Pharm

Question 1

Antacid side effects

Answer 1

• toxicity of Ca and Ma more likely in pt’s with renal disease
• Combo products seek to balance constipating with laxative effects

Question 2

magnesium salts

Milk of Magnesia

Answer 2

Saline laxative

draws water into the colon from surrounding tissue which stimulates contractions

use extensively for bowel prep

can be dangerous in pts with renal insufficiency

onset of action variable

Question 3

Aluminum salts

Amphogel

Answer 3

Antacid

Question 4

Magnesium & Calcium

Rolaids

Answer 4

Combo Antacid

Question 5

sucralfate

Cytotec

Answer 5

Mucosal protectant

directly protects duodenal ulcers by forming barrier

no systematic effects

given before meals and at bedtime on an empty stomach

used as anti-ulcer agent in pts on LT NSAIDs and aspirin treatment

side effects

• abdominal pain
• diarrhea
• spontaneous abortion

Question 6

Hypertonic Solutions

Answer 6

• D5LR
• 3%NS
• D5 1/2NS
• D5NS

Question 7

Ferrous Sulfate (Iron)

Answer 7

• Necessary for production of hgb
• Treats iron deficiency anemia
  (r/t chronic or acute blood loss, pregnancy, poor diet)

Mild anemia- increase dietary sources

Moderate anemia- PO/IM/IV supplementation

Severe anemia- transfusion

Question 8

Hypotonic Solutions

Answer 8

• 0.45% NaCl (1/2NS)

Question 9

Magnesium & Aluminum

Maalox

Answer 9

Combo Antacid

Question 10

Soapsuds enema

Answer 10

addition of castile soap

soap irritates intestines

Question 11

Isotonic Solutions

Answer 11

• 5% dextrose in H20 (D5W)
• 0.9%NaCl (NS)
• Lactated Ringer’s (LR)

Treat hypernatremia, replace water, used to administer medications

Question 12

hydrochlorothiazide

Microzide

Answer 12

Thiazide diuretic

Question 13

spironolactone

Aldactone

Answer 13

Potassium-sparing diuretic

Question 14

Antiemetic Drugs

Answer 14

most effective when given in advance of event

most effective when combined to block different pathways

various routes utilized

Question 15

senna/sennosides

Senokot

Answer 15

Stimulant Laxatives

bowel irritants- trigger peristatic contractions

harshest category, causes abdominal cramping

short-term use for acute constipation

Question 16

Hypotonic enema

Answer 16

tap water

exerts pressure pefore escaping bowel into interstital space

Question 17

prochlorperazine

Compazine

Answer 17

Antidopaminergic Antiemetics

blocks dopamine receptors

antipsychotic and anticholinergic effects

frequently used for chemo and post-op

side effects

• drowsiness
• constipation
• dry mouth/eyes
• restlessness
• blurred vision
• disorientation
• extrapyramidal effects (muscle issues)

Question 18

Isotonic enema

Answer 18

saline

stimulates peristalsis by presence

Question 19

Folic Acid (Folate)

Answer 19

• preggers need double the dose

- Deficiency caused by dietary deficits, GI diseases, chemo, malignancy, cirrhosis

Question 20

Cleansing enema

Answer 20

any type that promotes complete bowel evcuation

Question 21

Vit b12 (Cyanocobalamin)

Answer 21

• deficiency usually caused by poor or absent absorption (gastric resection, Crhon’s, pernicious anemia)
• Dietary: meats, seafood eggs
• Pernicious anemia, lacking intrisic factor/protein, need parental administration

Question 22

Sodium Salts

Alka-seltzer

Answer 22

Antacid

Question 23

Nursing Implications for Ferrous Sulfate

Answer 23

• causes constipation
• causes dark green or black stool
• calcium inhibits absorption
• Vit C enhances absorption
• Best absorbed on empty stomach
• Liquid needs to be dilute and drink through straw
• use Z track for IM and monitor for phlebitis

Question 24

meclizine

Antivert

Answer 24

Antihistamine antiemetic

blacks h1 receptors in inner ear (motion sickness)

Side effects

• sedation
• dizziness
• dry mouth

Question 25

glycerin suppositories | MiraLax, GoLytley

Answer 25

Hypersomotic laxative draw water into colon from surrounding tissues which stimulates contractions used for colon prep prior to diagnostic procedures onset variable

Question 26

``` docusate sodium (Colace) ```

Answer 26

emollient laxatives (stool softeners, surfactant laxatives ) enable mositure and fat to penetrate the stool, make it easier to pass increased mass of stool stimulates peristalsis widely used preventaively

Question 27

psyllium | Metamucil

Answer 27

Bulk forming laxatives high in fiber which attracts fluid into colon treat chronic constipation gentle action, slow onset danger of obstruction if fluid intake inadequate

Question 28

Calcium Salts | TUMS

Answer 28

Antacid

Question 29

Antacids

Answer 29

- Neutralize stomach acid, provide only symptom relief - long term use can cause electrolyte imbalances - Most effective take 1-2 hours after eating and at bedtime - Liquids coat esophagus and stomach - Chewables need to be fully chewed and chased with water - May interfere with absorption of other drugs, do not take other meds within 1-2 hrs - cause premature release of enteric coated drugs

Question 30

metoclopramide | Reglan

Answer 30

Prokinetic Antiemtics Stimulates forward peristalsis in GI tract (also blocks dopamine receptors) side effects - drowsiness - extrapyramidal rxns - restlessness

Question 31

Famotidine | Pepcid

Answer 31

H2 receptor antagonist (all "-tidine" drugs) supresses secretion of gastric acid once daily doses most effective if taken at bedtime Multi-day dose taken after meals and at bedtime Avoid antacids- interfere with absorption Smoking decreases effectiveness

Question 32

ondansetron | Zofran

Answer 32

Serotonin antagonist antiemetic selectively blocks specific serotonin receptors in GI tract, chemoreceptor trigger zone and medullary vomiting center side effects (minimal) - headache - dizziness - diarrhea/constipation

Question 33

furosemide | Lasik

Answer 33

Loop diuretic

Question 34

Hypertonic enema

Answer 34

fleet, small volume draws fluid into colon

Question 35

omeprazole | Prilosec

Answer 35

Proton Pump Inhibitor (all "-prazole" drugs) Totally blocks acid secretions Stronger and longer lasting that h2 receptor antagonists Drug of choice for gastric and duodenal ulcer treatment long-term therapy associated with osteoporosis most effective taken before first meal of day can use antacid concurrently (Ca advised for LT therapy) Avoid alcohol, antacids, irritating foods

Question 36

Magnesium Salts | Milk of Magnesia

Answer 36

Antacid and Laxative

Question 37

oil retention enema

Answer 37

lubricates rectum, colon and stool penetrates stool to increase bulk and soften