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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

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7
Q

Nursing Considerations

alosetron

A

Last resort due to potential for significant side effects.

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8
Q

Indications

alosetron

A

IBS-D

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9
Q

MOA/Class

loperamide

A

Inhibits GI motility

Synthetic opiate

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10
Q

Side Effects

loperamide

A

Constipation

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11
Q

Nursing Considerations

loperamide

A

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

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12
Q

Indications

loperamide

A

Diarrhea / IBS-D

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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

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14
Q

Side effects

linaclotide

A

Diarrhea, altered electrolyte levels

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15
Q

Nursing Considerations

linclotide

A

Contraindicated with possibility of bowel obstruction

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16
Q

Indications

linaclotide

A

IBS-C

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17
Q

MOA/Class

sulfasalazine
mesalamine

A

Antiinflammatory

Salicylate/DMARD

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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
Q

MOA/Class

prednisone, hydrocortisone, methylprednisolone

A

Inhibits inflammatory mediators / immunosuppressant

Corticosteroid/glucocorticoid

Tucker 36

26
Q

Side Effects

prednisone, hydrocortisone, methylprednisolone

A

Fluid retention, weight gain, immunosuppression, amenorrhea, impaired wound healing, fragile skin, hyperglycemia, osteoporosis, peptic ulcers, growth suppression, increased IOP

Tucker 36

27
Q

Nursing Considerations

prednisone, hydrocortisone, methylprednisolone

A

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.

Tucker 36

28
Q

Indications

prednisone, hydrocortisone, methylprednisolone

A

Management of inflammatory, autoimmune, or allergic disorders. Usually used for flare-up/exacerbation; not maintenance therapy due to adverse effects.

Tucker 36

29
Q

MOA/Class

azathioprine
cyclosporine

A

Suppresses cell-mediated immunity

Immunosuppressant

Tucker 17

30
Q

Side Effects

azathioprine
cyclosporine

A

Bone marrow suppression. Hepatotoxicity.

Tucker 17

31
Q

Nursing Considerations

azathioprine
cyclosporine

A

Increased risk for infection and cancers. Avoid live-virus vaccines. Good infection control implementation. Avoid grapefruit juice.

Tucker 17

32
Q

Indications

azathioprine
cyclosporine

A

Crohn’s disease/UC
(also transplant rejection, RA)

Tucker 17

33
Q

MOA/Class

methotrexate

A

Anti-metabolite. (Interferes with folic-acid metabolism - inhibits cell replication.) Suppresses immune response.

Immunosuppressant/DMARD

Tucker 14

34
Q

Side Effects

methotrexate

A

Bone marrow suppression. Hepatotoxicity.

Tucker 14

35
Q

Nursing Considerations

methotrexate

A

Supplement folic acid intake

Tucker 14

36
Q

Indications

methotrexate

A

Crohn’s disease/UC
(also psoriasis, RA)

Tucker 14

37
Q

MOA/Class

omeprazole
pantoprazole

A

Suppresses gastric acid secretion by blocking the proton pump of the parietal cells.

Proton pump inhibitor

Tucker 57

38
Q

Side Effects

omeprazole
pantoprazole

A

Headache, dizziness, abdominal pain.
Bone density loss, c. diff, pneumonia (with long-term use).

Tucker 57

39
Q

Nursing Considerations

omeprazole
pantoprazole

A

May alter absorption of other drugs.
Self-medication with OTC drugs may mask underlying problems.

Tucker 57

40
Q

Indications

omeprazole
pantoprazole

A

Hypersecretory conditions. GERD. Stress ulcer prevention.

Tucker 57

41
Q

MOA/Class

cimetidine
famotidine

A

Blocks H2 receptors on parietal cells preventing the release of HCl acid.

Histamine (H2) receptor blocker

Tucker 57

42
Q

Side Effects

cimetidine
famotidine

A

Headache, somnolence, confusion, hallucinations, gynecomastia.

Tucker 57

43
Q

Nursing Considerations

cimetidine
famotidine

A

Cimetidine has higher profile for adverse side effects than famotidine.

Tucker 57

44
Q

Indications

cimetidine
famotidine

A

Hypersecretory conditions. GERD. Stress ulcer prevention.

Tucker 57

45
Q

MOA/Class

  • Bisocodyl, senna
  • Psyllium
  • Magnesium formulations, lactulose, polyethylene glycol
  • Docusate
A
  • Bisocodyl, senna - stimulant laxative
  • Psyllium - bulk-forming laxative
  • Magnesium formulations, lactulose, polyethylene glycol- osmotic laxative
  • Docusate - lubricant laxative

Tucker 58

46
Q

Side Effects

  • Bisocodyl, senna
  • Psyllium
  • Magnesium formulations, lactulose, polyethylene glycol
  • Docusate
A

Diarrhea, cramping, bloating

Tucker 58

47
Q

Nursing Considerations

  • Bisocodyl, senna
  • Psyllium
  • Magnesium formulations, lactulose, polyethylene glycol
  • Docusate
A

Contraindicated with acute abdominal disorders (risk for bowel rupture).
Overuse can lead to dependence.

Tucker 58

48
Q

Indications

  • Bisocodyl, senna
  • Psyllium
  • Magnesium formulations, lactulose, polyethylene glycol
  • Docusate
A

Constipation
(lactulose - elevated serum ammonia)

Tucker 58

49
Q

Indication

bismuth subsalicylate
diphenoxylate with atropine

A

Diarrhea

Tucker 58

50
Q

MOA/Class

metoclopramide

A

Stimulates motility of the upper GI tract and accelerates gastric emptying

Prokinetic

Tucker 58

51
Q

Side Effects

metoclopramide

A

Low BP/HR, weakness, fatigue (from increased PNS stimulation)
Serious adverse effects include EPS, seizures, and TD

Tucker 58

52
Q

Nursing Considerations

metoclopramide

A

Does not have significant effect on bowel movements since action is in upper GI tract

Tucker 58

53
Q

Indications

metoclopramide

A

Nausea, diabetic gastroparesis, facilitates small bowel intubation

Tucker 58

MSII Medication Review (13 decks)

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