Pharmacology: Gastrointestinal and Endocrine Medications Flashcards
Exemplars of Gastrointestinal Medications
- Histamine 2 Receptors (Famotidine)
- Proton Pump Inhibitor (Pantoprazole)
- Antiemetic (Ondansetron)
- Laxative (Senna)
- Anti-diarrheal (Loperamide)
H2-Receptor Antagonist
(Famotidine)
- H2-antagonists block histamine from stimulating the acid-secreting parietal cells of the stomach
- promote healing of duodenal and gastric ulcers
- reduce gastric acid production
- reduce gastric-acid secretion to prevent stress ulcers
- use cautiously; can increase the blood level of many drugs that can lead to toxicity
Famotidine Patient Teaching
(Histamine 2- Receptor)
- do not take with antacid
- may take drug with snack
- best taken at bedtime
- take only for 6-12 weeks per MD order
- smoking stimulates gastric acid secretion and worsens the disease
- use cautiously in patients with renal impairment
Proton Pump Inhibitors: Pantoprazole
- disrupt chemical binding in stomach cells to reduce acid production
- indicated for short-term treatment of active gastric ulcers and duodenal ulcers
Adverse Reactions with Proton Pump Inhibitor: Pantoprazole
- headaches
- abdominal pain
- diarrhea
- nausea + vomiting
Patient Teaching for Proton-Pump Inhibitor: Pantoprazole
- take before eating
- swallow tablets whole (enteric-coated) to bypass the stomach because they are unstable in acidic environments
- rapidly absorbed from the small intestine
Antiemetic Drugs: Ondansetron
- decrease nausea, which reduces urge to vomit
- used to prevent motion sickness
Side Effects of Antiemetic: Ondansetron
CNS Effects:
- drowsiness
- disorientation
- anxiety
- euphoria
- agitation
- depression
- headache
- insomnia
- restlessness
- weakness
- tremors
- BP changes
What to Monitor For in Antiemetic: Ondansetron
- I’s & O’s
- Vital Signs
- Electrolyte Levels
- Frequency + Amount of Vomiting
Patient Teaching with Antiemetic: Ondansetron
- avoid alcohol
- avoid hazardous activities until CNS effects are known
Laxatives
(Senna)
- stimulant laxative
- increases intestinal peristalsis and promotes fluid accumulation in the colon and small intestine leading to emptying the bowel
- preferred drug for constipation and preparation for surgery or endoscopic procedures
What to Monitor For in Laxatives: Senna
-Bowel Sounds
>if not present, laxative should not be given
>lack of bowel sounds can indicate a bowel obstruction and administering laxatives could cause perforation of the bowel to occur
Teaching For Laxatives: Senna
- combine laxative therapy with
- increased fiber
- increased fluid intake
- increased activity
Anti-Diarrheal Medications: Loperamide
- used to treat short-term, treatment of severe diarrhea
- inhibits peristalsis
- reduces fecal volume
- increases fecal viscosity and bulk thus diminishing loss of fluid and electrolytes
What to Assess for With Anti-Diarrheal Medications (Loperamide)
- bowel status of patient before administering these drugs
- diarrhea can be a sign of partial bowel obstruction, causing bowel excretions to become liquefied as it squeezes by the obstructed area of the bowel
- assess fluid + bowel status throughout treatment
- at risk for dehydration due to loss of fluid
Side Effects of Anti-Diarrheal (Loperamide)
- drowsiness
- constipation
Patient Teaching for Anti-Diarrheal (Loperamide)
- use cautiously with other CNS depressants
- take medication only as directed
Exemplars of Endocrine Medications
- Antidiabetic Medications (Insulin, Glipizide)
- Hormones (Levothyroxine)
Antidiabetics (Insulin, Glipizide)
-lower blood glucose levels
Anti-diabetic (Insulin)
-increases glucose transportation across muscle and fat cell membranes to reduce blood glucose levels and converts glucose to its storage form glycogen
Anti-diabetics, what Type 1 and Type 2 require
Type 1= require an external source of insulin to control blood glucose levels because their body is no longer manufacturing insulin
Type 2= use anti-diabetic meds but also needs insulin supplementation because the body is not able to manufacture enough insulin to supply the bodys needs
Teaching for Antidiabetic: Insulin
- insulin cannot be given orally as the GI system inactivates it
- insulin is administered by subcutaneous injection or
- IV in emergency situations
Insulin Nursing Interventions
- dosages are often ordered on a sliding scale to ensure that the dosage is appropriate to the patients current blood glucose level
- patients will be taught to check their blood sugar levels frequently using a finger stick blood glucose monitor to determine appropriate dose
- monitor for adverse effects: hypoglycemia or hypersensitivity reactions
Oral Anti-diabetic Meds: Glipizide
- produce actions within and outside the pancreas to regulate blood glucose
- decrease glucose production in the liver and increase the number of insulin receptors in the peripheral tissues
- for type 2 diabetics where diet + exercise do not control disease
Side Effects of Oral Anti-diabetic Meds: Glipizide
- hypoglycemia due to too much insulin production
- GI symptoms
- CNS symptoms
Hormones
(Levothyroxine)
- hormone replacement therapy supplements the bodys ability to manufacture hormones naturally
- ensures appropriate hormonal levels are maintained in the body
- common hormones replaced: insulin, thyroid, pituitary, estrogens + androgens
- monitor hormone level
- monitor for symptoms of excess or insufficiency of hormonal meds
Levothyroxine (Thyroid Hormones)
- thyroid hormone increases metabolic rates in tissues affecting protein and carbohydrate metabolism
- thyroid hormone increases heart rate and cardiac output
- increases blood flow to the kidneys
- increases glomerular filtration rate
- monitor for signs + symptoms of elevated thyroid hormone levels
- monitor for; nervousness, insomnia, tremor, tachycardia, palpitations, angina, arrhythmias, cardiac arrest
Thyroid hormone; Nursing Interventions
- monitor thyroid hormone levels, pulse, BP, and clotting times if on anticoagulants
- taking anticoagulants with levothyroxine–> dosage should be decreased and PT tests done routinely
- monitor for signs + symptoms of thyrotoxicosis or increased thyroid levels
- including: diarrhea, irritability, listlessness, rapid heartbeat, vomiting, weakness
- take meds one hour before eating in the morning
