Antiemetics - Therapeutic use
- Decrease nausea and vomiting
- Inhibit dopamine/serotonin receptors in the brain
Antiemetics - Medication Types (3)
1) Anticholinergic and Antihistamine
2) Dopamine Antagonist
3) Serotonin Receptor Antagonist
Antiemetrics - Anticholinergic/Antihistamine (H1 Receptor Antagonist) - Actions and Uses
- Inhibits vestibule stimulation in the middle ear (inhibits dizziness)
- Blocks histamine
- Block muscarinic and nicotinic receptor sites - Inhibits cholinergic - Increases Sympathetic Response!
Treatment: Simple nausea and vertigo - Motion Sickness
Anticholinergic/Antihistamine (H1 Receptor Antagonist) - Medication types
- dimenhydrinate (Gravol)
- Meclizine (Bonamine)
Anticholinergic/Antihistamine (H1 Receptor Antagonist) - Side/Adverse effect
- Constipation
- Drowsiness
- Dry mouth
- Blurred vision
- Urinary retention
- Dizziness
- Fatigue
Anticholinergic/Antihistamine (H1 Receptor Antagonist) - Nursing Considerations
- Vitals (HR,BP)
- Increase fluid
- Assess urine output
- Assess muscle weakness
- Do not drive/operate machinery on medication
Dopamine Antagonist - Action and Uses
- Block dopamin II (vomiting response) receptors in the brain
- Decreases risk of vomiting
- Keeps normal levels of Acetylcholine (Parasympathetic)
- Lowers esophageal sphincter pressure
Treatment: Severe nausea and vomiting
Dopamine Antagonist - Medication Type
Metoclopramide
Dopamine Antagonist - Precaution
GI obstruction or hemorrhage risk
Dopamine Antagonist - Side/Adverse effects
- Chills
- Hypertension
- Dizziness
- Dark urine
- Tachycardia
- Abdominal pains
Dopamine Antagonist - Nursing Considerations
- Vitals (BP,HR)
- Assess
- Abdominal assessment
Serotonin Receptor Antagonist - Actions and use
- Suppresses nausea and vomiting by blocking serotonin receptors
- Blocks Cranial Nerve 10 (Vagus nerve)
Treatment: Serious nausea/vomiting relief - Preferred drug for anti-neoplastic therapy, radiation therapy or surgical procedures
Serotonin Receptor Antagonist - Medication type
Zofran
Serotonin Receptor Antagonist - Side/Adverse effects
- Drowsiness
- Confusion
- Anxiety
- Depression
- Headache
- Nervousness
- Weakness
Serotonin Receptor Antagonist - Nursing considerations
- Medication should be taken on a schedule - not PRN
- Assess LOC
- Abdominal assessment
- Monitor for low serotonin levels
- Assess mood/behavior
- Assess muscle weakness
Antidiarrheals - Action and Use
- Act systemically or locally
- Opiate medication/Absorbents
- Opiate - CNS depression that decreases peristalsis
- Absorbent - Allows more time for water and salts to be absorbed
Treatment: Acute/Chronic Diarrhea
Antidiarrheals - Opiates - Medication Type
loperamide (Imodium)
Antidiarrheals - Opiates - Side/Adverse Effect
- Nausea
- Vomiting
- Abdominal distention
- Fatigue
- Sedation
- Tachycardia
Antidiarrheals - Opiates - Nursing Considerations
- Do not use on children under 2
- Vitals (HR,BP)
- ECG
- Assess LOC
- Assess intake vs output
- Assess serum levels (Na, Mg, K)
Antidiarrheals - Absorbents - Actions and Uses
- Allows for more time to absorb Na+ and Water
- Coats wall of GI tract by absorbing/inhibiting bacteria/toxins
- Slows growth of bacteria that might cause diarrhea
- Binds bacteria to feces for excretion
Antidiarrheals - Absorbents - Medication types
bismuth subsalicylate (Pepto-Bismol)
Antidiarrheals - Absorbents - Side/Adverse Effects
- Constipation
- Black stool
- Dizziness
- Nausea
- Vomiting
Antidiarrheals - Absorbents - Nursing considerations
- Monitor fluid
- Assess output
- Abdominal assessment
- Assess electrolyte levels
- Kidney and liver function
Laxatives - Actions and Uses
- Promotes evacuation of large bowels
- Cathartic laxatives are stronger and completely empty the bowel (used before procedures such as a colonoscopy)
Treatment: Constipation
Laxatives - Medication Types (4)
1) Osmotic Laxatives
2) Bulk- forming laxatives
3) Emollients (Stool softeners)
4) Stimulant Laxatives
Osmotic Laxatives - Actions and Uses
- Increases water in feces from surrounding tissues
- Stool softener
