Quiz 3 Flashcards
H2 blockers
Prototype
MOA
Cimetidine
Reduces gastric acid secretion by blocking histamine
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
Side effects of proton pump inhibitor
Headache, dizziness, diarrhea, constipation, abdominal pain
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
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
Predisposing factors for peptic ulcers
Lifestyle (caffeine, ETOH, nicotine)
Drugs
Stress ulcer
Helicobacter pylori (H.pylori)
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
Side effects of H2 blockers
Headaches, dizziness, constipation, impotence, decreased libido, gynecomastia
Proton pump inhibitor
Prototype
MOA
Uses
Omeprazole
Reduce gastric acid secretion by inhibiting proton pump
1st line for H. pylori
Why shouldn’t you stop taking antiulcer medications
Ensure that the stomach is completely healed
Continue taking 1 month after pain goes away
Antacids
Prototype
MOA
Mylanta
neutralize acid in the stomach
Antacids
Contraindication and why
History of renal disease
Retains too much electolytes
Sodium bicarbonate: hypernatremia, water rentention
Calcium carbonate: hypercalcemia
Pepsin inhibitors
Prototype
MOA
Sucralfate
Creates a paste that paints the stomach and creates a shield
Side effects of pepsin inhibitors
constipation
Common side effects of ondansetron
headache, diarrhea, dizziness, fatigue
OTC options of Antihistamine
Adverse effects
Drowsiness, dry mouth, constipation
Dipenhydramine, meclizine, dramamine
Adverse effects of promethazine
sedation
Anticholinergic effects
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
Contraindications of antiemetics
Paralytic ileus, small bowel obstruction
Emetics
Prototype
MOA use
Syrup of ipecac
Stimulate CTZ and acts directly on gastric mucosa
Induce vomitting after toxicsubstance
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
