Quiz 3 Flashcards by Leila Casenas

H2 blockers
Prototype
MOA

Cimetidine
Reduces gastric acid secretion by blocking histamine

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Nursing education of H2 blockers

Administer before meals or bedtime
Avoid foods and liquids that cause gastric irritaiton
Impotence and gynecomastia are reversible
Feel better in 2 week

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Side effects of proton pump inhibitor

Headache, dizziness, diarrhea, constipation, abdominal pain

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Assessment for antacids

Fluid and electolyte imbalances
avoid administering with oral drugs
Encourage pt to drink 2 oz of water after taking to ensure drug reaches stomach

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Nursing interventions for pepsin inhibitors

Give 30 min before meals and bedtime
Administer on empty stomach
Increase fluids, dietary bulk, and exercise to relieve constipation

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Predisposing factors for peptic ulcers

Lifestyle (caffeine, ETOH, nicotine)
Drugs
Stress ulcer
Helicobacter pylori (H.pylori)

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Nonpharmacological measures
Peptic ulcers

Avoid tobacco and alcohol
Weight loss
Avoid hot, spicy, greasy foods
Take NSAIDs and oral glucocorticoids with food
Sit up right before and after meals
Do not eat before bedtime
Wear loose-fitting clothing

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Side effects of H2 blockers

Headaches, dizziness, constipation, impotence, decreased libido, gynecomastia

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Proton pump inhibitor
Prototype
MOA
Uses

Omeprazole
Reduce gastric acid secretion by inhibiting proton pump
1st line for H. pylori

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Why shouldn’t you stop taking antiulcer medications

Ensure that the stomach is completely healed
Continue taking 1 month after pain goes away

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Antacids
Prototype
MOA

Mylanta
neutralize acid in the stomach

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Antacids
Contraindication and why

History of renal disease
Retains too much electolytes
Sodium bicarbonate: hypernatremia, water rentention
Calcium carbonate: hypercalcemia

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Pepsin inhibitors
Prototype
MOA

Sucralfate
Creates a paste that paints the stomach and creates a shield

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Side effects of pepsin inhibitors

constipation

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Common side effects of ondansetron

headache, diarrhea, dizziness, fatigue

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OTC options of Antihistamine
Adverse effects

Drowsiness, dry mouth, constipation
Dipenhydramine, meclizine, dramamine

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Adverse effects of promethazine

sedation
Anticholinergic effects

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Nursing interventions of antiemetics

Mouth care after vomiting
Avoid driving a motor vehicle/engage in dangerous activities
Monitor bowel sounds for hypoactivity or hyperactivity
Fluids and electolytes replaced when vomiting

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Contraindications of antiemetics

Paralytic ileus, small bowel obstruction

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Emetics
Prototype
MOA use

Syrup of ipecac
Stimulate CTZ and acts directly on gastric mucosa
Induce vomitting after toxicsubstance

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Nonpharmacologic measures for vomiting

Weak tea, flat soda, gelatin, pedialyte, gatorade, crackers, dry toast

Antiemetics route and why

IV
Orally dissolving tablets: Want it to be a dissolving tablet because you don’t want water to irritate the stomach or initiate gag reflex and cause the pt to vomit again

Serotonin antagonists
Prototype
MOA

Ondansetron
Block serotonin receptors in CTZ

How is nausea triggered

Serotonin is released into gut faster than it can be digested

Antihistamine Prototype MOA

Hydroxyzine For motion sickness

Phenothiazine Prototype MOA

Promethazine Decrease stimulation of CTZ Need a reason to give

Cannabinoid Prototype What is it

synthetic marijuana Dronabinol

Side effects of cannabinoid

Mood changes, euphoria, drowsiness, dizziness, headache, confusion, incoordination, memory lapse, dry mouth

Caution with swallowing toxic substances Alternatives

avoid vomiting if substance is caustic or petroleum. Activated charcoal or gastric lavage

Psyllium What is it Action Administration

Bulk-forming laxative Absorb water into intestines Increase bulk and peristalsis Mix in glass of water or juice Stir and drink immediately Follow with 1 glass water

Side effects of psyllium

Cramps, nausea, vomiting, flatus, diarrhea < fluid = intestinal obstruction

Side effects of docusate sodium

Nausea, vomiting, diarrhea Mild abdominal cramping

Side effects of magnesium citrate

Fluid and electrolyte imbalances Hypotension Weakness Cramps Nausea Vomiting Flatulence Diarrhea

Bisacodyl What is it Action

Stimulant laxative Increase peristalsis by irritating nerve endings in intestinal mucosa

Contraindications of laxatives

Undiagnosed abdominal pain Inflammatory disorders of GI tract Bowel obstruction

Nursing interventions of laxatives

Fluid I&O Fluid & electrolyte imbalance = watery stool > water intake Avoid overuse of laxatives

Nonpharmacologic measures of diarrhea

Clear liquids Oral solutions: Gatorade, pedialyte IV electrolyte solutions

Diphenoxylate/Atropine (lomotil) What is it Action

Opiate-related agent Stop the contracting of the bowels

Adverse effects of diphenoxylate/atropine

Dry eye Dry mouth Constipation Dizziness

Nursing interventions of antidiarrheals

Monitor frequency of bowel movements and bowel sounds Evidence of dehydration Drink clear liquids

MiraLAX (polyethylene glycol 3350) What is it Action

Osmotic laxative Absorb water into intestines Increase bulk and peristalsis

Difference between a bulk-forming and an osmotic laxative

Osmotic help the intestines retain water Bulk-forming help bowels retain water

Docusate sodium What is it Action Use

Stool softener Lubricate feces for easier passage Constipation, decrease straining during defecation

Magnesium Citrate What is it? Action

Saline laxative, osmotic laxative Action: hypersmolar (high concentration) salts pull water into which stimulates peristalsis and defalcation

Lactulose What is it Action

Osmotic laxative Give to lower ammonia levels of pts with liver disease

How long does it take for Bisacodyl to take effect?

Orally: 6-12 hours Rectally: 15-60 min

Side effects of biscadoyl

Fluid and electrolyte imbalances Abdominal cramps, nausea, diarrhea

What is Traveler's diarrhea

Severe diarrhea that lasts 2 days usually caused by E.coli

Prevention of traveler's diarrhea

Drink bottled water Wash fruit Eat cooked vegetables Eat meals that are cooked until well done

Antidiarrheals Purpose Caution

Decrease GI motility Should not be used > 2 days or if fever present