GI Meds Comp 9 Flashcards
(65 cards)
1
Q
Antihistamine action and AE(3)
A
- acts on vomiting center
- AD: dizziness, drowsiness, urinary retention
2
Q
Anticholinergic (ACh blockers) example, action and AE(3)
A
- ex. scopolamine- treat motion sickness
- blocks transmission of nauseating stimuli to CTZ (chemoreceptor trigger zone)
- AD: dizziness, drowsiness, urinary retention
3
Q
Anticholinergic (ACh blockers) contraind
A
glaucoma
4
Q
Anticholinergic (ACh blockers) patch, who long they last and when to give it
A
lasts 72 hours, give 4 hours before event
5
Q
phenothiazine drugs action and indication
A
- blocks dopamine receptors in CTZ
- used for psych disorders, intractable hiccups, LOWER DOSES USED FOR ANTIEMETIC
6
Q
phenothiazine drugs AE
A
- OH
- extrapyramidal symptoms EPS (restless, anxiety, spasms of face and neck)
7
Q
Serotonin blockers (5-HT3) drug prefix, action, indication
A
- setron
- block serotonin receptors in CTZ and GI
- used for NV in PTs RECEIVING CHEMOTHERAPY AND FOR POSTOPERATIVE
8
Q
cannabinoids example and indication
A
- dronabinol (Marinol)
- used for NV r/t CHEMOTHERAPY AND ANOREXIA linked to weight loss in AIDS and cancer PTs
9
Q
cannabinoids AE
A
- mood changes
- OH
10
Q
Prokinetic drug example, action, indication
A
-metaclopramide (Reglan)
-cause CTZ to be desensitized to impulses from GI
+ stimulates peristalsis in GI –enhances gastric emptying
11
Q
Prokinetic drug indication and AE
A
- used as antiemetic and GERD and delayed gastric emptying
- AE: sedation, diarrhea, EPS
12
Q
Antiemetic Trimehtobenzamide (Tigan) action and SE
A
- suppresses impulses to CTZ
- SE: OH and EPS
13
Q
Antiemetic critical assessments
A
assess complete NV history + precipitating factors
14
Q
Antiemetic NI(3)
A
- many drugs cause drowsiness, don’t drive
- don’t drink alcohol - CNS depression
- move slowly - HoTN affects
- for chemo PT, antiemetics given 1-3 hours before chemo
15
Q
Emetic Ipecac (OTC) use and admin
A
- induces vomiting after toxic substances
- Admin: take with water, VOMITING OCCURS IN 15-30 min, if no vomit take activated charcoal
16
Q
acute vs chronic diarrhea time frame
A
- acute: 3 days - 2 weeks
- chronic: 3 weeks+
17
Q
non-pharm treatment of diarrhea
A
- ID underlying cause
- fluid replacement
- no milk and fatty foods
- wash fruit, no raw veggies and well done meat while traveling
18
Q
Antidiarrheals : opiates action
A
decrease intestinal motility, decreases peristalsis (more water and electrolytes absorbed)
19
Q
opiates AE
A
- drowsiness
- sedation
- respiratory depression
- HoTN
- urinary retention
20
Q
Anti-diarrheals: absorbants example
A
bismuth subsalicylate (Pepto-bismol)
21
Q
Anti-diarrheals: absorbants action
A
- coat the walls of the GI tract
- bind to the causative bacteria or toxin, is then eliminated through stool
22
Q
Anti-diarrheals: absorbants AE
A
- tarry black stools
- tinnitus
- metallic taste
- blue gums
23
Q
Octeotride (Sandostatin ) treats ….
A
severe diarrhea from cancer
24
Q
absorbants decrease absorption of…
A
- digoxin
- clindamycin
- quinidine
- hypoglycemic drugs
25
absorbants increase .....
bleeding time and bruising with anticoagulants
26
antacids can decrease effects of ....
anticholinergic antidiarrheal drugs
27
antidiarrheals critical assessments
Last BM and COCA, abdominal assessment (pain, NV, bowel sounds)
28
antidiarrheals NI
- DO NOT give bismuth subsalicylate to children or teenagers with chicken pox- risk of Reye's syndrome
- use with caution in elderly, decreased bleeding time, clotting disorders, recent bowel surgery, confusion
- avoid fried foods. milk, sedatives
29
Most gentle to strongest laxatives
1. emollient (stool softener)
2. bulk forming
3. stimulant (Contact)
4. Osmotic (Saline)
5. Chloride channel activators
30
laxative: emollient example and action
- docusate salts (Colace)
- promote more water and fat in stools
- gently soften the stool
31
Laxative: bulk-forming example and action
- psyllium (Metamucil)
- high fiber- absorb water to increase bulk
- results on 8-12 hrs
- only L that can be taken long term
32
Laxative: Stimulant examples
- bisacodyl (Dulcolax)
- senna (Senokot)
- castor oil
33
Laxative: Stimulant action and AE
- increases peristalsis via intestinal nerve stimulation
- oral 6-12 hrs, supp 15-60 min
- AE: reddish brown urine
34
laxatives: osmotic (Saline) examples
- magnesium salts- Milk of Mag, mag sulfate
- sodium salts-Fleet enema
- lactulose (reduce ammonia levels)
- glycerin (supp)
- Polyethylene glycol (Miralax) -PEG
35
PEG with electrolyte solution (GoLYTELY) used for.. and how much...
