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Pharm exam 4 Flashcards

1
Q

Men’s Health (4)

A

-testosterone is the primary male hormone
-Androgens (male hormones, primarily testosterone)
-seminiferous tubules: site of spermatogenesis
-testes: produce male sex hormones

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2
Q

Testosterone (5)

A

-Responsible for normal development and maintenance of primary and secondary male sex characteristics
-Development of bone and muscle tissue
-Inhibition of protein catabolism (metabolic breakdown)
-Retention of various electrolytes
-Stimulates the production of blood cells

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3
Q

anabolic steroids (6)

A

-synthetic derivatives of testosterone
-anabolic= synthesis of tissue and increasing tissue formation
-Schedule III, great potential for misuse
-approved indications
-adjunctive tx to promote weight gain after extensive surgery, trauma, chronic diseases, anemia, hereditary angioedema, metastatic breast cancer
-side effects:
-sterility, CV disease, liver cancer, psychological and physical dependence

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4
Q

finasteride (androgen inhibitors) indications (2)

A

-BPH
-male pattern baldness

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5
Q

finasteride (androgen inhibitors) MOA (2)

A

-block effects of natural (endogenous) androgens
-inhibits 5-alpha reductase

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6
Q

finasteride (androgen inhibitors) side effects (10)

A

-teratogenic: pregnant/possibly pregnant women should not touch
-decrease BP
-increased risk of high-grade prostate cancer
-may cause ED during or after tx
-loss of libido
-hypersensitivity
-gynecomastia
-severe myopathy
-50% decrease in PSA
-ejaculatory dysfx

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7
Q

finasteride (androgen inhibitors) nursing (9)

A

-teratogenic; women must wear gloves to handle/ administer
-therapeutic fx may take up to 6 mos. To manifest
-digital rectal exams should be done prior to and during tx
-assess s/s of BPH (problems with urination)
-administration with or without food
-teach:
-may cause ED during or after tx
-increased risk of prostate cancer
-Obtain baseline vital signs, weight, height, and serum electrolyte levels.
-Assessment should include complete history, including medication history, urinary elimination problems, and potential contraindications.
-Assess PSA level and perform digital rectal examination before beginning any drugs for treatment of prostate disease
-Assess current medications for potential interactions.

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8
Q

oxybutynin class

A

anticholinergic aka cholinergic-blocking drugs, parasympatholytics, and antimuscarinic drugs

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9
Q

finasteride class

A

androgen inhibitor

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10
Q

oxybutynin indications (5)a

A

-frequent urination
-urgency
-nocturia
-urge incontinence
-overactive bladder

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11
Q

oxybutynin (anticholinergic) MOA (3)

A

-blocks / inhibits the actions of acetylcholine (ACh) in the parasympathetic nervous system (PNS)
-When these drugs bind to receptors, they inhibit nerve transmission at these receptors
-this stops spasms in GU tract

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12
Q

oxybutynin (anticholinergic) side effects (6)

A

-dry mouth
-nausea
-urinary retention
-dizziness
-drowsiness
-constipation

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13
Q

oxybutynin (anticholinergic) nursing–12

A

-Obtain baseline vital signs, weight, height, and serum electrolyte levels.
-Assessment should include complete history, including medication history, urinary elimination problems, and potential contraindications.
-Assess current medications for potential interactions.
-monitor I/O
-take IR tabs on empty stomach
-take XL tabs regardless of meals
-do not take with alcohol or other CNS depressants
-antidote: physostigmine
-pts. may be hypersensitive to light
-increase fluids, chew gum, frequent mouthcare for dry mouth
-increased risk of heat stroke, pts should avoid physical exertion and heat
-teach to increase fluids and salt intake

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14
Q

oxybutynin (anticholinergic) contraindications –6

A

-allergy
-angle-closure glaucoma
-acute asthma or other respiratory distress
-myasthenia gravis
-acute cardiovascular instability
-GI or GU tract obstruction (including BPH)

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15
Q

phenazopyridine class

A

urinary analgesic

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16
Q

phenazopyridine (urinary analgesic) indications–2

A

-pain, itching, burning, urinary frequency or urgency associated with UTI or procedure
-given with antibiotic to fight infection

