Peptic Ulcers, Laxatives, GI agents

Question 1

Pantoprazole MOA

Answer 1

Inhibit H+,K+-ATPase to prevent generation of gastric acid

Question 2

Pantoprazole indications

Answer 2

Duodenal & gastric ulcers; GERD
Zollinger-Ellison syndrome
Aspiration pneumonitis
Stress ulcer prophylaxis

Question 3

Pantoprazole AE

Answer 3

Minor with short term use
Fractures
Rebound acid hypersecretion
↓ Mg with long term use
C-diff diarrhea

Question 4

Pantoprazole NC

Answer 4

Enteric-coated & tablets cannot be crushed, opened, chewed, etc.
Take before meals

Question 5

Famotidine MOA

Answer 5

Selectively blocks H2 receptors to reduce gastric secretions into GI tract

Question 6

Famotidine indications

Answer 6

Duodenal & gastric ulcers; GERD
Zollinger-Ellison syndrome
Aspiration pneumonitis
Heartburn, sour stomach, etc.

Question 7

Famotidine AE

Answer 7

CNS-related, including confusion, hallucinations, lethargy, and seizures
Pneumonia

Question 8

Famotidine NC

Answer 8

Does not need to taken with regard to meals
Educate patient on lifestyle measures to use with pharmacotherapy

Question 9

Sucralfate MOA

Question 10

Sucralfate indications

Answer 10

Duodenal & gastric ulcers

Question 11

Sucralfate AE

Answer 11

Constipation
No known serious effects

Question 12

Sucralfate NC

Answer 12

May impede absorption of some medications
Minimize by administering sucralfate at least 2 hours apart from other meds, including phenytoin, theophylline, digoxin, warfarin, and FQ abx

Question 13

Antacids MOA

Answer 13

React with gastric acid to produce neutral salts/lower acidity salts

Question 14

Antacids indications

Answer 14

peptic ulcer disease

Question 15

Antacids AE

Answer 15

Constipation and/or diarrhea
Sodium loading with Na compounds

Question 16

Antacids NC

Answer 16

May impede absorption of some medications, including H2RA and sucralfate
Minimize by administering antacids at least 1 hour apart from other meds

Question 17

Psyllium (Metamucil) MOA

Question 18

Psyllium (Metamucil) indication

Answer 18

Temporary tx of constipation
Diverticulosis
IBS

Question 19

Psyllium (Metamucil) AE

Answer 19

Minimal due to minimal systemic absorption
Esophageal obstruction if not taken with full glass of water/juice

Question 20

Psyllium (Metamucil) NC

Answer 20

Educate patients on proper administration

Question 21

Docusate

Question 22

Docusate indication

Answer 22

constipation

Question 23

Docusate AE

Answer 23

Minimal
Occasional cramping, nausea, diarrhea, bitter taste

Question 24

Docusate NC

Answer 24

Take with full glass of water

Question 25

Bisacodyl (Dulcolax) MOA

Answer 25

stimulates intestinal motility, increases amoutn of water and ions

Question 26

Bisacodyl (Dulcolax) indication

Answer 26

Opioid-induced constipation
Constipation resulting from slow intestinal transit

Question 27

Bisacodyl (Dulcolax) AE

Answer 27

Bisacodyl suppositories may cause burning sensation

Question 28

Bisacodyl (Dulcolax) NC

Answer 28

Do not chew or crush bisacodyl tablets
High abuse potential, educate patient on lifestyle measures and discourage long-term use
Take medication no sooner than 1 hour after ingestion milk or antacids

Question 29

Polyethylene Glycol (Miralax)

Question 30

Polyethylene Glycol (Miralax) indication

Answer 30

Bowel prep for procedures
Chronic constipation

Question 31

Polyethylene Glycol (Miralax) AE

Answer 31

Most common are nausea, bloating, cramping, flatulence, and diarrhea
Dehydration
Magnesium toxicity

Question 32

Polyethylene Glycol (Miralax) NC

Answer 32

Prevent dehydration by monitoring I/O and increasing fluid intake
Educate patients that bowel movements may not occur for another 2 - 4 days