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Pharm 1 Exam 3 > Elimination > Flashcards

Elimination Flashcards

1
Q

Proton pump inhibitor drugs, action, side effects, nursing interventions?

A

Drugs: Esomeprazole, omeprazole, pantoprazole
Action: Bind to H+ ions reducing gastric acid
Side effects: Headache, diarrhea, rash, nausea, dizziness
Nursing interventions: More effective than H2 receptor antagonists; heal 90% duodenal ulcers in 4 weeks, 90% gastric ulcers in 6-8 weeks.

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2
Q

H2 receptor antagonists drugs, action, side effects, nursing interventions?

A

Drugs: Cimetidine, famotidine, ranitidine
Action: Suppress volume & acidity or gastric secretions
Side effects: Depression w/ ranitidine
Nursing interventions: Do not take antacids at same time - reduces effectiveness. Cimetidine numerous drug - drug interactions. Supplement Vit B12. Monitor liver & kidney function. Anemia w/ long term use.

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3
Q

Antacids drugs, action, side effects, nursing interventions?

A

Drugs: Aluminum hydroxide, calcium carbonate (Tums), magnesium hydroxide, sodium bicarbonate (alka-seltzer).
Action: Neutralize stomach acid. Do not promote healing of the ulcer. Act in 10 minutes; lasts 2 hrs.
Side effects: Aluminum & calcium - constipation; magnesium - diarrhea, nausea, abdominal cramping.
Nursing interventions: None

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4
Q

Omeprazole (Prilosec) classification?

A

Proton pump inhibitor

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5
Q

Contraindications for Omeprazole?

A

Hypocalcemia
Vomiting
GI bleeding

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6
Q

Uses/action for omeprazole?

A

Gastric acid pump inhibitor; inhibits H+.
Relieves GI distress & promotes ulcer healing.
Uses: gastric ulcers, GERD, Dyspepsia > twice weekly.

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7
Q

Interactions with omeprazole?

A

> Phenytoin, diazepam, warfarin levels, antiretroviral agents, ginkgo, st john’s wort < plasma concentration, food < absorption by 35%.

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8
Q

Side effects for omeprazole?

A

None common.

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9
Q

Nursing interventions for omeprazole?

A

Report urinary problems: pain, blood in urine.
Diarrhea - drug may be discontinued.

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10
Q

How is helicobacter pylori treated?

A

Initial: proton pump inhibitor, clarithomycin (Biaxin) and amoxicillin (or other).
Alternative: PPI, clarithromycin & metronidazole (Flagyl) or PPE, bismth subsalicylate, metronidazole & tetracycline.

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11
Q

Patients who have heartburn may treat it with over-the-counter antacids. What patient education would you provide to a patient taking an antacid?

A

Take 2 hours before or after other drugs - can effect absorption of other drugs.

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12
Q

Angelina reports that for the past 10 years or so she has had intermittent constipation. What could be possible causes for her constipation?

A

Age (peristalsis slows)

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13
Q

Bullk forming drugs, action, side effects, nursing interventions?

A

Drugs: psyllium, methylcellulose
Action: Fiber, absorbs water, > fecal mass
Side effects: Abd fullness or cramping
Nursing interventions: Work slow, plenty of water.

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14
Q

Saline & Osmotic drugs, action, side effects, nursing interventions?

A

Drugs: Lactulose, magnesium, hydroxide, sodium biphosphate
Action: Pull water into colon quickly
Side Effects: Fluid & electrolyte imbalances, diarrhea, abdominal cramping
Nursing interventions: Used for bowel preps. Give w/ full glass of water.

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15
Q

Stimulant drugs, action, side effects, nursing interventions?

A

Drugs: Bisacodyl
Action: Irritate liming of intestines, act quickly
Side effects: Laxative dependence, fluid & electrolyte depletion, diarrhea, cramping.
Nursing interventions: Use sparingly

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16
Q

Stool softeners/surfactant drugs, action, side effects, nursing interventions?

A

Drugs: Ducosate
Action: Cause water & fat absorption into stool
Side effects: Abdominal, cramping, diarrhea
Nursing interventions: Prevent constipation, encourage water intake

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17
Q

Herbal agents drugs, action, side effects, nursing interventions?

A

Drugs: Castor oil, senna
Action: ———
Side effects: Abdominal cramping, diarrhea
Nursing interventions: ———

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18
Q

What classification of drugs can be given to treat diarrhea?

A

Opioids, Misc. drugs

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19
Q

Opioid drugs, action, side effects, nursing interventions?

A

Drugs: Diphenoxylate w/ atropine
Action: Slow peristalsis in colon
Side effects: Drowsiness, dizziness, nausea, dry mouth
Nursing interventions: Use only in acute diarrhea, due to opioid dependency. Contraindicated w/ glaucoma. No antihistamines - CNS depression.

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20
Q

Misc drugs - Bismuth salts action?

A

Binds & absorbs toxins.

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21
Q

Misc drugs - Psyllium action?

A

Add bulk to stool.

22
Q

Misc drugs - Lactobacillus acidophilus action?

A

Add normal flora back into intestine.

23
Q

What underlying condition can cause intermittent diarrhea?

A

Ulcerative collitis.

24
Q

Classification for sulfasalazine?