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17
Q

phenazopyridine (urinary analgesic) MOA–2

A
  • inhibits nerve fibers in the bladder that respond to mechanical stimuli
    -hinders kinases responsible for cell growth, metabolism, and nociception
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18
Q

phenazopyridine (urinary analgesic) side effects

A

-bright reddish orange urine

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19
Q

phenazopyridine (urinary analgesic) nursing –6

A

-Obtain baseline vital signs, weight, height, and serum electrolyte levels.
-Assessment should include complete history, including medication history, urinary elimination problems, and potential contraindications.
-Assess current medications for potential interactions
-OTC
-teach pt. to stop taking when sx relieved (finish antibiotics though)
-urine will be reddish orange
-notify HCP if rash, skin discoloration, unusual tiredness

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20
Q

testosterone class

A

hormone

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21
Q

testosterone (hormone) actions —3

A

-Responsible for:
- normal development and maintenance of primary and secondary male sex characteristics
-Inhibition of protein catabolism (metabolic breakdown)
-Retention of various electrolytes

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22
Q

testosterone (hormone) MOA–5

A

-Anabolic activity: synthesis of tissue and increasing tissue formation
-Stimulates the production of blood cells (Enhanced erythropoiesis)
-Stimulate increased synthesis of body proteins, aiding in the formation of muscular and skeletal proteins
-Stimulate normal growth and development of the male sex organs
-Development and maintenance of male secondary sex characteristics

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23
Q

testosterone (hormone) side effects–3

A

-fluid retention
-DVT, PE
-heart attack

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24
Q

testosterone (hormone) nursing –10

A

-Long-term dosage forms can last from 2 to 3 days to 2 to 4 weeks
-Oral forms have a high first-pass effect.
(Methyltestosterone,
Fluoxymesterone)
-transdermal forms available (patches, gels)
-Obtain baseline vital signs, weight, height, and serum electrolyte levels.
-Assessment should include complete history, including medication history, urinary elimination problems, and potential contraindications.
-Assess PSA level and perform digital rectal examination before beginning any drugs for treatment of prostate disease
-Assess current medications for potential interactions.
-Transdermal Testoderm patches are applied to the scrotal skin.
-Transdermal Androderm patches are applied to the skin on the body, never to scrotal skin
-Follow exact instructions for sublingual, buccal, and oral forms

