lactulose, polyethylene glycol * Docusate
Diarrhea, cramping, bloating ## Footnote Tucker 58
47
# Nursing Considerations * Bisocodyl, senna * Psyllium * Magnesium formulations, lactulose, polyethylene glycol * Docusate
Contraindicated with acute abdominal disorders (risk for bowel rupture). Overuse can lead to dependence. ## Footnote Tucker 58
48
# Indications * Bisocodyl, senna * Psyllium * Magnesium formulations, lactulose, polyethylene glycol * Docusate
Constipation (lactulose - elevated serum ammonia) ## Footnote Tucker 58
49
# Indication bismuth subsalicylate diphenoxylate with atropine
Diarrhea ## Footnote Tucker 58
50
# MOA/Class metoclopramide
Stimulates motility of the upper GI tract and accelerates gastric emptying | Prokinetic ## Footnote Tucker 58
51
# Side Effects metoclopramide
Low BP/HR, weakness, fatigue (from increased PNS stimulation) Serious adverse effects include EPS, seizures, and TD ## Footnote Tucker 58
52
# Nursing Considerations metoclopramide
Does not have significant effect on bowel movements since action is in upper GI tract ## Footnote Tucker 58
53
# Indications metoclopramide
Nausea, diabetic gastroparesis, facilitates small bowel intubation ## Footnote Tucker 58

MSII Medication Review (13 decks)

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