- Reduced ammonia in blood stream
Medication: Lactulose
Osmotic Laxatives - Side/Adverse effects
- Electrolyte imbalances
- Dehydration
- Abdominal pain
- Nausea
- Vomiting
Osmotic Laxatives - Nursing considerations
- Assess renal function
- Assess electrolyte levels
- Encourage fluid intake
- Asses output
Bulk- forming laxatives - Actions and Uses
- Absorb liquid in intestine and swell to form bulky stool
- Liquid acts as a stool softener
Medication: pysllium (Metamucil)
Bulk- forming laxatives - Side/Adverse Effects
- Stomach pain
- Nausea
- Vomiting
- Itchiness
Bulk- forming laxatives - Nursing considerations
- Encourage fluid intake
- Promote fiber based diets
- Assess output
- Assess electrolyte levels
Emollients (Stool softeners) - Actions and Uses
- Helping liquids to mix in the stool acting as a lubricant preventing dry hard stool
- Improves the ability of water within the colon
Medication: docusate sodium (Colace)
Emollients (Stool softeners) - Side/Adverse Effect
- Stomach pain
- Nausea
- Vomiting
- Dehydration
- Electrolyte imbalances
- Diarrhea
Emollients (Stool softeners) - Nursing considerations
- Encourage fluid intake
- Assess electrolyte levels
- Assess output
- Abdominal assessment
Stimulant Laxatives - Actions and Use
- Trigger contractions in intestinal muscles to promote peristalsis
- Increases water in stool
Medication: bisacodyl (Dulcolax)
Stimulant Laxatives - Side/Adverse Effects
- Abdominal discomfort
- Nausea
- Vomiting
- Abdominal cramps
- Faintness
- Diarrhea
- Dehydration
Stimulant Laxatives - Nursing Considerations
- Educate on use - watch for signs of over use (severe weight loss)
- Encourage fluid intake
- Assess electrolyte balance
- Abdominal assessment
- Assess output
Antacids - Actions and Use
- Alkaline substances that neutralize gastric acid
- Treatment of GERD and Gastric ulcer symptoms
Antacids - Medication types (3)
- calcium carbonate (Tums)
- aluminum hydroxide (Maalox)
- magnesium hydroxide (Milk of Magnesia)
Antacids - Side/Adverse Effects
- White stools
- Constipation
- Diarrhea
- Electrolyte imbalances
Antacids - Nursing Considerations
- Occasional use only for heartburn symptoms
- Avoid use for patients with renal failure
- Take at least 2 hours before or after other oral medications
- Assess electrolyte levels
- Encourage fluid intake
Anti-ulcers - Actions and Use
- Decreases gastric secretions
Treatment: GERD and Gastric Ulcers
Anti-ulcers - Medication Types (4)
1) H2- receptor antagonists (Histamine2-blockers)
2) Proton pump inhibitors (PPIs)
3) Antacids
4) Antibiotics
H2- Receptor Antagonists - Actions and Use
- Inhibit histamine at H2-receptor sites in parietal cells
- Decreases gastric acid secretions
Medication: ranitidine (Zantac)
H2- Receptor Antagonists - Side/Adverse Effect
- Diarrhea
- Headaches
- Decreased LFT
- Abdominal Pain
- Loss of B12 absorption
H2- Receptor Antagonists - Nursing Considerations
- Assess for B12 deficiency
- Assess LFT
- Assess output
- Educate on caution with clients who have kidney/liver dysfunctions
Proton pump inhibitors (PPIs) - Actions and Use
- Blocks the enzyme responsible for HCl secretion
- Reduce HCI secretion
- Severe Anti-Ulcer medication
Medication:
pantoprazole (Pantoloc)
Proton pump inhibitors (PPIs) - Side/Adverse Effect
- Diarrhea
- Headaches
- Decrease LFT
- Nausea
- Abdominal Pain
Proton pump inhibitors (PPIs) - Nursing Considerations
- Take 30 min before breakfast
- Eat food with probiotics
- Assess LFT (long term use)
- Assess output
- Abdominal assessment
Anti–inflammatory for IBD (Irritable Bowel Disease) - Actions and Use
- Lowers inflammation and immune response
- Treats bowel inflammation
Medication: Corticosteroids and Aminosalicylates (NSAID)
Treatment: Crohn’s Disease and IBD
Anti–inflammatory for IBD - Side/Adverse Effects
- Insomnia
- Urinary retention
- Increase K secretion
- Impaired wound healing
- Stomach Ulcers
Anti–inflammatory for IBD - Nursing Considerations
- Encourage fluid intake
- Assess K levels
- Assess output
- Assess for signs of infection
- Vitals (BP)