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25
zolpidem class
hypnotic
26
zolpidem (hypnotic) indications--2
-difficulty initiating sleep -Many side effects, to be used for short term treatment
27
zolpidem (hypnotic) MOA
depress CNS by binding to GABA receptors
28
zolpidem (hypnotic) side effects --3
-may perform tasks while asleep -daytime drowsiness -dizziness
29
zolpidem (hypnotic) nursing--6
-May perform tasks ”while asleep”. You need 7-8 hours of sleep when you start this medication. -Withdrawals are possible when you stop abruptly -Do not drink alcohol while using -reduce external stimuli before taking -take at bedtime and go to bed immediately after taking -assess: -sleep pattern -potential for abuse
30
melatonin class--2
hormone, supplement
31
melatonin (hormone/supplement) indications
difficulty initiating sleep
32
melatonin (hormone/supplement) MOA
hormone involved in sleep/wake cycle
33
melatonin (hormone/supplement) side effects--4
-headache -daytime drowsiness -dizziness -nausea
34
melatonin (hormone/supplement) nursing --5
-teach: -don’t drive or use heavy machinery <5hrs after taking -talk to HCP before taking -short-term use only -try to improve sleep routine before taking -take @bedtime
35
ondansetron class
serotonin antagonist
36
Ondansetron (serotonin antagonist) indications
n/v (including induced by pregnancy, chemo, radiation, or anaesthesia)
37
Ondansetron (serotonin antagonist) MOA
Block serotonin receptors in the GI tract, CTZ, and VC
38
Ondansetron (serotonin antagonist) side effects--4
-h/a -diarrhea -dizziness -dysrhythmia (widened QT interval)
39
Ondansetron (serotonin antagonist) nursing--9
-Can be given PO, IM or IV -Watch for widened QT interval -No significant drug interactions -caution with clients that have electrolyte imbalances -May place on cardiac monitor to watch for dysrhythmia -Also monitor for -h/a -diarrhea -dizziness -serotonin syndrome (high BP, tachycardia, fever, sweating, dilated pupils, diarrhea, seizures, extensive muscle breakdown)
40
prochlorperazine class
anti-emetic
41
Prochlorperazine (anti-emetic) indications
-n/v related surgery, cancer, chemotherapy, toxins -also used for psychotic d/o, intractable hiccups -can be used in children
42
Prochlorperazine (anti-emetic) MOA
Block dopamine receptors in the CTZ
43
Prochlorperazine (anti-emetic) side effects--5
-Extrapyramidal reactions -Anticholinergic effects -Hypotension -sedation -Contraindicated if seizure, coma, encephalopathy, bone marrow suppression
44
Prochlorperazine (anti-emetic) nursing--6
-available as oral, rectal, and injection -Cautious assessment for dehydration -Monitor for extrapyramidal reactions -Monitor for anticholinergic symptoms -Monitor for ↓BP & sedation -Monitor for orthostatic hypotension & safety
45
Meclizine hydrochloride class
anti-emetic, antihistamine
46
Meclizine hydrochloride (anti-emetic, antihistamine) indications --5
-n/v -motion sickness -nonprroductive cough -allergy sx -sedation
47
Meclizine hydrochloride (anti-emetic, antihistamine) MOA
- Prevents nausea and vomiting by reducing the activity of the center in the brain that controls nausea
48
Meclizine hydrochloride (anti-emetic, antihistamine) side effects--8
- Drowsiness -Fatigue -Headache -Blurred vision -Dry Mouth -Constipation -Urinary retention -Contraindicated if shock, liver disease, or lactation
49
Meclizine hydrochloride (anti-emetic, antihistamine) nursing except monitoring
-PO - Be cautious with using if history of closed angle glaucoma - May increase risk for dementia - Teach to take before motion sickness occurs -Safety
50
Meclizine hydrochloride (anti-emetic, antihistamine) nursing monitoring--7
-hypotension -headache -fatigue -blurred vision -dry mouth -constipation -urinary retention
51
metoclopramide class
dopamine antagonist / prokinetic agent
52
Metoclopramide (dopamine antagonist / prokinetic agent) indications
-GERD -delayed gastric emptying
53
Metoclopramide (dopamine antagonist / prokinetic agent) MOA--2
-Block dopamine receptors in the CTZ, cause CTZ to be desensitized to impulses it receives from the gastrointestinal (GI) tract -Also stimulates peristalsis in GI tract, enhancing emptying of stomach contents
54
Metoclopramide (dopamine antagonist / prokinetic agent) side effects--9
-Tardive dyskinesia -drowsiness -headache -dizziness -trouble sleeping -agitation -bradycardia -hypotension -Contraindicated if seizure disorder, bowel obstruction, perforation of bowel, ETOH, procainamide
55
Metoclopramide (dopamine antagonist / prokinetic agent) nursing