bowel evacuation prior to GI procedures (colonoscopy) or GI surgery
-2-3 L
36
laxatives: osmotic (Saline) action and AE
- more water enters intestine >bowel distention>peris. and BM
- AE: magnesium toxicity (with renal insufficiency)
37
All Laxatives AE
- rectal irritation
- diarrhea
- electrolyte imbalances
38
laxatives contraindications
- undiagnosed abdominal pain
- inflammatory disorders of the GI tract
- spastic colon
- bowel obstruction
- pregnancy
39
laxatives critical assessments
- last BM and COCA
| - abdominal assessment (bowel sounds, pain, NV)
40
laxatives NI
- assess PT history: allergies, BM pattern, fluid and electrolytes before therapy
- do not take if experiencing NV, abdom. pain, suspected acute abdom.
- high fiber, lots of fluid in diet
- **PT should take all lax tablets with 6-8oz of water- esp. bulk-forming
41
Laxatives, call doc if....
- severe abdominal pain
- muscle weakness
- cramps
- dizziness
(fluid and electrolyte loss)
42
HCL secretion triggered by....
- food
- large fatty meals
- a lot of alcohol
- emotional stress
43
acid-related diseases caused by..
imbalance of the three cells of the gastric gland and their secretions
- most common hyperacidity (indigestion, sour stomach, heart burn)
44
Acid-related disorders
- Peptic Ulcer disease (PUD)
- gastroesophageal reflux disease (GERD)
- Helicobacter pylori (treat with proton-pump inhibitors and antibiotics)
45
proton pump inhibitors (216)
completely block production of acid , alters absorption of drugs
46
Peptic ulceration patho
- mucosal lining erosion (esophageal, gastric, duodenal)
| - hypersecretion (HCL, Pepsin, pH of 2-5)
47
Peptic ulcer risk factors and symptoms
- H. pylori
- mechanical
- genetic
- environment
- drugs
- symptom: aching pain
48
antiulcer drugs
- tranquilzers
- anticholinergic drugs
- histamine 2 blockers
- proton pump inhibitors
- antacids
- prostaglandin E analog
- pepsin inhibitor
49
tranquilizer glycopyrrolate (Robinul) action
reduces vagal stimulation , decreases anxiety
50
anticholinergic Propantheline (Pro-Banthine) action
inhibits release if HCL by blocking ACh and histamine
51
antacids action
- neutralize stomach acid and reduces pain
- DO NOT prevent overproduction of acid
- DO neutralize the acid once it is in stomach
52
antacids can be used with..
- aluminum salts
- calcium salts
- magnesium salts
- sodium bicarbonate
53
Antacid : Aluminum salt use and AE
- have constipating effect, used with Mg to reduce
- used for PT with renal disease, easy excrete
- AE: constipation, hypercalcemia
54
Antacid: Calcium salt example and SE
- Tums (calcium carbonate)
- may cause constipation, kidney stones
- not recom. for PT with renal disease- toxic
55
Antacid: Magnesium Salts SE and caution
- commonly cause DIARRHEA, use with other drugs to counter
| - dangerous with renal failure, accumulates
56
Antacids: Sodium Bicarbonate caution
-sodium content may cause problems in PT with HF, HTN, or renal insufficiency
57
Critical assessments for Antacids
appropriate electrolyte level
58
Antacids NI
1. assess for allergies, contrandications
2. not for PT with HF or HTN
3. MOST MEDS SHOULD BE GIVEN 1-2 HOURS AFTER GIVING ANTACID
4. may cause premature dissolve of enteric coated meds
59
histamine type 2 H2 blockers examples
- most popular:
- cimetidine (Tagamet)
- famotidine (Pepcid)
- ranitidine (Zantac)
60
histamine type 2 H2 blockers action and SE
- reduce gastric acid by blocking H2 receptors of parietal cells in stomach
- SE: HA, dizziness
61
H2 blockers NI
- smoking decreases effect
- **All H2 antagonists may inhibit the absorption of drugs that require an acidic GI environment for absorption**
- contact doc if prolonged HA occurs
- 1 hour before or after meals
- caution with PT who are confused, disoriented, or elderly
62
Proton pump inhibitors (PPI) suffix and action and result and
-"prazole"
-reduce gastric acid by
inhibiting hydrogen/K+ ATPase
-result: achlorhydria- ALL gastric acid secretion is temporarily blocked
63
PPI SE
- HA
- insomnia
- dizziness
64
PPI NI
1. works best taken 30-50 min before meals
2. capsules swallowed whole
3. may open and mix with apple sauce, eat immed
4. may increase levels of DIAZEPAM, PHENYTOIN, and more bleeding with WARFARIN
65
Sucralfate (Carafate) action and admin
- attracted to ulcer base, and forms a protective barrier
- give 30 min before meals and bedtime
- impairs other drug absorption ( give 2 hrs before sucra.)
