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Pharmacology Test 2 > Test 2 GI Meds > Flashcards

Test 2 GI Meds Flashcards

1
Q

famotidine: class

A
  • H2 receptor antagonist
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2
Q

famotidine: MOA

A
  • binds to H2 R and blocks it, so suppresses secretion of gastric acid
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3
Q

famotidine: indications

A
  • tx and prevention of duodenal ulcers
  • tx of gastric ulcers
  • GERD
  • ZE Syndrome (hypersecretory states)
  • OTC: heartburn, acid indigestion, sour stomach
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4
Q

famotidine: SEs

A
  • elevation of gastric pH may inc risk of pneumonia
  • **no antiandrogenic effects b/c does not bind to androgen Rs
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5
Q

famotidine: ADRs

A
  • arrhythmias
  • agranulocytosis
  • aplastic anemia
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6
Q

ranitidine: class

A
  • H2 receptor antagonist
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7
Q

ranitidine: MOA

A
  • H2 receptor blocker that suppresses secretion of gastric acid from parietal cells
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8
Q

ranitidine: indications

A
  • short term tx of gastric/duodenal ulcers
  • prophylaxis of recurrent duodenal ulcers
  • tx of ZE Syndrome: better than cimetidine
  • tx of GERD
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9
Q

ranitidine: SEs

A
  • rare CNS effects: b/c penetrates BBB poorly
  • **no antiandrogenic effects b/c does not bind to androgen Rs
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10
Q

ranitidine: ADRs

A
  • arrhythmias
  • agranulocytosis
  • aplastic anemia
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11
Q

H2 receptor antagonist: nursing implications

A
  • may be taken w/o regard to meals
  • make sure pt knows the dosing schedule
  • avoid cigarettes and aspirin/NSAIDs
  • advise pt to stop drinking b/c drinking exacerbates ulcer symptoms
  • tell pts 5-6 small meals may be preferable to 3 larger meals
  • educate pt about signs of GI bleed: black/tarry stools, coffee ground vomitus
  • inform pt about S/S of respiratory infection, notify provider if these occur
  • for PUD, need dx with visualization of ulcer and test for H. pylori
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12
Q

omeprazole: class

A
  • proton pump inhibitor (PPI)
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13
Q

omeprazole: MOA

A
  • undergoes conversion to its active form w/in parietal cells of the stomach
    • the active form causes irreversible inhibition of H/K ATPase (proton pump) which is the enzyme that generates gastric acid
  • b/c it blocks the final pathway of gastric acid production, it can inhibit basal and stimulated acid release
  • see effects w/in 2 hours
    • b/c inhibition of the ATPase is not reversible, effects persist until new enzyme synthesized
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14
Q

omeprazole: indications

A
  • short term therapy of duodenal ulcers, gastric ulcers, erosive esophagitis, and GERD
  • long term therapy of hypersecretory conditions (ZE Syndrome)
  • prevent stress ulcers (when used in the hospitals), but should only use on pts in ICU and with other risk factors
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15
Q

how do PPIs compare to H2RAs?

A
  • omeprazole and other PPIs reduce 24 hour acid secretion by 90% compared with 65% for H2RAs
  • PPIs also act faster than H2RAs to reduce gastric acidity and relieve ulcer symptoms
  • pts who fail to respond to H2RAs can often benefit from PPIs
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16
Q

omeprazole: SEs

A
  • headache
  • diarrhea
  • nausea
  • vomiting
    • all are rare though
17
Q

omeprazole: ADRs

A
  • pneumonia b/c of alteration of upper GI flora (due to reduced acid) and impairment of WBC function
  • fractures/osteoporosis, b/c reducing acid secretion can dec absorption of calcium
  • rebound acid hypersecretion when they stop taking PPIs
  • hypomagnesemia b/c reduced Mg absorption
  • C. diff
  • nephrotoxic
18
Q

omeprazole: nursing implications

A
  • contraindicated if hypersensitive to the drug or to component of the formulation
  • tx should be limited to 4-8 weeks unless taking for hypersecretory states
  • pts should be encouraged to take Ca and vitamin D to prevent osteoporosis
  • use for shortest time and in lowest effective dose to prevent rebound dyspepsia
  • watch Mg levels and supplement if necessary
  • take just before eating
19
Q

misoprostol: class

A
  • PG E1 analog
  • anti-ulcer drug
20
Q

misoprostol: MOA

A
  • prevents NSAID induced ulcers by acting as a replacement for endogenous PG
    • PGs protect stomach by suppressing secretion of gastric acids and promotes secretion of bicarbonate and protective mucous
21
Q

misoprostol: indication

A
  • prevention of gastric ulcers caused by long term therapy with NSAIDs
    • w/ mifepristone, can induce medical termination of pregnancy
22
Q

misoprostol: SEs

A
  • dose related diarrhea
  • abdominal pain
  • spotting
  • dysmenorrhea
23
Q

misoprostol: ADRs

A
  • miscarriage
24
Q

misoprostol: nursing implications

A
  • women of child bearing age must:
    • be able to comply with birth control
    • be given oral/written warnings about the dangers
    • have a negative serum pregnancy test result w/in 2 weeks before beginning therapy
    • begin therapy only on 2nd or 3rd day of next normal menstrual cycle
    • category X
25
Q

bismuth subsalicylate: class

A
  • anti diarrheals
  • anti ulcer
26
Q

bismuth subsalicylate: MOA

A
  • Promotes intestinal adsorption of fluids and electrolytes.
  • Decreases synthesis of intestinal prostaglandins.
  • act to disrupt the cell wall of H. pylori and cause lysis and death
    • also inhibit urease activity and prevent H. pylori from binding to gastric surface
27
Q

bismuth subsalicylate: indications

A
  • Mild to moderate diarrhea.
  • Nausea, abdominal cramping, heartburn, and indigestion that may accompany diarrheal illnesses.
  • Treatment of ulcer disease associated with Helicobacter pylori (with anti-infectives).
  • Treatment/prevention of traveler’s (enterotoxigenic Escherichia coli) diarrhea.
28
Q

bismuth subsalicylate: SEs

A
  • black tongue
  • black stool
29
Q

bismuth subsalicylate: nursing implications

A
  • medication contains aspirin, so do not take any other medications with aspirin
    • report any ringing in the ears (tinnitus)
    • do not give children b/c of possible Reye’s Syndrome
30
Q

metronidazole: class

A
  • anti infective
  • anti protozoal
  • anti ulcer
31
Q

metronidazole: MOA

A
  • prodrug that is harmless until converted to more chemically active form that only occurs in anaerobic cells
    • so does not occur in human cells, since most are aerobic
  • interacts with DNA and causes strand breakage and loss of helical structure
32
Q

metronidazole: indications

A
  • symptomatic intestinal amebiasis
  • systemic amebiasis
  • giardiasis
  • trichomoniasis
  • E. histolytica
33
Q

metronidazole: SEs

A
  • nausea
  • headache
  • dry mouth
  • metallic taste in mouth
  • stomatitis
  • vomiting
  • diarrhea
  • insomnia
  • vertigo
  • weakness
  • darkening of urine
34
Q

metronidazole: ADRs

A
  • hypersensitivity rxns
  • Stevens Johnson syndrome
  • seizures
  • neurologic injury
35
Q

metronidazole: nursing implications

A
  • avoid during 1st trimester of pregnancy and be cautious after
  • DO NOT use alcohol for at least 3 days after med is stopped
  • be careful is using warfarin
  • do not drink grapefruit juice

Pharmacology Test 2 (9 decks)

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