GI/GU Meds

Question 1

Why do peptic ulcers need to avoid NSAIDs?

Answer 1

Because they might irritate stomach lining causing worse GI problems

Question 2

What do histamine h2 blockers do?

Answer 2

Decrease stomach acid production

Question 3

Histamine h2 blockers adverse reactions

Answer 3

Gynecomastia
Agranulocytosis
Aplastic anemia

Question 4

Histamine h2 blockers ex?

Answer 4

Cimetidine (Tagamet)

Question 5

Cimetidine (Tagamet) class?

Answer 5

Histamine h2 blockers

Question 6

What to avoid when giving histamine h2 blockers?

Answer 6

Avoid antacids within 1 hr
Avoid smoking, alcohol, and NSAIDs, anything that might increase GI irritation

Question 7

Proton pump inhibitors (PPIs) ex?

Answer 7

Omeprazole (Prylesect)
Pantoprazole (Protonics)
Lansoprazole (Prevesed)
Esomeprazole (Nexium)

Question 8

What does PPIs do?

Answer 8

Decrease acid in stomach so ulcers can heal

Question 9

Omeprazole (Prylesect) class?

Answer 9

PPIs

Question 10

Pantoprazole (Protonics) class?

Answer 10

PPIs

Question 11

Lansoprazole (Prevesed) class?

Answer 11

PPIs

Question 12

Esomeprazole (Nexium) class?

Answer 12

PPIs

Question 13

What’s the effect of PPIs on vitamin B12?

Answer 13

Stomach acid helps absorb B12
PPIs reduce stomach acid
So less stomach acid = less B12

Question 14

What electrolyte do you need to monitor when pt is on PPIs?

Answer 14

Magnesium

Question 15

Prolonged use of PPIs can lead to?

Answer 15

Bone loss b/c less intestinal absorbed Calcium!
Risk for fractures

Question 16

When in the day should pt take PPIs?

Answer 16

Before breakfast

Question 17

What can pt do to prevent bone loss while taking PPIs?

Answer 17

Weight bearing exercise

Question 18

What do mucosal protectants do?

Answer 18

Coat your stomach, creat a barrier

Question 19

Mucosal protectant ex?

Answer 19

Sucralfate (Carafate)

Question 20

Sucralfate (Carafate) class?

Answer 20

Mucosal protectant

Question 21

Should nucosal protectants be taken with or without food?

Answer 21

Without

Question 22

When should you give mucosal protectants?

Answer 22

1 hr before meal and at bedtime

Question 23

Can mucosal protectants and antacids be taken together?

Answer 23

No

Question 24

How long should you wait to give antacids after giving mucosal protectants?

Answer 24

30 min

Question 25

How long should you wait before giving warfarin, theophylline, phenytoin, digoxin, tetracycline, and diazepam after giving mucosal protectants?

Answer 25

2 hr

Question 26

Antacids ex?

Answer 26

Aluminum hydroxide

Question 27

What do antacids do?

Answer 27

Neutralize gastric acid

Question 28

How should you give antacids?

Answer 28

Empty stomach, 1 hr before meals and at bedtime

Question 29

What adverse reactions can antacids cause?

Answer 29

Constipation and diarrhea

Question 30

Can antacids be given with any other drugs?

Answer 30

No b/c gastric acid needs time to be neutralized

Question 31

What does serotonin antagonists do?

Answer 31

Block serotonin receptors Treat nausea and vomiting

Question 32

Serotonin antagonist ex?

Answer 32

Ondansetron (Zofran)

Question 33

Ondansetron (Zofran) class?

Answer 33

Serotonin antagonist, antiemetics

Question 34

What drug does ondansetron have to avoid?

Answer 34

Apomorphine b/c they may cause severe hypotension when used together

Question 35

What to always do before throwing meds at pt?

Answer 35

Collect data, assess

Question 36

Ondansetron adverse reactions?

Answer 36

Serotonin syndrome Headache Dizziness Constipation Diarrhea

Question 37

What do antihistamines/anticholinergics help with?

Answer 37

Vertigo/dizziness

Question 38

How does antihistamine/anticholinergic help with vertigo?

Answer 38

By blocking the release of histamine h1 receptors in the inner ear

Question 39

Adverse reactions of antihistamine/anticholinergic

Answer 39

Can't see/pee/spit/shit Sedation

Question 40

What happens if using MAOIs with antihistamine/anticholinergic?

Answer 40

Increase anticholinergic effects

Question 41

Antihistamine/anticholinergic ex?

Answer 41

Dimenhydrinate (Dramamine)

Question 42

Dimenhydrinate (Dramamine) class?

Answer 42

Antihistamine/anticholinergic

Question 43

Dopamine antagonist action?

Answer 43

Increase GI motility

Question 44

Adverse reaction of dopamine antagonists

Answer 44

Sedation, diarrhea, restlessness

Question 45

What should you educate pt on dopamine antagonists?

Answer 45

Change position slowly Increase fluid intake Do not drive or operate machines

Question 46

Dopamine antagonist ex?

Answer 46

Metoclopramide (Reglan)

Question 47

Metoclopramide (Reglan) class

Answer 47

Dopamine antagonist

Question 48

What is bulk-forming agents used for?

Answer 48

Nondigestible, absorb water to form a mass The mass stimulates peristalsis, form stool in 1-3 days

Question 49

How long does it take for bulk-forming agents to see affect?

