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GI Drugs Flashcards

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0
Q

Appetite suppressants effect which neurotransmitter to increase feelings of satiety?

A

Serotonin

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1
Q

Drugs to gain weight include:

A

Steroids (e.g. Megace)

THC derivatives

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2
Q

Appetite Suppressants that have potential for abuse are:

A

norepinephrine mimics and amphetamines

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3
Q

Side effect of norepinephrine appetite suppressant is:

A

SNS stimulation

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4
Q

Obesity medications that block some absorption of fat have these side effects:

A

Stool leakage
Fecal urgency
diarrhea
bloating

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5
Q

Ondansetron (Zofran)

A

Serotonin antagonist for N/V

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6
Q

Side effects of Ondansetron (Zofran) can include:

A

constipation, headache, transient increase in liver function tests (LFTs)

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7
Q

Prochlorperadine (Compazine)

A

phenothiazine

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8
Q

Promethazine (Phenergan)

A

phenothiazine

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9
Q

What routes are appropriate to give promethazine?

A

Oral or rectal, not IV

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10
Q

Side effects of phenothiazines can include:

A
  1. orthostatic hypotension
  2. tachycardia
  3. EPS symptoms (twitching, mouth movements)
  4. ACH triad: dry mouth, urinary retention, blurred vision
  5. Constipation
    Sedation
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11
Q

Metoclopramide (Reglan)

A

Prokinetic

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12
Q

metoclopramide (Reglan) treats nausea and vomiting by:

A

Promoting movement of substances through the GI tract by activating the PNS

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13
Q

Side effects of Prokinetics can include:

A
  1. EPS (young adults especially)
  2. sedation
  3. fatigue
  4. N/V
  5. diarrhea
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14
Q

What is a natural emetic?

A

Salt

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15
Q

Meclizine (Antivert)

A

antihistamine

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16
Q

hydroxyzine (Vistaril)

A

antihistamine

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17
Q

dimenhydrinate (Dramamine)

A

antihistamine

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18
Q

Antihistamines are used for what in the GI system?

A

Primarily for motion sickness and to decrease GI secretions

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19
Q

Side effects of antihistamines are:

A

dizziness
drowsiness
confusion (makes old people crazy and confused)
ACH triad (blurred vision, dry mouth, urinary retention)

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20
Q

Ondansetron (Zofran) is preferred sometimes because:

A

it effects the chemotherapeutic zone so fewer GI and CNS effects

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21
Q

Histamine Receptor Antagonists work by

A

decreasing production of acid. cells become less responsive to histamine, but this is an incomplete inhibition.

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22
Q

cimetidine (Tagamet)

A

Histamine Receptor Antagonist

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23
Q

Ranitidine (Zantac)