PO or IV -Severe adverse effects if not used correctly -Long-term use may cause irreversible tardive dyskinesia -Monitor for s/s seizure -Monitor for bowel function -Monitor for tardive dyskinesia (may be permanent) -Monitor BP and heart rate -Monitor for headache, drowsiness, agitation and trouble sleeping
56
dimenhydrinate class (2)
antihistamine / anticholineregic
57
dimenhydrinate (antihistamine / anticholineregic) indication—1
suppression of motion sickness
58
dimenhydrinate (antihistamine / anticholineregic) MOA
Blocks receptors for acetylcholine in addition to receptors for histamines
59
dimenhydrinate (antihistamine / anticholineregic) side effects--5
- Constipation -Sedation -Urinary retention -dry mouth -blurred vision
60
dimenhydrinate (antihistamine / anticholineregic) nursing --3
- Available OTC, usually oral - Monitor for adverse effects and teach patient same -Avoid use w/CNS depressants
61
scopolamine class
antihistamine
62
scopolamine (antihistamine) indications--3
-motion sickness -post-op n/v -anticholinergic effects at end of life
63
scopolamine (antihistamine) MOA --2
- Bind to and block ACh receptors in the inner ear labyrinth, Block transmission of nauseating stimuli to CTZ - Block transmission of nauseating stimuli from the reticular formation to the VC
64
scopolamine (antihistamine) side effects--6
- Dry mouth -Blurred vision -Drowsiness -Urinary retention -Constipation -Disorientation
65
scopolamine (antihistamine) nursing excluding monitoring and precautions
- Available in oral, subcutaneous and transdermal form - Most common = 72-hour transdermal patch, releases 1 mg -contradicted if glaucoma
66
scopolamine (antihistamine) nursing monitoring (2) and precautions (5)
- Monitor for: -Safety -Closed angle glaucoma - Precautions: -Renal & liver impairment -slow gastric motility -seizures -urinary retention -psychosis
67
antiemetics assessment--3 / monitoring--2
- Assess complete nausea and vomiting history, including precipitating factors -Assess current medications, include OTC (ginger) -Assess for contraindications and potential drug interactions - Monitor for therapeutic effects - Monitor for adverse effects
68
anti-emetics teaching--5
-Many of these drugs cause severe drowsiness -Warn patients about driving or performing any hazardous tasks - Taking antiemetics with alcohol may cause severe CNS depression - Teach patients to change positions slowly to avoid hypotensive effects - For chemotherapy, antiemetics are often given 30 to 60 minutes before chemotherapy begins
69
BPH s/s--5
-urinary hesitancy -urinary urgency -increased frequency of urination -dysuria -nocturia
70
BPH tx--3
-surgery -watchful waiting -drug tx
71
classes of drugs for BPH (2)
-5-alpha-reductase inhibitors (finasteride) -Alpha1-adrenergic antagonist (blocks alpha 1 receptors, relaxing smooth muscle in bladder neck) -decreases blood pressure
72
3 types of cells in stomach glands
-parietal -chief -mucous
73
PUD def:
upper GI d/o caused by imbalance between mucosal and aggressive factors
74
PUD aggressive factors --5
-H. pylori -NSAIDs -acid -pepsin -smoking
75
PUD defensive (mucosal) factors --4
-mucus -bicarbonate -blood flow -prostaglandins
76
GI cells that secrete prostaglandins
parietal cells
77
what produces HCL when stimulated
proton pump
78
PUD serious complications
-hemorrhage -perforation
79
PUD tx
-alleviate sx -promote healing -prevent complications -prevent recurrence -drugs create conditions for healing, do not cure themselves
80
classes of drugs for PUD tx and desired effects
-antibiotics: eradicate H.pylori -anti-secretory agents (H2 receptor antagonists or PPI): reduce gastric acidity -mucosal protectants: enhance mucosal defenses -anti-secretory agents that enhance mucosal defenses -antacids: reduce gastric acidity
81
antibiotics for ulcers H. pylori
-eradication rates are good for 10-day course, slightly better if 14 day -at least 2 antibiotics prescribed at once (up to 3) to reduce risk of resistance developing -ex: metronidazole, tetracycline -usually given with bismuth subsalicylate
82
bismuth subsalicylate (pepto Bismol) MOA
-lyses H.pylori by disrupting it’s cell wall, lysing it - May inhibit urease activity and may prevent H. pylori from adhering to the gastric surface
83
bismuth subsalicylate (pepto Bismol) indication--2
-acid reflux -n/v/d
84
- bismuth subsalicylate (pepto Bismol) side effects
-long term tx: - Possible risk of neurologic injury - risk for Reye’s syndrome in children
85
bismuth subsalicylate (pepto Bismol) nursing
-OTC -stool and tongue may turn black
86
Famotidine class
(Histamine 2 (H2) receptor antagonists)
87
Famotidine (Histamine 2 (H2) receptor antagonists) indications --5
