NEW MEDS

Question 1

types of acid controlling drugs

Answer 1

• PPI (best)
• H2 antagonists
• antacids

Question 2

antacids

Answer 2

• neutralize stomach acids
• salts of aluminum, magnesium, calcium, and sodium
• take 1-2 hours after drugs bc may interact

Question 3

antacid indications

Answer 3

• acute relief of symptoms associated w peptic ulcer, gastritis, gastric hyperactivity, and heart burn

Question 4

aluminum salts

Answer 4

• antacid
• can be used w Mg to counteract constipation
• good for ppl with renal failure

Question 5

antacid contraindications

Answer 5

• GI obstruction
• electrolyte imbalance
  be careful giving Na to anyone with heart problems
• may decrease absorption of acidic drugs and increase excretion of acidic drugs

Question 6

magnesium salts

Answer 6

• can cause diarrhea
• dont give to anyone with renal problems
• can be given with Ca or Al to offset constipation

Question 7

calcium salts

Answer 7

• can cause kidney stones
• can cause constipation
• can cause rebound hyperacidity (stomach acid levels increase)
• long duration of action

Question 8

sodium bicarb

Answer 8

• can cause metabolic alkalosis

- short duration of action and fast acting

Question 9

calcium carb

Answer 9

• can cause farding and burping

Question 10

H2 Antagonists

Answer 10

• reduce acid secretion
• cimetidine (tayamet = inhibits absorbtion of some drugs raising the level, can cause gynocomastia and impotence), nizatidine (axid), famotidine (pepcid), zantac (ranitidine)
• indications = GERD, PUD, upper GI bleeding
• be careful in older patients (confusion/disorientation), pt with renal or liver prob
• smoking decreases effectiveness
• take 1-2 hr before antacids

Question 11

PPIs

Answer 11

• stops production of HCL acid
• indications = GERD, peptic ulcers, NSAID ulcers, H. pylori ulcers
• lansoprazole, omeprazole, pantaprazole
• adverse effects = possible predisposition to GI infections like C. diff, osteoporosis, pneumonia, depletion of Mg+, lupus
• increase chance of bleeding w warfarin
• NGT must be 16 G or bigger to give thru
• sucralfate may delay absorption of PPI

Question 12

sucralfate (carafate)

Answer 12

muccusal protectant

Question 13

misoprostol (cytotec)

Answer 13

decreases ulcers in pts taking NSAIDS

Question 14

simethicone (mylican)

Answer 14

gas reduction, can be taken with calcium carb

Question 15

chetalation

Answer 15

• chemical binding of another drug, basically meaning reduced drug absorption (antacids w acidic drugs)

Question 16

absorbants

Answer 16

• anti-diarrhea
• bind to causative agent which is then eliminated in stool
• for milder cases
• adverse affects : increased bleeding time, blue tongue, metallic taste, tinnitus, constipation, dark stools, toxic w methotrexate
• bismuth subsalicylate (pepto), activated charcoal, aluminum hydroxide

Question 17

anticholinergics

Answer 17

• anti-diarrhea
• decreased muscle tone and peristalsis of the GI tract slowing the rate doodoo
• drying effect, decreased secretions
• used in severe cases
• atropine and hyosegamine
• adverse effects: urinary retention, impotence, headache, confusion, dizziness, blurred vision, dry skin and flushing, hypotension, bradycardia

Question 18

opioids

Answer 18

• anti-diarrhea
• relieves pain and bowel spasms
• allow more time for nutrients and electrolytes to be absorbed
• severe cases
• codeine and loperamide
• adverse affects: hypotension, flushing, urinary retention

Question 19

probiotics

Answer 19

• antidiarrheal
• intestinal flora modifers and bacteria replacers
• supply missing bacteria to GI and suppress growth of diarrhea causing bacteria
• used for antibiotic induced diarrhea
• lactobacillus

Question 20

bulk forming

Answer 20

• psyllium and methylcellulose
• for constipation
• high fiber to absorb water, increasing bulk
• distends bowel
• can cause impaction, fluid overload, esophageal blockage

Question 21

emoillment

Answer 21

• stool softeners (docusate salts) and lubricant (mineral oil)
• promote more water and fat in stools
• lubricate fecal and GI walls
• can cause less absorption of nutrients, lipid pneumonia

Question 22

hyper-osmotic

Answer 22

• increase fecal water content
• results in bowel distention, increased peristalisis and evacuation
• polyethylene glycal, lactulose, sorbitol, evacuation

Question 23

saline

Answer 23

• magnesium hydroxide (milk of magnesium)
• increase osmotic pressure within the intestinal tract, causing more water to enter intestines
• bowel distention causing more peristalsis

Question 24

stimulants

Answer 24

• senna and bisacodyl
• increases peristalsis via intestinal nerve stimulation
• can cause discolored urine and nutrient malabsortion

Question 25

antiemetic

Answer 25

• used to relieve vomiting and naseua

Question 26

antcholinergic (scopolamine)

Answer 26

• blocks transmission of nauseating stimuli in inner ear

- used to treat motion sickness, secretions reduction prior to surgery

Question 27

antihistamines (diphenhydrine and meclizine)

Answer 27

• inhibits Ach, H1 receptor blockers
• prevents stimulation in vestibular and reticular ares
• used for motion sickness, cough, allergy, and sedation

Question 28

antidopaminergic (promethazine, phenergan)

Answer 28

• block dopamine receptors in CTZ and used for hiccup and pyschotic disorders

Question 29

pro-kinetics (metopromide)

Answer 29

• block dopamine receptors in CTZ and causes CTZ to become desensitized to impulses from the GI
• stimulates GI mobility and stomach emptying, also used for GERD

Question 30

serotonin blockers (odansetron or zograf)

Answer 30

• used for naseau and vommitting in pts getting chemo and post op