Module 8: GI Maze Flashcards
A microorganism that causes disease
Pathogen
A test that is used to detect the presence of bacteria or fungi in the blood
Culture
A test to determine how susceptible a microorganism is to a medication
Sensitivity
An antimicrobial that targets only specific subsets of bacterial pathogens
Narrow Spectrum Antimicrobial
An antimicrobial that targets a wide variety of bacterial pathogens including gram positive and gram negative bacteria.
Broad -Spectrum Antimicrobial
Secondary infection in a patient that has a preexisting infection
Superinfection
Drugs that stop bacteria from reproducing
Bacteriostatic
Drugs that kill their target bacteria
Bactericidal
The way in which a drug affects microbes at the cellular level
Mechanism of Action
Antagonism can occur between two antimicrobials or between antimicrobials and non-antimicrobials being used to treat other conditions; produce harmful effects
Antagonistic Interactions
Concurrent drug administration produces a _________ ________ that is better than the efficacy of either drug alone.
Ex: trimethoprim and sulfamethoxazole (Bactrim)
Synergistic Interaction
If a medication inhibits the growth of a microorganism, the organism is __________ to the medication.
; Sensitive
Methicillin Resistant Staphylococcus Aureus (MRSA) is an example of
Gram Positive
Type of antimicrobials that minimize the risk of superinfections
Narrow Spectrum Antimicrobials
Inhibit RNA protein synthesis and suppress reproduction of the bacteria.
-Are bacteriostatic as they do not actually kill bacteria, but inhibit additional growth and allow the body’s immune system to kill the offending bacteria
Macrolides
_______ occurs when gastric or duodenal ulcers are caused by the breakdown of GI mucosa by pepsin, in combination with the caustic effects of hydrochloric acid.
; the most harmful disease related to hyperacidity because it can result in bleeding ulcers, a life-threatening condition.
Peptic Ulcer Disease (PUD)
used to neutralize stomach acid and reduce the symptoms of heartburn
Ex: Calcium Carbonate
Antacids
Greek word for twisted chain, is responsible for many types of infectious diseases in humans. (Gram +)
Streptococcus
A second example of a Gram + bacteria. The bacteria comes from a Greek word for bunches of grapes, which describes their microscopic appearance in culture.
Staphylococcus
Directly impact interaction and reproduction of the offending microorganism; treat specific viral infections.
Antiviral drugs
Rate at which 50% of a drug is eliminated from the plasma
Half-life
This means that there is a more significant killing of the bacterial with increasing levels of the antibiotic.
Dose dependent
These medications have optimal bacterial killing effect at lower doses over a longer period of time; These antimicrobials exert the greatest effect by binding to the microorganism for an extensive length of time.
Time dependent
; Penicillin
Three common mechanisms of antidiarrheals are:
- Absorbents: help eliminate the toxin or bacteria from the GI tract
- Antimotility Agents: slow peristalsis
- Probiotics: help to restore normal bacteria found in lower intestine
- Oral rehydration agents may also be used to replace fluid
- Antibacterial agents may also be used to treat diarrhea caused by specific infections
Classification: Antiemetic; antihistamine
Action: To stop nausea, vomiting, dizziness; inhibits vestibular stimulation
Why Take It: Vertigo, nausea, car sickness
Overexpression:
Administration: not to exceed 400mg/day
Follow Up: Still experiencing nausea?
Education: May cause drowsiness, may cause dry mouth, avoid driving after taking
Dimenhydrinate (Gravol)
Classification: Antidiarrheal
Action: Work to absorb more fluid out of the stool and low peristalsis down (allows for more solid stool)
Why Take It: Diarrhea
Overexpression: Constipation
Administration: May not want to give if the diarrhea is from a bug/virus/bacteria as this will trap it inside the body
Follow Up: Still experiencing diarrhea, any constipation?
Education: watch for constipation
Loperamide
Classification: Prokinetic Antiemetic
Action: Blocks dopamine receptors, which cause nausea when triggered
Why Take It: Nausea, vomiting, hiccups, migraine, prevention of chemotherapy-induced emesis
Overexpression: Extrapyramidal symptoms
Administration: IV use can cause EPS
Follow Up: Still experiencing nausea?
Education: May cause drowsiness, signs of EPS; can cause GI upset and diarrhea
Metoclopramide
Classification: Histamine-2 Receptor Antagonist, Antiulcer Agent
Action: Attach to histamine-2 receptors on parietal cells in the stomach which prevents acid from being released
Why Take It: Ulcer, GERD, heartburn
Overexpression: Acid rebound
Administration:
Follow Up: pain? acid reflux?
Education: may cause drowsiness (Driving), avoid alcohol and other things that may cause GI irritation
Ranitidine
; INHIBITS RELEASE OF ACID
Classification: Antacid
Action: Neutralizes the acid in the stomach (acid causes pain to the lining of the stomach where ulcer is)
Why Take It: Ulcer
Overexpression: Hypercalcemia, too much acid produced due to brain thinking stomach needs more with neutralized acid
Administration: Rebound effect; patient should be on something longer acting for long term use
Follow Up: Pain? GERD?