A

Histamine Receptor Antagonist

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24
Famotidine (Pepcid)
Histamine Receptor Antagonist
25
Side effects of Histamine Receptor Antagonists could include:
Confusion in the elderly
26
Nursing interventions for Histamine Receptor Antagonists include teaching the patient to:
take at regular intervals (BID, daily) | Take 30-60 minutes before meals
27
What could lower the effectiveness of Histamine Receptor Antagonists?
Smoking
28
In general, what type of medicine is prescribed first for heartburn?
antacids
29
Which type of medicine is good for occasional heartburn and stomach upset?
antacids
30
How do antacids work?
Buffer acid already in stomach
31
Possible side effect of aluminum or calcium antacids?
constipation
32
What is a possible side effect of magnesium antacids?
diarrhea
33
What type of drug should not be given to patients with electrolyte imbalace?
antacids
34
lansoprazole (Prevacid)
Proton pump inhibitor
35
omeprazole (Prilosec)
Proton Pump Inhibitors
36
pantoprazole (Protonix)
Proton Pump Inhibitor
37
esomeprazole (Nexium)
Proton Pump Inhibitor
38
Proton pump inhibitors work by:
binding to the pump mechanisms in parietal cells, thereby totally blocking all hydrogen ion secretion from parietal cells.
39
If antacids are not successful in controlling heartburn, or if it is occurring too often, what is the next drug class prescribed?
histamine receptor antagonist
40
If histamine receptor antagonists are unsuccessful, what is the next drug type prescribed?
proton pump inhibitors
41
What are possible side effects of PPIs?
Increased risk of osteoporosis (possibly) Increased risk of MI (possibly) Increased risk of C. Diff
42
When pantoprazole (protonix) is administered IV, how should it be given?
diluted
43
What type of liquid is effective in mixing with Protonix to administer via NG tube?
apple juice
44
What type of drug might increase risk of bleeding with Warfarin (Coumadin)
Proton Pump Inhibitors
45
How are PPIs administered for extended therapy?
It must be given consistently for best results, once or twice daily. Take without regard to meals.
46
Bismuth subsalicylate is used to treat what malady?
diarrhea (Pepto Bismol)
47
What allergy is a contraindication for bismuth subsalicylate (Pepto Bismol)?
Aspirin
48
What are the side effects of bismuth subsalicylate (Pepto Bismol)?
tinnitus increased bleeding time darkened tongue dark stools
49
diphenoxylate (Lomotil) is used for what condition? how?
diarrhea. inhibits GI motility and propulsion.
50
Caution should be used with diphenoxylate (Lomotil) because:
It is an opioid derivative and can cause abuse and physical dependence
51
What are the side effects of diphenoxylate (Lomotil)?
drowsiness sedation N/V respiratory depression
52
loperamide (Immodium) is used for what condition? how?
Diarrhea. decreases bowel motility and increases the absorption of H2O.
53
How would one take loperamide? (Immodium)
OTC, taken after each loose stool, up to 16 mg daily. Not to be used with severe colitis.
54
Docusate (Colace)
Stool softener (emollient)
55
Mineral Oil
Stool softener (emollient)
56
How do stool softeners (emollients) work?
they lubricate the stool passage by prevent water movement out of the intestines
57
What is are contraindications of stool softener (emollient) use?
Obstruction Abdominal pain N/V
58
Mineral oil can be used oral, rectally as an enema, or both?
both
59
Docusate (Colace) works by:
making passage of stool easier, not by causing defecation.
60
lactulose, MiraLax, and glycerin suppositories
Osmotic laxatives
61
Osmotic laxatives work by:
increasing water in feces which leads to bowel distension, peristalsis, and evacuation.
62
Possible side effects of Osmotic Laxatives?
abdominal bloating, rectal irritation
63
psyllium (metamucil)
bulk forming laxative
64
methylcellulose (Citrucel)
Bulk forming laxative
65
Bulk forming laxatives work by:
increasing water absorption, causing greater bulk of contents
66
Bulk forming laxatives like psyllium (Metamucil) and methylcellulose (Citrucel) are used for:
acute/chronic constipation, IBS, diverticulosis
67
What should be assessed before giving any type of laxative?
Ability of the GI tract to eliminate feces
68
Senna (Ex-lax, senokot)
stimulant laxative
69
bisacodyl (Dulcolax)
stimulate laxative
70
Stimulant laxatives work by:
inducing parastalsis
71
Caution should be used with stimulant laxatives because:
they have a potential for abuse.
72
Possible side effects of stimulant laxatives:
rectal irritation | rebound constipation
73
Biologic modifier immunosuppressants are used for which disease process?
Inflammatory Bowel Disease
74
Corticosteroids do what to improve IBD?
decrease inflammation in the GI tract
75
Anti-neoplastic immunosuppressants are used in IBD to do what?
decrease immune response
76
Antimicrobials are used for IBD to do what?
treat infections
81
What is a natural side effect of using lactulose to trap ammonia in the gut?
Increased stooling, cramping, abdominal distension
82
octreotide (Sandostatin) works by:
causing vasoconstriction in the gastric beds, reducing portal vessel pressure in bleeding ulcers
83
What is the side effect of octreotide (Sandostatin)?
Suppresses insulin, causing hyperglycemia. | Could also depress CNS
84
To evaluate the efficacy of lactulose in trapping ammonia, what would the nurse assess?
LOC, mentation and affect
85
octreotide (Sandostatin)
Liver medication
86
Antibiotics are used in liver disease to do what?
decrease normal flora in the GI tract, reducing ammonia production
87
lactulose is a laxative, but is also used to:
trap ammonia in the gut, decreasing amount in the blood. The ammonia is then excreted in the stool

Gastrointestinal (3 decks)

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