- Short-term treatment of gastric/duodenal ulcers - Prophylaxis of recurrent duodenal ulcers - Treatment of Zollinger-Ellison syndrome and hypersecretory states - Treatment of GERD - Over-the-counter (OTC): Treatment of heartburn, acid indigestion, sour stomach
88
Famotidine (Histamine 2 (H2) receptor antagonists) MOA--3
- block H2 receptors on parietal cells of stomach lining - Increase in pH of stomach - Promote healing by suppressing secretion of gastric acid
89
Famotidine (Histamine 2 (H2) receptor antagonists) side effects --4
- Serious side effects are uncommon - Possible increased risk for pneumonia caused by elevation of pH - CNS effects in elderly patients include confusion and disorientation – use cautiously - Thrombocytopenia – monitor for
90
Famotidine (Histamine 2 (H2) receptor antagonists) nursing--2
- Do not administer with antacids – space 1 to 2 hours apart -oral or IV
91
omeprazole class
Proton Pump Inhibitor (PPI)
92
omeprazole (proton pump inhibitors (PPIs)) MOA
- Inhibits gastric secretion
92
omeprazole (proton pump inhibitors (PPIs)) indications
- GERD, erosive esophagitis, short-term treatment of active duodenal and benign gastric ulcers - Zollinger-Ellison syndrome - NSAID induced ulcers - Stress ulcer prophylaxis - H. pylori–induced ulcers (Given with an antibiotic)
93
omeprazole (proton pump inhibitors (PPIs)) side effects--10
-well tolerated for short-term - Rebound acid hypersecretion -Vitamin B12 insufficiency -Pneumonia -Headache -GI effects -Fractures -Hypomagnesemia -C. difficile infection -Gastric cancer
94
omeprazole (proton pump inhibitors (PPIs)) interactions --5
- ↑ levels of diazepam and phenytoin -↑ chance of bleeding w/warfarin -Can ↓effect of clopidogrel -Sucralfate may delay the absorption -Food may ↓ absorption
95
sucralfate (mucosal barrier fortifier) indications--3
- Peptic ulcers -Stress ulcers -maintenance therapy
96
sucralfate (mucosal barrier fortifier) MOA--2
- Creates a protective barrier against acid and pepsin for up to 6 hours - Little absorption from the gut
97
sucralfate (mucosal barrier fortifier) side effects--3
- Constipation -nausea -dry mouth
98
sucralfate (mucosal barrier fortifier) nursing--2
- Administered 4x/day oral - Given on empty stomach, 1 hour before meals/bedtime
99
sucralfate (mucosal barrier fortifier) interactions--4
May impair absorption of other drugs - Do not give with other medications -Give other drugs at least 2 hours before sucralfate -Antacids may interfere with effects of sucralfate -binds with phosphate
100
misoprostol class
Prostaglandin E analog
101
misoprostol (prostaglandin E analog) indications
- Only approved GI indication is prevention of gastric ulcers caused by long-term NSAID therapy
102
Misoprostol (prostaglandin E analog) MOA
- Prevents NSAID-induced ulcers by serving as a replacement for endogenous prostaglandins
103
misoprostol (prostaglandin E analog) side effects
-teratogenic - Most common: -Dose-related diarrhea -h/a -abdominal pain -vaginal bleeding
104
misoprostol (prostaglandin E analog) nursing
- Administered oral 4x/day w/meals -assess pt. for possible pregnancy -- Antacids may reduce absorption - Contraindicated: -If allergy -During pregnancy: Category X
105
-antacids MOA--4
-React with gastric acid to produce neutral salts or salts of low acidity -Reduce destruction of gut wall by neutralizing acid -May also enhance mucosal protection by stimulating production of prostaglandins -Except for sodium bicarbonate, antacids do not alter systemic pH
106
antacids side effects
- Aluminum hydroxide: Constipation -Magnesium hydroxide: sodium loading
107
-antacids nursing except cautions and contraindications--5
-Assess for allergies and conditions that may restrict the use of antacids, such as: -Fluid imbalances, renal disease, HF -GI obstruction, pregnancy -Give meds 1 to 2 hours after an antacid -Ensure chewable tablets are chewed thoroughly and liquid forms are shaken well before giving -Give w/ 8 oz of water to enhance absorption (except for “rapid-dissolve” forms) -Monitor for adverse effects, effects from long term use, and therapeutic effect
108
antacids precaution (1) and contraindications (4)
-Contraindications: -allergy -renal failure -GI obstruction -electrolyte imbalance Caution: renal impairment
109
antacids drug interactions
-caution: interferes with the body’s absorption of other drugs -Chelation: chemical binding, or inactivation, of another drug -produces insoluble complexes resulting in decreased drug absorption -Cimetidine -Ranitidine -Sucralfate -tetracyclines -warfarin -digoxin -causes increased stomach pH which: -increases absorption of basic drugs -decreases absorption of acidic drugs -causes increased pH of urine, which: -increases excretion of acidic drugs -decreases excretion of basic drugs