Education:
Calcium Carbonate
; NEUTRALIZE ACID
Classification: Proton Pump Inhibitor
Action: Interferes with proton pump that has a role in acid production; inhibition of production of acid
Why Take It: Ulcer, GERD
Overexpression: Too much reduction of production of acid (rebound effect)
Administration: Best on empty stomach; other meds may not work properly if they require an acidic environment
Follow Up: GERD? Pain?
Education: Advise patient to avoid alcohol, report black tarry stool, report abdominal pain, take med as directed for full course of TX
Pantoprazole
(prazoles)
; INHIBIT PRODUCTION OF ACID
Classification: Macrolide Antibiotic
Action: Inhibit RNA protein synthesis and suppress reproduction of the bacteria; bacteriostatic
Why Take It: Infection; streptococcal infections; syphilis; gonorrhea
Overexpression: Nausea; kill normal/good flora= GI symptoms; superinfections (yeast infections, thrush of mouth, fungal infections, gut infections (diarrhea/C. diff)
Administration: Anaphylaxis? Renal toxicity, hepatotoxicity, can be given empty or full stomach, often given when people are allergic penicillin
Follow Up: resolution of signs and sx of infection? improvement of acne lesions if for acne
Education: take med around the clock when supposed to, take full course even if feeling better, may cause nausea/vomiting/stomach cramping/diarrhea
Erythromycin
Classification: Osmotic Laxative
Action: Increase fluid in stool to allow for better defecation
Why Take It: Constipation (natural or from med)
Overexpression: Diarrhea
Administration: PEG should not be used for more than 2 weeks at a time
Follow Up: reduced/stopped constipation; a soft formed bowel movement?
Education: Inform patient 2-4 may be needed to produce bowel movement; encourage non-pharmacological measures like fibre, fluids, and movement
Polyethylene Glycol (PEG)
Classification: Stimulant
Action: Stimulate lining of the intestine muscles to contract to move stool through
Why Take It: Constipation
Overexpression: Diarrhea
Administration: More aggressive than osmotic laxative; prolonged use may cause dependence
Follow Up: Soft, formed bowel movement? Resolution of constipation?
Education: Short term therapy; encourage non-pharmacological measures like fibre, fluids and movement
Bisacodyl
What are possible reason someone may experience nausea?
Illness, motion sickness, pregnancy, anxiety/stress, side effect of meds, withdrawal, substance use, surgery/anesthetic, anticipatory nausea, poison/toxin
; Stimulates motility of the upper GI tract
; Blocks dopamine in the CTZ (medulla oblongata)
; Works as antiemetic
; Can cause EPS with IV use
; Unlabeled use is to manage hiccups
Metoclopramide
Prokinetic Antiemetic
When going to Mexico to elope, I make sure to pack which medication?
Loperamide (Antidiarrheal)
What are important non-pharmacological interventions to prevent constipation?
; Encourage fluids ; Encourage mobility and movement as tolerated ; Prune juice ; Encourage fibre intake
Why is it important to deal with constipation?
; Bowel obstruction and perforation of the bowel(s)
Which laxative is used in “Active Treatment”?
Bisacodyl/Senekot
; Stimulant
Which laxative is used prophylactically(preventative)?
Polyethylene Glycol
; Osmotic Laxative
True or False:
The terms H2 Antagonist and Antihistamine are interchangeable terms as they mean the same thing.
False
; Antihistamine blocks H1 receptors and H2 Antagonist blocks H2 receptors
True or False:
Antacids can increase stomach acid.
True
; Bounce back effect after discontinuing AND also if you take them a lot they can increase acid (stomach becomes alkaline and signals brain to signal to produce more acid)
What important aspects of antibiotic therapy should the nurse include in patient education?
; Take full course of treatment even if feeling better
; Use probiotic while on antibiotic to encourage normal flora
; When to take in
; How to take it, empty/full stomach
Works to absorb more fluid out of the stool and slow peristalsis down (allows for more solid stool)
Loperamide (Antidiarrheal)
Blocks dopamine receptors, which cause nausea when triggered
*EPS possible when given by IV
Metoclopramide
; Prokinetic Antiemetic
Attach to histamine-2 receptors on parietal cells in the stomach which prevents acid from being released
*INHIBITS RELEASE OF ACID
Ranitidine
; Histamine 2 Receptor Antagonist
Neutralizes the acid in the stomach (acid causes pain to the lining of the stomach where ulcer is)
Calcium Carbonate
; Antacid
*NEUTRALIZES ACID
Interferes with proton pump that has a role in acid production; inhibition of production of acid
Pantoprazole
; Protein Pump Inhibitor
*INHIBITS PRODUCTION OF ACID
Inhibit RNA protein synthesis and suppress reproduction of the bacteria; bacteriostatic
Erythromycin
; Macrolide Antibiotic
Increase fluid in stool to allow for better defecation
Polyethylene Glycol
; Osmotic Laxative
*Prophylactic
Stimulate lining of the intestine muscles to contract to move stool through
*Used in active treatment
Bisacodyl
; Stimulant
inhibits vestibular stimulation
Dimenhydrinate
Antiemetic & Antihistamine
