GI

Question 1

Treatment of peptic ulcer diease

Answer 1

combination of lifestyle and pharmacotherapy work best

goals of treatment are to eliminate infection by H.pylori, promote ulcer healing, prevent recurrence of sympotms

Question 2

Drugs used to treat Peptic Ulcer Disease

Answer 2

H2-receptor antagonists
proton pump inhibitors
antacids
antibiotics
miscellaneous drugs

Question 3

Antibiotics (used for PUD)

Answer 3

administered to treat H.Pylori infections of GI tract

two or more antibiotics are given concurrently to increase effectiveness and lower the potential of creating resistance to treatment

usually uses a proton pump inhibitor and bismuth compounds (which inhibit bacterial growth and prevent h.pylori from adhering to gastric mucosa)

Question 4

Therapeutic Action of Miscellaneous Drugs (for PUD)

Answer 4

SUCRALFATE - coats ulcer and protects it from further erosion

MISTOPROSTOL - inhibits acid and stimulates production of mucus

PIRENZEPINE - inhibits autonomic receptors responsible for gastric secretion

Question 5

Therapeutic Action of H2-Receptor Blockers

Answer 5

suppress the volume and acidity of stomach acid

often drugs of choice to treat PUD

also treats GERD and heartburn

Question 6

H2-Receptor Antagonists (blockers)

Answer 6

cimetidine
famotidine
nizatidine
ranitidine

Question 7

Ranitidine (zantac)

Answer 7

prototype h2-receptor blocker or antagonist

used to treat PUD

acts by blocking h2-receptors in stomach to decrease acid production

adverse effects are possible reduction in the number of red and white blood cells and platelets, impotence, or loss of libido in men

Question 8

What are some risks nurses must monitor for with h2-receptor antagonist therapy?

Answer 8

assess kidney and liver function

evaluate cbc for possile anemia during long term use

risk of dysrythmia and hypotension with IV cimetidine

Question 9

therapeutic action of proton pump inhibitors

Answer 9

binds with the enzyme H+, K+, ATPase - this enzyme increases HCl

used for short term therapy of PUD and GERD

more effective at reducing gastric-acid H2-receptor blockers

need to be taken 30 minutes prior to eating and may be administered at same time as antacids

Question 10

proton pump inhibitors

Answer 10

esomeprazole
lansoprazole
omeprazole
pantoprazole
rabeprazole

Question 11

omeprazole

Answer 11

reduces acid secretion in stomach by binding irreversibly to enzyme H+, K+, ATPase

primarily used for short term (4-8 week) treatment of peptic ulcers and GERD

adverse effects include headache, nausea, diarrhea, rash, abdominal pain, drug interactions

**long term use associated with an increased risk of gastric cancer

Question 12

Therapeutic action of antacids

Answer 12

neutralize stomach acid

are inexpensive and effective

simethicone added to reduce gas

relieve symptoms but don’t promote ulcer healing

Question 13

Antacids

Answer 13

aluminum hydroxide
calcium carbonate
calcium carbonate with magnesium hydroxide
magnesium hydroxide
magnesium hydroxide with aluminium hydroxide
magnesium hydroxide with aluminium hydroxide with simethicone
sodium bicarbonate

Question 14

Aluminium Hydroxide

Answer 14

prototype antacid

neutralizes stomach acid by raising pH of stomach contents

primarily used in combination with other antiulcer agents for relief of heartburn due to GERD or PUD

adverse effects are constipation or drug interactions

Question 15

Drugs for treating bowel disorders

Answer 15

laxatives

antidiarrheals

antiemetics

drugs for pancreatitis

Question 16

therapeutic action of laxatives

Answer 16

promotes bowel movements

bulk forming agents absorb water, adding size to fecal mass

stool softeners or surfacants cause more water and fat to be absorbed into stools

stimulants irritate bowel to increase peristalsis

saline or osmotic laxatives are not absorbed in intestine (pull water into fecal mass to create more watery stool)

herbal agents are natural product available OTC, the most common is SENNA

misc. agents include mineral oil, which acts as poop lube

Question 17

Laxatives and Cathartics: Bulk-forming Agents

Answer 17

calcium polycarbophil
methylcellulose
psyllium mucilloid

Question 18

Laxatives and Cathartics: saline and somotic agents

Answer 18

magnesium hydroxide
polyethylene glycol
sodium biphosphate

Question 19

Laxatives and Cathartics: stimulants

Answer 19

bisacodyl
castor oild
phenolphthalein

Question 20

Laxatives and Cathartics: stool softeners

Answer 20

doxusate

Question 21

Laxatives and Cathartics: misc. agents

Answer 21

mineral oil

Question 22

What are important things to assess for when treating constipation?

