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GI Drugs Flashcards

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1
Q

common disorders with Upper GI

A

Heartburn, GERD, Peptic Ulcer Disease, Duodenal ulcer

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2
Q

Nursing Assessment for GI secretion drugs

A

baseline H&P including allergies and medications
focus: GI and abdominal assessment related to disorder and AE
Follow administration protocol

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3
Q

Nursing Education for GI secretion drugs

A

non-pharm interventions for disorder
proper administration
shortest duration to reduce risk for AE

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4
Q

Common AE for GI secretion drugs

A

nausea
vomiting
diarrhea
constipation
abdominal discomfort
rash

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5
Q

Sodium Bicarbonate class

A

antacids

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6
Q

Sodium Bicarbonate MoA

A

neutralize stomach acid by direct chemical reaction

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7
Q

Sodium Bicarbonate Indications

A

relief of upset stomach r/t hyperacidity

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8
Q

Sodium Bicarbonate Route

A

PO: rapid onset, short duration, give PRN to treat symptoms
also used IV for metabolic acidosis and cardiac emerg. (more severe AE profile and urgent nursing)

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9
Q

Sodium Bicarbonate AE

A

gastric acid rebound, belching, fluid retention, hypokalemia, metabolic alkalosis (headache, confusion, irritability, nausea, weakness, tetany) if overdosed

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10
Q

Sodium Bicarbonate nursing considerations

A

give other meds 1-2 hours after oral antacid; chew tab and give with 8 oz of water; do not take with milk; electrolyte disturbances; teach- not to take 2 wks; OTC

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11
Q

Cimetidine (Tagamet) class

A

Histamine 2 (H2) antagonists

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12
Q

Cimetidine (Tagamet) MoA

A

blocks histamine-2 receptor sites to reduce gastric acid secretion and pepsin production

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13
Q

Cimetidine (Tagamet) Indications

A

GI ulcers; GERD; hyper-secretory conditions; heartburn and acid indigestion

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14
Q

Cimetidine (Tagamet) AE

A

headache, dizziness; severe: cardiac arrhythmias

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15
Q

Cimetidine (Tagamet) Nursing

A

Teach: smoking diminishes effectiveness of med; extended duration (greater than 6 months) risk for vitamin B12 malabsorption; OTC

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16
Q

Omeprazole (Prilosec) class

A

proton pump inhibitors (PPI)

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17
Q

Omeprazole (Prilosec) MoA

A

blocks secretion hydrochloric acid in the stomach; ALL gastric acid secretion is temporarily blocked

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18
Q

Omeprazole (Prilosec) indications

A

GERD, GI ulcers; prevention ulcers in acute care

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19
Q

Omeprazole (Prilosec) cautions

A

long term use risk: atrophic gastritis (malabsorption of vitamin B 12- pernicious anemia), osteoporosis related fracture (decreased Ca absorption); associated with C diff.

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20
Q

Omeprazole (Prilosec) AE

A

headache, dizziness, upper respiratory infection (URI)

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21
Q

Omeprazole (Prilosec) nursing

A

administer on an empty stomach (30-60 min before a meal);
Teach- shortest duration, report s/s severe diarrhea; monitor h/h; OTC

