Gastrointestinal Sys(Pharm)

Question 1

Cimetidine

Answer 1

Generic name: Cimetidine

Trade name: Tagamet

Question 2

Famotidine

Answer 2

Generic Name: Famotidine

Trade name: Pepcid

Question 3

Prochlorperazine

Answer 3

Generic Name: Prochlorperazine

Trade Name: Compazine

Question 4

Hydroxyzine

Answer 4

Generic Name: Hydroxyzine

Trade Name: Atarax-Vistaril

Question 5

Meclizine

Answer 5

Generic Name: Meclizine

Trade Name: Antivert

Question 6

Metoclopramide

Answer 6

Generic Name: Metoclopramide

Trade Name: Reglan

Question 7

Psyllium

Answer 7

Generic Name: Psyllium

Trade Name: Metamucil

Question 8

Bisacodyl

Answer 8

Generic Name: Bisacodyl

Trade Name: Dulcolax

Question 9

Magnesium Hydroxide

Answer 9

Generic Name: Magnesium Hydroxide

Trade Name: MOM

Question 10

Docusate Sodium

Answer 10

Generic Name: Docusate Sodium

Trade Name: Colace

Question 11

Diphenoxylate HCl

Answer 11

Generic Name: Diphenoxylate HCl

Trade Name: Lomotil

Question 12

Loperadmide HCL

Answer 12

Generic Name: Loperadmide HCL

Trade Name: Imodium

Question 13

Lactulose

Answer 13

Generic Name: Lactulose

Trade Name: Cephulac

Question 14

Sucralfate

Answer 14

Generic Name: Sucralfate

Trade Name: Carafate

Question 15

Omeprazole

Answer 15

Generic Name: Omeprazole

Trade Name: Prilosec

Question 16

Ondansetron HCL

Answer 16

Generic Name: Ondansetron HCL

Trade Name: Zofran

Question 17

Magnesium Sulfate

Answer 17

Generic Name: Magnesium Sulfate

Trade Name: Epsom Salt

Question 18

Antacids(Action)

ANTI_ULCER

Answer 18

neutralize and decrease acidity

Question 19

Antacids(Indication)

ANTI-ULCER

Answer 19

• Hyperacidity
• Heartburn and Acid Indigestion
• Sour Stomach
• Gastroesophageal Reflux Disease(GERD)
• Peptic Ulcer Disease(PUD)
• Zollinger Ellison Syndrome=peptic ulcer with hyper secretion/hyperacidity due to tumor
• Hyperphophatemia related to renal failure=elevated levels of phosphorus=Amophjel)
• Calcium deficiency=Tums
• Magnesium deficiency=MOM

Question 20

Goal of Antacid therapy:

Answer 20

• reduce pain
• maintain ph btw 3 and 4
• acute ill goal to have ph level at 7

Question 21

Side Effect and preparation

ANTI-ULCER

Answer 21

Magnesium
-given for alcohol pt
SE: diarrhea/toxicity

Aluminum

• given for hyperphosphate in renal patient
• SE: common=constipation, toxicity resemble Alzeihmers: forgetful

Calcium

• given for hypocalcemia in post menopausal pt
• SE: common=bloating, hypercalcemia, rebound activity

Sodium Bicarb
-SE: alkalosis rebound acidity, common: systemic alkalosis

-all can cause electrolyte imbalance and systemic alkalosis

Question 22

Antacid

ANTIULCER

Answer 22

Dose

• liquid(suspension), shake for 15-30ml, do not follow with water
• solid=tablet, chew thoroughly=follow with full glass of water
• frequency=acute: q1hr while awake, long term: 1-2hrs PC(after meals) and HS(hour of sleep)
• therapy will contine 4-6 weeks after symptoms no longer exist
• give antacids 1before 2hrs after any medication

Nursing implication

• antacids work for about 3hrs
• change stool whitish color
• Blood electrolyte monitoring
• drug can cause alkolosis/electrolyte imbalance
• can be used in renal patients to treat hyperphosphate

Drug
-Magnesium Hydroxide(MOM)

Question 23

Antisecretory(H2 receptor Antagonist)(Action)

ANTIULCER

Answer 23

• block h2 receptor site on parietal cells decreasing the volume and pH of gastric acid
• work day and night
• effect volume and ph level

Question 24

Antisecretory(H2 receptor Antagonist)(Indication)

ANTIULCER

Answer 24

• short term: 4-8weeks
• hypersecretory states
• PUD
• GERD
• Zollinger Ellison

Question 25

Antisecretory(H2 receptor Antagonist)(DRUG) | ANTIULCER

Answer 25

-H2 blockers taken with food Cimetidine(Tagamet) - 300mg q6hrs - long term qhs=400-800mg Famotidine(Pepcid) -po/im/iv=20-40mg QD Nizatidine -only on empty stomach

Question 26

Antisecretory(H2 receptor Antagonist)(SIDE EFFECTS) | ANTIULCER

Answer 26

- common with cimetidine(tagament)=drowsiness - cns stimulation, depression - cns- dizziness, headache, disorientation, hallucination, depression - cardiac- decrease hr, decrease bp, cardiac arrhythmia=more common w/ iv route - Hema- decrease bone marrow=severe adv=monitor infection/cbc/bleeding - MS-skin rash,muscle pain - GI-Diarrhea - Men-decrease sperm count,impotence,not drug of choice for male, gynecomastia

Question 27

Antisecretory(H2 receptor Antagonist)(Interaction) | ANTIULCER

Answer 27

- cigarette smoke=reverse effect of h2 blocker - CNS depressants=increase drowsiness - Antiarrhythmics=drop bp/hr=i/v - Methyl-Xanthines=bronchodilator=can cause theophyline toxicity(n/v) with cimetidine(tagament) - warfarin - dilantin - tricyclic antidepressants

Question 28

Antisecretory(H2 receptor Antagonist)(CONTRAINDICATION) | ANTIULCER

Answer 28

- children under 16 - lactating women - chronic liver disease - chronic kidney disease - can alter results of allergy test=stop for 4 days effect allergy testing - can alter results gastric acid testing - monitor mental status= in older age - h2 prevent secretion of HCL effect volume and acidity

Question 29

Antisecretory(H2 receptor Antagonist)(Nursing Implication) | ANTIULCER

Answer 29

- give with food except for Nizatidine - IV fusion= slow= concern about bp/hr/cardiac - IM forms=deep IM=large muscle =pepcid/xantac - promoting absorption= 1hr b4 = 2hr after - CNS depression= tagament caused drowsiness common= driving/operate heavy machinery=once a day dose=given at hr of sleep

Question 30

Antisecretory(H2 receptor Antagonist)(Nursing Implication) | ANTIULCER

Answer 30

- bowel plan - assess for mood changes=commonly seen with 2-3 days of treatment - examine for bleeding daily - foods to avoid=avoid foods that irritate gi- caffeinated/spicy foods/alcohol - resolution gynecomastia=restores over time,stop use - smoking reverse the effects - monitor stool/vomit from gi tract, resp tract - gi bleed=hyperacidity conditions