Gastrointestinal Sys(Pharm) Flashcards Preview

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Flashcards in Gastrointestinal Sys(Pharm) Deck (30):
1

Cimetidine

Generic name: Cimetidine
Trade name: Tagamet

2

Famotidine

Generic Name: Famotidine
Trade name: Pepcid

3

Prochlorperazine

Generic Name: Prochlorperazine
Trade Name: Compazine

4

Hydroxyzine

Generic Name: Hydroxyzine
Trade Name: Atarax-Vistaril

5

Meclizine

Generic Name: Meclizine
Trade Name: Antivert

6

Metoclopramide

Generic Name: Metoclopramide
Trade Name: Reglan

7

Psyllium

Generic Name: Psyllium
Trade Name: Metamucil

8

Bisacodyl

Generic Name: Bisacodyl
Trade Name: Dulcolax

9

Magnesium Hydroxide

Generic Name: Magnesium Hydroxide
Trade Name: MOM

10

Docusate Sodium

Generic Name: Docusate Sodium
Trade Name: Colace

11

Diphenoxylate HCl

Generic Name: Diphenoxylate HCl
Trade Name: Lomotil

12

Loperadmide HCL

Generic Name: Loperadmide HCL
Trade Name: Imodium

13

Lactulose

Generic Name: Lactulose
Trade Name: Cephulac

14

Sucralfate

Generic Name: Sucralfate
Trade Name: Carafate

15

Omeprazole

Generic Name: Omeprazole
Trade Name: Prilosec

16

Ondansetron HCL

Generic Name: Ondansetron HCL
Trade Name: Zofran

17

Magnesium Sulfate

Generic Name: Magnesium Sulfate
Trade Name: Epsom Salt

18

Antacids(Action)
ANTI_ULCER

neutralize and decrease acidity

19

Antacids(Indication)
ANTI-ULCER

-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

20

Goal of Antacid therapy:

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

21

Side Effect and preparation
ANTI-ULCER

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

22

Antacid
(ANTIULCER)

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)

23

Antisecretory(H2 receptor Antagonist)(Action)
ANTIULCER

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

24

Antisecretory(H2 receptor Antagonist)(Indication)
ANTIULCER

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

25

Antisecretory(H2 receptor Antagonist)(DRUG)
ANTIULCER

-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

26

Antisecretory(H2 receptor Antagonist)(SIDE EFFECTS)
ANTIULCER

-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

27

Antisecretory(H2 receptor Antagonist)(Interaction)
ANTIULCER

-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

28

Antisecretory(H2 receptor Antagonist)(CONTRAINDICATION)
ANTIULCER

-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

29

Antisecretory(H2 receptor Antagonist)(Nursing Implication)
ANTIULCER

-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

30

Antisecretory(H2 receptor Antagonist)(Nursing Implication)
ANTIULCER

-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