Pharm week 9 Flashcards by Kayla Stahl

Risk factors for peptic ulcer disease

Family history
Blood group O
Smoking – increases gastric secretion
Caffeine
NSAIDs, ASA
Psychological stress
H. pylori
treatment: triple or quadruple therapy with antibiotics and PPIs

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What is GERD

Weakening of lower esophageal sphincter

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Lifestyle changes to treat GERD

Weight loss
Elevate HOB
Avoid fatty and acidic foods
Do not eat 3 hours before bed
No ETOH
No smoking

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proton pump inhibitor

omeprazole, esomeprazole, lansoprazole

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Long term effects of omeprazole, esomeprazole, lansoprazole

pneumonia, osteoporosis, hypomagnesemia**

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How long should proton pump inhibitor therapy be limited to

2 months

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omeprazole, esomeprazole, lansoprazole drug interactions

increased bleeding with warfarin; increased digoxin & phenytoin levels

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omeprazole, esomeprazole, lansoprazole drug interactions

increased bleeding with warfarin; increased digoxin & phenytoin levels

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Lifespan considerations for proton pump inhibitors:geriatric

osteoporosis, iron and B12 deficiency, Increase intake of calcium & magnesium, Incorporate weight-bearing exercises

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H2 receptor antagonist

ranitidine, famotidine, cimetidine

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Nursing for H2 receptor antagonists

use in older adults can cause CNS symptoms- confusion

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drug interactions for ranitidine, famotidine, cimetidine

antacids should not be given within 1 hr of H2 antagonists because it may reduce absorption

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antacid

aluminum hydroxide, magnesium hydroxide, calcium carbonate

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MOA of antacids

neutralizes acid

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Nursing for antacids

administer 2hrs before or after other drugs; chew & drink with 8 oz water

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contra-indications of antacids

bowel obstruction; caution renal patients- they cannot eliminate aluminum**

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Nursing for PUD

-Avoid smoking which can delay wound healing
-Avoid food that promote gastric secretion- coffee, caffeine and decaff beverages
-Avoid ASA and NSAIDs
-Avoid ETOH which can exacerbate PUD
-Eat meals on a regular schedule in a relaxed setting and do not overeat

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Prostaglandin analog/gastric protectant

misoprostol, sucralfate

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use of misoprostol

prevents ulcers caused by meds (NSAIDS, ASA)

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contradictions of misoprotol

pregnancy

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action of sucralfate

creates a protective barrier against acid & pepsin

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drug interactions with sucralfate

blocks absorption of warfarin, phenytoin, digoxin, antibiotics; take 2 hours away from these meds

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What is constipation

less than 3* bowel movements per week

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Causes of constipation

-Lack of exercise
-Lack of fiber
-Decreased fluid intake
-Medications: opioids, anticholinergics, antihistamines, antacids, iron
-Foods: dairy, chocolate, refined white flour
-Diseases: hypothyroidism, DM, IBS

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What is diarrhea

More than 3* bowel movements a day*

Causes of diarrhea

Medications: antibiotics Infection: C diff, VRE Inflammation: IBS, IBD Travel out of the country

bulk-type laxative prototype

psyllium

Nursing interventions for psyllium

mix with 8 oz of water and follow with 8 oz of water

Contraindications for psyllium

undiagnosed abdominal pain, intestinal obstruction, fecal impaction

Surfactant/emollient laxatives and action

docusate sodium: lowers surface tension to all ow penetration of water

Stimulant laxatives and action

bisacodyl senna: stimulates intestinal peristalsis

Osmostic laxatives and action

-magnesium hydroxide (MOM), magnesium citrate, sodium phosphates (Fleet’s), polyethylene glycol, lactulose -draws water into large intestine to produce bulk and stimlulates peristalsis

antidiarrheal prototype

diphenoxylate with Atropine

adverse effects of diphenoxylate with Atropine

dizziness, drowsiness (with high doses)