A

Anti-inflammatory DMARD (disease-modifying antirheumatic drugs)

25
Contraindications for sulfasalazine?
Folate deficiency megaloblastic anemia renal failure intestinal & urinary tract obstruction
26
Uses/action for sulfasalazine?
Anti-bacterial & anti-inflammatory, inhibits prostaglandins that cause diarrhea. Uses: off label use for Chron's disease; rheumatoid arthritis.
27
Interactions with sulfaslazine?
Antibiotics alter absorption.
28
Side effects of sulfasalazine?
Nausea Vomiting bloody diarrhea anorexia headache skin reactions
29
Nursing interventions for sulfasalazine?
Monitor folate levels. Discolor urine & Skin orange-yellow Relapses - 40% Monitor kidney function Check for sulfa drug allergy.
30
What are three steps in treating inflammatory bowel disease (IBD)?
1) 5-aminosalicylate acid medications (most rapid symptom relief) 2) If those fail, oral corticosteroids are used 3) Immunosuppressant drugs (methotrexate) 3 month onset of action.
31
What are antiemetics used for?
Nausea and vomitting
32
Anticholinergics & antihistamines drugs, action, side effects, nursing interventions?
Drugs: Hydroxyzine, meclizine Action: ------- Side effects: Drowsiness, dry mouth, blurred vision Nursing interventions: Motion sickness - 20-60 minutes before travel
33
Benzodiazepines drugs, action, side effects, nursing interventions?
Drugs: Lorazepam Action: Relaxation & anti-emetic effect Side effects: Dizziness, drowsiness, fatigue, slurred speech Nursing interventions: -------
34
Cannabinoids drugs, action, side effects, nursing interventions?
Drugs: Dronabinol Action: Relaxation & anti-emetic effect Side effects: Dizziness, drowsiness, euphoria, confusion Nursing interventions: --------
35
Corticosteroids drugs, action, side effects, nursing interventions?
Drugs: dexamethasone Action: Anti-emetic Side effects: Mood swings, wt gain, acne, insomnia, Na + fluid retention Nursing interventions: Short-term acute nausea w/ chemo & post-surgical
36
Neurokinin receptor antagonists drugs, action, side effects, nursing interventions?
Drugs: Aprepitant Action: anti-emetic Side effects: Fatigue, constipation, diarrhea, anorexia, nausea, hiccups Nursing interventions: Chemo or surgery
37
Phenothiazines drugs, action, side effects, nursing interventions?
Drugs: prochlorperazine, promethazine Action: normally used to treat psychoses Side effects: dry eyes, blurred vision, dry mouth, constipation, drowsiness Nursing interventions: Chemo
38
Serotonin receptor antagonist drugs, action, side effects, nursing interventions?
Drugs: Ondansetron Action: ----- Side effects: Headache, drowsiness, fatigue, constipation, diarrhea Nursing interventions: Chemo, radiation, surgery, given prophylactically
39
Classification for Promethazine (phenergan)?
Antihistamine, antiemetic, antivertigo
40
Contraindications for promethazine?
Angina, atrial fibrillation, hypertension, MAOIs, depression, hepatic disease.
41
Uses/action for promethazine?
Depression of TZ in medulla. Uses: motion sickness, N&V, nystagmus
42
Before giving promethazine?
Take BP
43
Interactions with promethazine?
Alcohol, CNS depressants, anticholinergics
44
Side effects of promethazine?
Sedation, drowsiness, blurred vision, dry mouth. Transient hypertension or hypotension
45
Nursing interventions for promethazine?
Motion sickness - take 30-60 minutes before travel, repeat @ 8-12 hr intervals. Do not drive until effects known. Avoid alcohol, other CNS depressants.
46
What are associated risk factors for peptic ulcers?
Close family history Blood group O Smoking tobacco Caffeine Drugs (corticosteroids, NSAIDS, platelet inhibitors) Excessive psychological stress Infection with helicobater pylori
47
What are duodenal ulcers, and who do they occur in? Symptoms?
-- More common than gastric ulcers -- Occur most commonly in 30-50 age group -- Usual symptom: Gnawing or burning upper abdominal pain ------ Occurs 1-3 hrs after a meal ------ Pain worse when stomach is empty -- Other symptoms: nocturnal pain, nausea, vomiting -- bleeding may occur ------ bright red blood in vomit ------ black, tarry stools
48
What are gastric ulcers? Who do they occur in? Symptoms?
-- Less common type of ulcer -- More common in over-60 age group -- Symptoms ------ Pain may be relieved after food or may continue after a meal ------ Anorexia, weight loss, vomiting -- remissions infrequent or absent -- more commonly associated with cancer
49
What is GERD? Who do they occur in? Symptoms?
Gastroesophageal reflux disease -- Caused by loosening of sphincter between esophagus and stomach -- Associated with obesity -- Acidic stomach contents move up into esophagus ------ intense burning (heartburn) ------ lead to esophageal ulcers, esophagitis, or strictures -- Lifestyle changes can improve GERD symptoms
50
Antacid drugs, mechanism of action, primary use?
Drugs: aluminum hydroxide, magnesium hydroxide, calcium carbonate Mechanism of action: Neutralizes stomach acid by raising pH of stomach acid contents
51
Antacid drugs, mechanism of action, primary use?
Drugs: aluminum hydroxide, magnesium hydroxide, calcium carbonate Mechanism of action: Neutralizes stomach acid by raising pH of stomach acid contents Primary use: In combination with other antiulcer agents for relief of heartburn due to PUD or GERD ------ Administer aluminum antacids at least 2 hours before or after other drugs because absorption could be affected ------ Aluminum, calcium - constipation; magnesium - diarrhea

Pharm 1 Exam 3 (5 decks)

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