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Collab Therapies 2 > GI System And Acid Controlling Meds > Flashcards

GI System And Acid Controlling Meds Flashcards

1
Q

What are some indications for antacids use?

A

Acute relief of symptoms of:

  • peptic ulcer
  • gastritis
  • gastric hyperacidity
  • reflux
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2
Q

What are some GERD treatment options?

A
  • eat smaller meals
  • break time between meals and lying down (2h-3hrs before bedtime)
  • no smoking (weakens lower esophagus sphincter)
  • control weight (healthy weight to be maintained)
  • avoid wearing tight clothes
  • relaxation techniques
  • medication therapy: antacids, h2 blockers, proton pump inhibitors
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3
Q

What are foods to avoid with GERD?

A
  • should avoid high fat foods
  • avoid foods or substances that lower the LES : peppermint
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4
Q

What are some treatment of PUD?

A
  • adéquate rest
  • diet modifications : no red and black peppers, no chili pepper, no caffeine, no alcohol, no fried foods
  • drug therapy
  • smoking cessation
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5
Q

What is the main concept of acid related diseases?

A

Impairement of the balance Amine the substances secreted by the stomach

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6
Q

What are the 3 classes of acid controlling meds?

A
  • antacids
  • H2 antagonist
  • PPIs (proton pump inhibitors)
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7
Q

What is an important implementation with antacids related to other meds?

A

Antacids should never be taken with other meds because it neutralizes the stomach acid immediately.

Other meds are to be avoided for 1-2hrs of taking an antacid

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8
Q

What are the main AE of aluminum and calcium antacids?

Aluminum salts (almagel)
Calcium carbonate (tums)

A

They can cause constipation due to their constricting effect.

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9
Q

What is often given with aluminum salts (almagel) to prevent AE?

A

Often given with magnesium to counteract constipation since mg causes diarrhea.

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10
Q

What is a possible AE of magnesium salts (milk of magnesia)?

A

Can cause diarrhea

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11
Q

What are 3 other AE only caused by calcium carbonate? Other than constipation

What is often given with it to minimize one of those effects?

A

Calcium carbonate can produce gas and belching
Will often be given with simethicone (ovol) which is an anti gas medication to reduce discomfort

Can also cause kidney stones due to calcium so not recommended for long term use
And rebound hyperacidity

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12
Q

Which antacid is the only one recommended for renal disease (the most easily excreted)?

A

Aluminium hydroxide salts (Almagel)

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13
Q

What is a big contraindication with magnesium salts (milk of magnesia) or maalox?

A

Dangerous when used in pts with renal failure bc the failing kidney cannot excrete extra mg which causes accumulation.

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14
Q

Which antacid can cause rebound hyperacidity after medication discontinuation?

A

Calcium carbonate (tums)

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15
Q

Which conditions would alert for cautious use of antacids?

A

Caution use Recommended in pts who have HF, HTP, other heart diseases requiring sodium restriction

Especially if antacid is high in sodium content (ex sodium bicarbonate)

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16
Q

What are some nursing implications with antacids?

A

Assess for conditions that may restrict antacid use:
- pregnancy
- fluid imbalances
- renal disease
- GI obstruction
- HF

• Pts with HF or HTP should not use sodium bicarbonate antacids
• long term antacid use is discouraged
• meds should not be given within 1-2hrs of antacid administration
• administer with at least 240mLs of water to enhance absorption

17
Q

Which antacid can cause milk-alkali syndrome and how does it present?

A

Calcium containing antacids (calcium carbonate (tums))

Presents as : headaches, anorexia, n&v, unusual tiredness

18
Q

What is the prototype medication for histamine 2 receptor blocker?

A

Famotidine (Pepcid)

Used for acid related disorders such as GERD, PUD, erosive esophagitis, GI bleeds

19
Q

What are the nursing implications with famotidine (Pepcid) ?
(How should it be taken)

A
  • Should be taken 1hr before antacids
  • should be given without regards to food (with or without) (best 30-60min before meals)
  • should avoid smoking bc it decreases H2 antagonist effectiveness

If given Iv:

Monitor infusion for risk of hypotension

20
Q

What are some interactions with famotidine (Pepcid) the h2 antagonist?

A

Interacts with meds that need an acidic GI environment for gastric absorption (may decrease the absorption of those drugs)

21
Q

What should be reported and assessed-/monitored with famotidine (Pepcid) the h2 receptor blocker if taken for ulcers or GI irritation?

A
  • monitor for GI tract bleeding: tell pt to report black tarry stool, hematemesis,
  • inspect quadrants
  • listen to bowel sounds
  • palpate and percuss
22
Q

What should be avoided with famotidine (Pepcid) therapy?

H2 antagonist

A
  • avoid alcohol
  • avoid aspirin
  • avoid NSAIDs
  • avoid smoking
  • avoid foods that can increase GI irritation
23
Q

What are the three prototypes meds for Proton pump inhibitors?

A
  • Lansoprazole (Prevacid)
  • omeprazole magnesium (Losec)
  • pantoprazole (Pantoloc)
24
Q

What are some conditions that are associated with long term use of PPIs ?

Proton pump inhibitors
Lanso, ome and pantoprazole

A

Long term use associated with:
- c. Diff
- osteoporosis
- pneumonia
- mg depletion

25
Q

What are older pts more at risk of with PPI therapy?

A

More at risk of AKI and intestinal nephritis

26
Q

Which is the only PPI available IV?

A

Pantoprazole (pantoloc) is the only PPI available IV
Used for GI bleeds continuous infusion

27
Q

How should PPIs PO be taken?

A
  • take on an empty stomach (usually 30-60min before breakfast)
  • swallow whole, do not crush or chew

Lansoprazole: quick dissolving capsules for tube feedings can be opened and mixed with apple sauce

28
Q

What are some nursing monitoring and assessments to be done with PPI therapy?

A
  • assess for allergies and history of kidney disease
  • monitor for diarrhea and constipation
  • take small frequent meals
29
Q

What are some uses for the Ulcer adherent sucralfate medication?
What is its general mechanism of action?

A

Best for active stress ulcers, PUD and esophageal erosion

Works locally by binding to the surface of an ulcer

30
Q

What are some possible interactions with ulcer adherent medication sucralfate?

A

May interfere with absorption of other meds so :
- take other meds at least 2hrs before
- take antacids 2hrs before or 1 hr after

31
Q

How should the ulcer adherent med sucralfate be taken?

A
  • Should be taken on an empty stomach (1-2hrs before meals)
  • best taken at bedtime
  • safe during pregnancy
32
Q

Which nursing diagnosis is appropriate for a pt receiving famotidine (Pepcid)?

A) risk for infection related to immunosuppression
B) risk for injury related to thrombocytopenia
C) impaired urinary elimination related to retention
D) ineffective peripheral tissue perfusion related to hypertension

A

B

Collab Therapies 2 (28 decks)

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