contraindications of diphenoxylate with Atropine

severe dehydration, electrolyte imbalance

nursing for diphenoxylate with Atropine

drink fluids with electrolytes, avoid caffeine

drug interactions with diphenoxylate with Atropine

alcohol & CNS depressants produce sedation

OD of diphenoxylate Atropine

naloxone for respiratory depression

sulfonamide/ 5-aminosalicylate Prototype

sulfasalazine

adverse effects of sulfasalazine

n/v/d, skin rashes, blood disorders

nursing for sulfasalazine

do not administer if allergy to sulfa, ASA, or thiazide diuretics*

contraindications for sulfasalazine

sulfa or salicylate sensitivity

meds for IBS-C

lubiprostone, linaclotide

is lubiprostone and linaclotide used in women or men

women

side effects of lubiprostone and linaclotide

diarrhea, nausea

contra-indication of lubiprostone and linaclotide

bowel obstruction

nursing for lubiprostone and lincaclotide

take with food

meds for IBS-D

alosetron

is alosetron used in women or men

women

side effects of alosetron

constipation, obstruction, impaction, or perforation

contraindications for alosetron

chronic constipation, Crohns, colitis, diverticulitis

antiemetic/serotonin antagonist prototype

ondansetron: (zofran), granisetron, dolasetron

side effects of antiemetic/serotonin antagonists

headache, dizzy, diarrhea, drowsiness

contraindications of antiemetic/serotonin antagonists

dysrthmias

drug interactions with antiemetic/serotonin antagonists

CNS depressants & antipsychotics- can intensify CNS effects

Dopamine antagonists

Chlorpromazine, prochlorperazine, promethazine

Prokinetics

metoclopramide

Anticholinergics

Scopolamine patch

Antihistamines

Dimenhydrinate, diphenhydramine, hydroxyzine, meclizine

Cannabinoids

Dronabinol, nabilone

pancreatic enzymes prototype

pancrelipase

nursing for pancrelipase

do not crush or open enteric coated tablets; may sprinkle on food; give with meals and snacks*

contraindications for pancrelipase

pork allergy

drug interactions for pancrelipase

decreased absorption of iron; antacids may decrease effect of pancrelipase

these restore the normal flora of the intestine following diarrhea, particularly from antibiotic therapy

probiotic

You should not take a probiotic the same time as an antibiotic (T/F)

True

what is the only vitamin humans produce

it is okay to consume up to three times the daily recommended levels of all vitamins except these two

A and D

causes of undernutrition

low dietary intake, malabsorption disorders, fad diets, alcoholism, eating disorders, surgery, trauma, wasting disorders such as cancer or AIDS

lipid-soluble vitamins

vitamin A

uses of vitamin A

night blindness, slow wound healing, GI disorders

Long term effects of high amounts of vitamin A

drying and scaling of the skin, alopecia, fatigue

Which vitamin is labeled category X in pregnancy

MOA of folic acid

RBC, WBC, platelet production

primary use of folic acid

during pregnancy to promote normal fetal growth, reversing symptoms of deficiency from inadequate intake or alcohol abuse

drug interactions of folic acid

levels are decreased by methotrexate (mtx) and sulfonamides

nursing action of folic acid

assess CBC, folic acid levels; include food sources such as: green leafy vegetables, citrus fruits, dried beans

Mineral

magnesium sulfate, oxide, hydroxide

side effects of magnesium sulfate, oxide, hydroxide

muscle weakness, suppresses AV conduction in the heart, can cause respiratory depression, diarrhea; flushing with IV infusion

nursing actions for minerals

monitor magnesium, calcium levels, vital signs, monitor for absent DTRs, normal magnesium levels: 1.3-2.1 mEq/L; include food sources: whole grains, nuts, legumes, green leafy vegetables, bananas

Mineral OD

IV calcium gluconate

Pharm week 9 Flashcards

(81 cards)