Gastrointestinal Meds (Inflammation) Flashcards
Proton Pump Inhibitors
- Anti-ulcer medications
- Used to treat active ulcer disease, erosive esophagitis, pathological hypersecretory conditions.
- side effects: headache, GI disturbances
- ex: Omeprazole (Prilosec), pantoprazole (Protonix) (“-zole”)
*Only stay on anti-ulcer meds for 16 weeks max
Histamine type II
- Anti-ulcer medications
- Used for alleviating heartburn s/s, prevent complications of PUD, prevents stress ulcers and reduces recurrence of ulcers.
- side effects: anxiety, black stools, tachycardia
- ex: Famotidine, Ranitidine (-dine)
- Don’t take with antacids
- No smoking, NSAIDs, alcohol
- Inform HCP of bleeding
- Elevate HOB
Anti-Ulcer Class
Sucralfate (Carafate)
- Used for management of peptic ulcers
- s/e: dizziness, constipation, diarrhea, indigestion, nausea
- Take medicine for entire course
- Take 1 hour before meals (empty stomach)
- May impede absorption of warfarin, phenytoin, theophylline, digoxin, and some ABX (Give 2 hours apart from these meds)
Misoprostol (Cytotec)
-Used to prevent gastric mucosal injury from NSAIDs (including ASA) in elderly or high risk clients. Also if you have a hx of ulcers.
-s/e: miscarriage~, abdominal pain, constipation
*enhances mucosal defenses, dec gastric acid
*Given with meals
*Assess women of childbearing age for pregnancy.
*Start Misoprostol on 2-3rd day of menstrual cycle following a negative pregnancy test.
~Misoprostol will cause spontaneous abortion. Contraception must be used throughout therapy use.
Antiemetics
Meclizine, Prochlorperazine~
-Used for motion sickness, nausea/vomit control
-Monitor for drowsiness and protect the client from injury
-Monitor VS, I/Os
-Limit odors with nausea, Limit oral intake to cl lq diet when vomiting
~Watch for NMS, agranulocytosis, Reye’s syndrome (<16 years old)
Metoclopramide
- Used to prevent emesis related to chemo and surgery. Reduction of GERD. (Unlabeled: tx hiccups)
- s/e: drowsiness, anxiety, dry mouth, hypo/HTN
- Watch for NMS, Bone marrow suppression
- Avoid CNS depressants
- Maintain hydration and avoid extreme temps
Dronabinol (THC), Nabilone (Cesamet)
- Used for tx of n/v due to chemo and client hasn’t responded to other antiemetics.
- Uses Marijuana to inhibit vomit control
- s/e: drowsiness, disoriented, hallucinations, impaired judgment, palpitations, dry mouth
- Causes impaired judgment
- Avoid Alcohol, CNS Depressants
Sodium Polystyrene Sulfonate
Kayexalate
- Cationic Exchange Resin
- Used for mild to mod hyperkalemia
- s/e: constipation, fecal impaction, F/E imbalance
- Low Na+ Diet
- Avoid High K+ foods
- Monitor serum levels, I/Os, daily wt
Antiflatulents
- Simethicone (Degas, Gas-x)
- Used to relieve painful excess gas symptoms
- s/e: None
- Inform clients on a good diet; avoid carbonation
- Can lie on side in fetal position to relieve discomfort
Lubiprostone (Amitiza)
- Chloride Channel Activator
- Used for tx of chronic idiopathic constipation, opioid induced constipation, IBS-C
- s/e: headache, abdominal pain/distention
- Assess for s/s of bowel obstruction
- Monitor bowel movement frequency
Calcium Salts
- Mineral Replacement or Supplement
- Tx of osteoporosis, tx of electrolyte IMB, Antacid tx of gastritis
- s/e: arrhythmias, bradycardia, constipation
-Ex: Calcium Carbonate, Calcium Citrate, Calcium Gluconate
- Monitor serum levels before and after administration
- Monitor BP, pulse, ECG
Diarrhea
- Goal of this is to treat underlying cause, dehydration; replace fluids and electrolytes; relief of abdominal discomfort; reduce passage of stool
- Opioids
- To dec intestinal motility, peristalsis
- Don’t use opioids for poison, infection, or bacterial toxins
Magnesium Salts
-Mag Oxide, Mag Citrate, Mag Hydroxide (MOM)
- Used for tx and prevention of hypomagnesemia. A lax/bowel evacuant. PO Liquid can be used as an antacid.
- s/e: diarrhea, cramps, bloating
- Don’t take within 2 hrs of other medications, esp ABX.
- Monitor electrolytes and watch BP
Hyoscyamine (Levsin, Anaspaz)
- Antispasmodic/anticholinergic class
- Used to tx spastic bladder and bowel (diverticulitis, IBS, infant colic, biliary/renal colic, PUD) and neurogenic bowel disturbances.
- s/e: dry mouth, tachycardia, bloating, constipation, nausea
- May cause drowsiness, avoid tasks needing alertness.
- Oral rinse, sugarless gum/candy, frequent good hygiene (helps relieve dry mouth)
- Anticholinergic meds cause symptoms categorized with sayings such as “hot as a hare”, “dry as a bone”, “blind as a bat”
Anticholinergic/Antiemetic
Scopolamine
- Used to prevent motion sickness. N/V management asso. w/ opioid analgesic or anesthesia.
- S/e: drowsy, confused, tachycardia, constipation.
- Causes drowsiness, avoid tasks requiring alertness
- Avoid alcohol, CNS depressants
GI Anti-inflammatories
Mesalamine, Sulfasalazine, Olsalazine
- Used for treatment of inflammatory bowel diseases (Crohn’s, UC)
- S/e: headache, malaise, pancreatitis, anaphylaxis
- Assess for allergies to sulfonamides or salicylates
- Fluid intake should be 1500-2000 mL/daily. Monitor daily wt and I/Os
Anti-IBS agents
Linaclotide (Liness)
- Used for treatment of IBS or chronic idiopathic constipation
- s/e: diarrhea, abdominal pain, GERD
- Diarrhea may occur 1-2 weeks after therapy, notify HCP
- No OTC or herbal meds for constipation while taking Linaclotide
Antidiarrheals
- Used for acute diarrhea therapy. Chronic diarrhea asso with IBS. Decs volume of ileostomy drainage
- s/e: Drowsiness, dry mouth, constipation, N/V/D
- ex: Diphenoxylate/Atropine(Lomotil, Lonox), Difenoxin/Atropine (Motofen), Loperamide (Imodium)
- Anticholinergic meds cause symptoms categorized with sayings such as “hot as a hare”, “dry as a bone”, “blind as a bat”
- Take with plenty of fluids
- Monitor I/O, stools (character and numbers)