Answer 22

colon cancer

esophageal obstruction

intestinal obstruction

fecal impaction

undiagnosed abdominal pain

Question 23

psyllium mucilloid

Answer 23

prototype laxative, bulking agent

swells and increases size of fecal mass

primary use is to promote passage of stool

adverse effects are rare and cramping is less than with stimulant type laxatives

Question 24

therapeutic action of antidiarrheals

Answer 24

for mild diarrhea

effective at returning elimination patterns to normal

for severe cases, opioids are the most efficacious antidiarrheal agents

Question 25

Antidiarrheals: Opioids

Answer 25

belladonna with opium diphenoxylate with atropine loperamide

Question 26

antidiarrheals: misc. agent

Answer 26

bismuth subsalicylate | bismuth subsalicylate with kaolin-pectin

Question 27

For whom is antidiarrheal therapy countraindicated?

Answer 27

severely dehydrated, those with electrolyte imbalance patients with liver and renal disorders glaucoma patients

Question 28

diphenoxylate with atropine

Answer 28

antidiarrheal, opioid slows peristalsis primarily used for moderate to severe diarrhea adverse effects are dizziness and drowsiness NOT recommended for children

Question 29

Therapeutic action of drugs for Inflammatory bowel disears

Answer 29

mild to moderate is treated with 5-aminosalicylic acid or 5-ASA corticosteroids used in more persistent cases particularly severe may require immunosuppresent drugs

Question 30

`therapeutic action of drugs for irritable bowel syndrome

Answer 30

treatment is supportive targeted at symptoms medications include bulk laxatives, anticholinergic drugs, serotonin agonists

Question 31

therapeutic actions of antiemetics

Answer 31

drugs from at least 8 classes used to prevent nausea and vomitting act by inhibiting dopamine or serotonin receptors in brain

Question 32

select antiemetics

Answer 32

anticholinergic: SCOPOLAMINE antihistamines: DIMENHYDRINATE DIPHENHYDRAMINE HYDROXYZINE benzodiazipines: DIAZEPAM LORAZEPAM cannabinoids:CANNABIDIOL glucocorticoids: DEXAMETHASONE METHYPREDNISOLONE ``` phenothiazines and phenothiazine like agents METOCLOPRAMIDE PERPHENAZINE PROCHLORPERAZINE PROMETHAZINE ``` serotonin receptor antagonists DOLASETRONETRON ONDANSETRON GRANISETRON

Question 33

What are emetics?

Answer 33

emetics are drugs that stimulate nausea or vomiting

Question 34

prochloperazine

Answer 34

prototype antiemetic blocks dopamine receptors to brain, inhibiting signals to vomiting center in medulla primarily used for severe nausea and vomiting, but also to treat psychosis adverse effects include dore-related anticholinergic side effects(dry mouth, sedation, constipation, orthostatic hypotension, tachycardia, extrapyrimidal symptoms** **the serious concern with prolonged therapy

Question 35

therapeutic action for pancreatitis

Answer 35

pancrease secretes essential digestive enzymes carboxypeptidase, chymotrypsin, and trypsin lipase, amylase and nuclease require presence of bile lack of secretion results in malabsorption disorders. replacement therapy is sometimes warrented

Question 36

pancrelipase

Answer 36

prototype drug for pancreatitis contains lipase, protease, and amylase of pork origin which: facilitates conversion of lipid into glycerol and fatty acids; converts starches to dextrin & sugars andconverts proteins to peptides primarily used as replacement therapy for clients with insufficient pancreatic exocrine secretions adverse effects include GI symptoms of nausea, vomiting and or diarrhea. can cause hyperuricosuria