110
treatment of constipation
-surgical -nonsurgical treatments -dietary (adequate fiber intake) -behavioral/lifestyle (exercise) -pharmacologic
111
pharmacologic tx of constipation (5)
-bulk forming -stimulant -hyperosmotic -saline -emollient
112
constipation med MOAs --4
-Effect on stool consistency -Increased movement of stools through the colon -Increased # of stools through the colon -Amount/timing of bowel movements via rectum
113
laxative indications--8
-Promote BM (constipation, bedrest, pregnancy, pain medications) -Prevent obstruction -Soften stool, reduce painful BM -Prevent straining (cardiac patients, ↑ICP) -Loss of perianal/abdominal muscle tone (older adults, stroke) -Obtain stool sample -Remove parasites, toxic substances, ammonia -Empty bowel before a procedure or surgery
114
laxative nursing--5
- Obtain a thorough history of symptoms, elimination patterns, and allergies - Assess fluid and electrolytes, vs, BS before initiating therapy - Teach patients not to take laxative if N/V or abdominal pain - Encourage fluids and fiber in diet - Teach patients that long term use of laxatives can reduce bowel tone, lead to dependency/abuse
115
psyllium class
bulk forming agent
116
Psyllium (bulk forming agents) indication--3
-IBS -diverticulosis -constipation
117
Psyllium (bulk forming agents) MOA
-Absorb water into intestine to increase bulk and distend bowel to initiate reflex bowel activity = BM
118
Psyllium (bulk forming agents) side effects--4
-Few systemic effects because not systemically absorbed -Gas -allergic reaction -electrolyte imbalance
119
Psyllium (bulk forming agents) nursing--4
-Contraindicated if obstruction, fecal impaction, N/V, abdominal pain -OTC; Safe for long term use -Oral dosing, powder, wafer -Usually works in 1-3 days (teach)
120
Bisacodyl class
stimulant laxatives
121
Bisacodyl (stimulant laxatives) indication--1
constipation
122
Bisacodyl (stimulant laxatives) MOA--1
- Increases peristalsis via intestinal nerve stimulation
123
Bisacodyl (stimulant laxatives) side effects
- Nutrient malabsorption, -skin rashes - GI irritation -electrolyte imbalances (↓K) -discolored urine -rectal irritation - Prolonged use – proctitis of rectum
124
- Bisacodyl (stimulant laxatives) nursing--7
- Available as oral tablet, rectal suppository - Most likely type to cause dependence - Available OTC - Usually works in 6 – 12 hours (rectal suppository is 15 min – 1 hr) - Produces semi-fluid stool - Used for bowel prep before procedures, surgery - Assess for abuse potential
125
senna class
stimulant laxative
126
Senna (stimulant laxatives) indications--2
-constipation -bowel prep
127
Senna (stimulant laxatives) MOA--1
- Increases peristalsis via intestinal nerve stimulation
128
Senna (stimulant laxatives) side effects--7
- Nutrient malabsorption -skin rashes - GI irritation -electrolyte imbalances (↓K) -discolored urine -rectal irritation - Prolonged use – proctitis of rectum
129
Senna (stimulant laxatives) nursing--7
- Available as oral tablet, rectal suppository - Most likely type to cause dependence - Available OTC - Usually works in 6 – 12 hours (rectal suppository is 15 min – 1 hr) - Produces semi-fluid stool - Used for bowel prep before procedures, surgery - Assess for abuse potential
130
lactulose class
osmotic laxative
131
lactulose (osmotic laxatives) indications--3
-Constipation -bowel prep -hepatic encephalopathy
132
lactulose (osmotic laxatives) MOA
-Uses osmosis to draw water into intestine to soften and ↑ mass of stool, stretching musculature, which results in peristalsis -↓ serum ammonia by converting to ammonium and excreting
133
lactulose (osmotic laxatives) side effects--4
-Bloating -rectal irritation -electrolyte imbalance -abdominal pain
134
lactulose (osmotic laxatives) nursing--7
-Available oral and rectal -Onset is 24 hours -Contraindicated if low lactose diet -caution in older patients -administer with juice, water to increase palatability -Normal oral dose color is orange -Monitor electrolytes with extended use
135
Polyethylene glycol class
osmotic laxative
136
Polyethylene glycol (osmotic laxatives) indications--2
-Bowel prep -constipation
137
Polyethylene glycol (osmotic laxatives) MOA
-Uses osmosis to draw water into intestine to soften and increase mass of stool, results in peristalsis
138
Polyethylene glycol (osmotic laxatives) side effects --6
-Abdominal cramping -bloating -flatulence -dehydration -electrolyte imbalance -rectal irritation
139
Polyethylene glycol (osmotic laxatives) nursing (minus contraindications) --5