Answer 49

1-3 days

Question 50

How should pt take bulk-forming agents?

Answer 50

1-3 times/day, take with 8+ oz of water or juice

Question 51

Buil-forming agents ex?

Answer 51

Psyllium/Metamucil

Question 52

Psyllium/Metamucil class?

Answer 52

Bulk-forming agents

Question 53

what is another name for stool softeners?

Answer 53

Surfactant laxatives

Question 54

Surfactant laxatives ex?

Answer 54

Docusate sodium (Colace)

Question 55

Docusate sodium (Colace) class

Answer 55

Surfactant laxatives

Question 56

Surfactant laxatives action?

Answer 56

Change the surface tension of stool to increase water absorption and soften stool

Question 57

How should pt take surfactant laxatives?

Answer 57

With 8 oz of water

Question 58

Pt education for surfactant laxasives

Answer 58

Stop med when diarrhea happens 2-3 L of fluid per day High fiber foods

Question 59

Can any laxatives be taken everyday?

Answer 59

No!

Question 60

Stimulant laxatives ex?

Answer 60

Bisacodyl (Senna), castor oil

Question 61

Bisacodyl (Senna) class?

Answer 61

Stimulant laxatives

Question 62

Stimulant laxatives action?

Answer 62

Stimulate intestinal motility

Question 63

What pt use stimulant laxatives?

Answer 63

When experiencing constipation due to opioid use When evacuating colon prior to surgery

Question 64

Can stimulant laxatives be used repeatedly?

Answer 64

No

Question 65

Aminosalicylates uses?

Answer 65

Inflammation in GI tract

Question 66

Aminosalicylates ex?

Answer 66

Sulfasalazine

Question 67

Sulfasalazine class?

Answer 67

Aminosalicylates

Question 68

Contraindications of sulfasalazine?

Answer 68

Digoxin, chamomile

Question 69

Antidiarrheals ex?

Answer 69

Diphenoxylate (Lomotil) Loperamide (Immodium)

Question 70

Loperamide (Immodium) class

Answer 70

Antidiarrheals

Question 71

Diphenoxylate (Lomotil) class

Answer 71

Antidiarrheals

Question 72

Antidiarrheals action?

Answer 72

Decrease flow of fluids and electrolytes into bowel

Question 73

Can antidiarrheal be used for acute diarrhea?

Answer 73

No, only for chronic

Question 74

Antiflatulents ex?

Answer 74

Smithicone (Gas-X)

Question 75

Smithicone (Gas-X) class

Answer 75

Antiflatulents

Question 76

Antiflatulents action?

Answer 76

Decrease surface tension of GI gas bubbles to eliminate them

Question 77

Pt education for antiflatulents

Answer 77

Avoid foods that make you fart (cabbage, onion, beans) Use a straw for drinking Cut down on carbs

Question 78

If pt is on female hormone replacement therapy, what should you educate them on?

Answer 78

Monitor for vaginal bleeding Have a yearly pelvic exam

Question 79

Is estrogen used by itself?

Answer 79

No it's used with progestin to reduce the risk of endometrial cancer

Question 80

Estrogen's affect on warfarin?

Answer 80

It decreases the effects of warfarin

Question 81

Estrogen's affect on tricyclic antidepressants?

Answer 81

It increases the effects of them

Question 82

LH and FSH stimulant ex?

Answer 82

Clomid

Question 83

Clomid class

Answer 83

LH and FSH stimulant

Question 84

Clomid action

Answer 84

Stimulates the ovary to produce mature follicles

Question 85

Pt education on clomid

Answer 85

Take with food Expect hot flashes Report pelvic pain Can take OTC anti-inflammatory drugs PRN

Question 86

Benign prostatic hypertrophy drug ex?

Answer 86

Finasteride (Proscar)

Question 87

Finasteride (Proscar) class?

Answer 87

BPH drug

Question 88

BPH drugs action?

Answer 88

Shrink prostate size

Question 89

Is BPH med PRN or rountine?

Answer 89

Routine!

Question 90

Pt education on BPH meds

Answer 90

Will take several months before symptoms (ex: painful urination) will get better Do not stop taking even if symptoms got better b/c will reoccur

Question 91

Erectile dysfunction med ex?

Answer 91

Sildenafil (Viagra) Tadalafil (Cialis)

Question 92

Tadalafil (Cialis) class

Answer 92

Erectile dysfunction

Question 93

Sildenafil (Viagra) class

Answer 93

Erectile dysfunction meds

Question 94

Erectile dysfunction meds action

Answer 94

Dilate vessels, increase blood flow to penis

Question 95

Erectile dysfunction meds contraindications

Answer 95

Nitrates for chest pain b/c both can cause hypotension

Question 96

What do you need before treating UTI?

Answer 96

Culture and sensitivity

Question 97

Can kind of juice can pt with UTIs take?

Answer 97

Cranberry, prevent bacteria from sticking to bladder walls

Question 98

Urinary analgesics ex

Answer 98

Phenazopyridine (Pyridium)

Question 99

Phenazopyridine (Pyridium) class?

Answer 99

Urinary analgesics

Question 100

How long can pt take phenazopyridine (Pyridium) for?

Answer 100

No longer than 2 days, if symptoms continue, cannot take another round!

Question 101

An expected finding of phenazopyridine (Pyridium)

Answer 101

Brown-orange color urine