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22
Q

Sucralfate (Carafate) class

A

gastrointestinal protectant

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23
Q

Sucralfate (Carafate) MoA

A

binds to base of ulcers and erosions forming protective barrier from pepsin

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24
Q

Sucralfate (Carafate) indications

A

GI ulcer; chronic renal failure/hyperphosphatemia

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25
Sucralfate (Carafate) AE
constipation, dry mouth, dizziness
26
Sucralfate (Carafate) nursing considerations
administer med on an empty stomach, 1 hour before or 2 hours after meals and at bedtime; admin other meds at least 2 hours before (impairs absorption)
27
Assessment for Laxatives
baseline H&P including allergies and medications focused assessment: bowel sounds, I&O, electrolytes contraindicated in acute bowel disorders such as ileus, obstruction, ischemia, perforation
28
Monitoring for Laxatives
loose stools (diarrhea), nausea, vomiting, abdominal pain, dehydration, electrolyte imbalance achievement of soft bowel movement within 24 hours of administration
29
implementation for laxatives
hold if loose stools encourage 3 L of water daily, high fiber diet, increase activity for multiple PRN softener/laxative orders (first use docusate if no results try bisacodyl or polyethylene glycol- may need multiple drugs for result
30
teaching for laxatives
teach not to take a laxative if experiencing nausea, vomiting, abdominal pain. contact provider if experiencing severe abdominal pain, muscle weakness, cramps, and or dizziness long term use of laxatives results in decreased bowel tone and may lead to dependency; use for no more than 7 days.
31
Docusate (colace) class
lubricant/stool softener
32
Docusate (colace) MoA
promotes electrolyte and water absorption into colon, promotes incorporation of water into the stool (results in stool softening)
33
Docusate (colace) indications
relief and prevention of constipation, prevent straining
34
Docusate (colace) route
PO or suppository
35
Docusate (colace) AE
well tolerated, low risk for dehydration and electrolyte imbalance
36
Docusate (colace) nursing considerations
first-line pharmacologic therapy for prevention of constipation
37
bisacodyl (dulcolax) class
bowel chemical stimulant
38
bisacodyl (dulcolax) MoA
chemical irritant that directly stimulates GI tract motility
39
bisacodyl (dulcolax) indications
constipation, evacuate the bowel for diagnostic procedures
40
bisacodyl (dulcolax) route
PO or suppository
41
bisacodyl (dulcolax) AE
see nursing role
42
bisacodyl (dulcolax) nursing considerations
admin PO with water (interact milk, juice, antacids)
43
polyethylene glycol (Miralax) class
bulk stimulants; hyperosmotic laxative
44
polyethylene glycol (Miralax) MoA
increase water absorption into the colon and GI tract (water follows polyethylene glycol; which stays in the colon and GI tract)
45
polyethylene glycol (Miralax) indications
constipation, evaluate bowel for diagnostic procedure (high dose)
46
polyethylene glycol (Miralax) AE
see nursing role
47
polyethylene glycol (Miralax) nursing considerations
mix with 4-8 oz of water; acute care fall risk
48
antidiarrheal contraindications
diarrhea caused by poisoning or by bacterial toxins acute abdominal disorders including GI obstructions
49
antidiarrheal assessment
baseline H&P including allergies and medications I&Os and elimination patterns, electrolytes, hydration, bowel sounds and abdomen TE: decrease number of bowel movements
50
antidiarrheal teaching
teach to take medications exactly as prescribes notify HCP if symptoms persist after 2 days and or s/s dehydration do not use for infectious diarrhea keep hydrated 3L/day
51
loperamide (imodium) class
antidiarrheals
52
loperamide (imodium) MoA
slow the motility of GI tract through direct action on lining of GI tract
53
loperamide (imodium) indications
non-infectious diarrhea
54
loperamide (imodium) AE
constipation, abdominal distension, abdominal discomfort, nausea, dry mouth
55
loperamide (imodium) nursing considerations
admin drug after each loose stool; not to exceed recommended daily maximum dose.
56
antiemetic agent assessment
baseline H&P including allergies and medications focus: GI, I&O, neuro/LOC document emesis: output amount, color, frequency s/s dehydration, electrolyte imbalance from vomiting fall risk drug-drug CNS depressants
57
antiemetic agent implementation
give PRN medication as appropriate consider appropriate route, use least invasive verify route-wrong route can be dangerous Preventative therapy: admin 30-60 prior to chemotherapy dose or end of surgery
58
how patient situation affects antiemetic routes
oral preferred, but if vomiting, select alternate route (contact provider) suppository often used in hospice care
59
antiemetic teaching
timing of administration no heavy machinery
60
antiemetic evaluation
TE: absence of nausea and vomiting- document response AE: drowsiness, dizziness, cardiovascular lifespan older adults: poly-pharmacy, anticholinergic effects, CNS effects- falls
61
ondansetron (zofran) class
serotonin blockers
62
ondansetron (zofran) MoA
blocks serotonin peripherally, centrally and small intestine; blocks chemoreceptor trigger zone
63
ondansetron (zofran) indications
n/v (post op, chemotherapy, illness)
64
ondansetron (zofran) caution
cardiac arrhythmias, CNS depression
65
ondansetron (zofran) AE
drowsiness, dizziness, headache, diarrhea, prolonged QTc/dysrhythmias
66
ondansetron (zofran) nursing considerations
see general nursing
67
acute acetaminophen overdose
leads to acute liver failure: nausea, vomiting, jaundice, malaise, confusion
68
acute acetaminophen overdose treatment
acetylcysteine- use within 24 hours of toxicity
69
hepatic encephalopathy
liver cirrhosis, increased ammonia levels
70
hepatic encephalopathy treatment
lactulose- excretes ammonia in stool loose stools are expected TE
71
lactulose (enulose) class
hyperosmotic laxative
72
lactulose (enulose) MoA
pulls fluid out of venous system and into lumen of small intestine; inhibits diffusion of ammonia back to blood, excreting more ammonia in stool
73
lactulose (enulose) indications
hepatic encephalopathy, constipation
74
lactulose (enulose) route
oral or enema
75
lactulose (enulose) AE
n/v/d; electrolyte imbalance
76
lactulose (enulose) nursing
titrate as directed (# of loose stools) or scheduled dose; monitor ammonia levels I&O, electrolytes, mental status, skin rectal area; use caution w/additional laxatives; teach: bad taste; compliance.

Pharmacology (6 decks)

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