-Can be used daily, as needed -onset 4+ hrs. -Monitor electrolytes, safety -encourage fluids -administer with flavored drinks
140
Polyethylene glycol (osmotic laxatives) contraindications--4
-GI obstruction -gastric retention -bowel perforation -ileus
141
Milk of Magnesia and Magnesium Citrate class
osmotic laxatives
142
Milk of Magnesia and Magnesium Citrate (osmotic laxatives) indications--2
-rapidly evacuate bowel for endoscopy -remove unabsorbed poisons from GI tract
143
Milk of Magnesia and Magnesium Citrate (osmotic laxatives) MOA
Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines
144
Milk of Magnesia and Magnesium Citrate (osmotic laxatives) side effects
-dehydration -fluid deficits
145
Milk of Magnesia and Magnesium Citrate (osmotic laxatives) nursing--6
- MOM: Available oral, liquid or tablet, OTC; Has unpleasant taste - Use with caution in renal insufficiency - Contraindicated if renal failure, abdominal pain, N/V, obstruction, rectal bleeding - Monitor for dehydration, fluids - Use with caution in older adults - Safety is priority
146
Docusate sodium class
emollient laxative
147
Docusate sodium (emollient laxatives) indications--4
- Constipation -fecal impaction -facilitate BM -prevent opioid-induced constipation
148
Docusate sodium (emollient laxatives) MOA
- Acts as fecal softener by lowering surface tension of stool to allow penetration of water
149
Docusate sodium (emollient laxatives) side effects--5
- Rashes -decreased absorption of vitamins -electrolyte imbalances -abdominal cramping -abdominal pain
150
Docusate sodium (emollient laxatives) nursing--4
- Available OTC, oral dosing - Onset is 1 -3 days - Produces soft stool - Monitor for Intestinal obstruction, fecal impaction, N/V
151
acute vs chronic diarrhea
acute: 3 -14 days chronic: 3-4 weeks
152
chronic diarrhea causes--6
- Tumors -Diabetes mellitus -Addison’s disease -Hyperthyroidism -Irritable bowel syndrome -AIDS
153
diarrhea tx MOAs--4
- Stopping the stool frequency -Alleviating the abdominal cramps -Replenishing fluids and electrolytes -Preventing weight loss and nutritional deficits from malabsorption
154
all antidiarrheal nursing considerations—4
-Obtain history of bowel patterns, general state of health, and recent history of illness or dietary changes -Assess fluid volume status, I&O, vs, labs, and mucous membranes before, during, and after treatment -Teach patients signs and symptoms to report -Teach patients to take as prescribed and to monitor fluid /dietary intake
155
loperamide class
anti-diarrheal agent
156
Loperamide (anti-diarrheal agent) MOA--1
Inhibits peristalsis in the intestinal wall and intestinal secretion, decreasing number of stools and water content
157
Loperamide (anti-diarrheal agent) side effect--1
none at directed dosage (black box warning for higher dosage causing serious heart problems)
158
Loperamide (anti-diarrheal agent) nursing
- Available OTC, oral - Contraindicated: -severe ulcerative colitis -pseudomembranous colitis -diarrhea associated with E coli
159
Diphenoxylate/atropine class
anti-diarrheal agent
160
Diphenoxylate/atropine (anti-diarrheal agent) MOA--1
-Activate opioid receptors in GI tract, inhibits GI motility & peristalsis → Allows more time for absorption of water and electrolytes → Stool becomes more formed, volume is ↓, and frequency of stool is ↓
161
Diphenoxylate/atropine (anti-diarrheal agent) side effects
-Dry mouth -abdominal pain -tachycardia -blurred vision -CNS depression -constipation
162
Diphenoxylate/atropine (anti-diarrheal agent) nursing--6
-Requires a prescription, Schedule V medication -Oral administration -Contraindicated: Diarrhea due to: -toxigenic bacteria -pseudomembranous colitis - teach patient to avoid ETOH, other CNS depressants; can enhance CNS depressant activity when combined -Use with caution in older adults -monitor for constipation
163
Dicyclomine hydrochloride class
anti-spasmodic (aka anticholinergic)
164
Dicyclomine hydrochloride (anti-spasmodic (aka anticholinergic)) indications
-IBS -cramping
165
Dicyclomine hydrochloride (anti-spasmodic (aka anticholinergic)) MOA
Anticholinergic (slows intestinal motility)
166
Dicyclomine hydrochloride (anti-spasmodic (aka anticholinergic)) side effects
-Constipation -tachycardia -delirium -confusion
167
Dicyclomine hydrochloride (anti-spasmodic (aka anticholinergic)) nursing--7
-Available oral and IM injectable -Contraindicated: -If sensitivity to anticholinergics -angle closure glaucoma -GI obstruction -myasthenia gravis -paralytic ileus -toxic megacolon -caution in elderly

Pharm (6 decks)

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