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54 Cards in this Set
- Front
- Back
Antacids
-What is their action? (3) |
-buffer or neutralize gastric acid
-increases gastric pH and neutralizes pepsin -improves mucosal protection |
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Antacids
-Used in what 3 conditions? |
GERD, gastritis, PUD
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-what is the only example of an magnesium based antacid?
-what are there 2 side effects? |
Milk of Magnesia
-Magnesium based may cause diarrhea & could cause magnesium toxicity in renal patients -Rapid acting -High acid neutralizing capabilities |
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Amphojel
AlternaGEL Alu-caps Basaljel are examples of what type of antacids? what are the 2 side effects? |
Aluminum based
Aluminum based may cause constipation & can cause hypophosphatemia •Warfarin: Alum binds to it and decreases absorption (2nd antacid in Maalox, Mylanta) •Slow Acting •Low ANC (acid neutralizing capability) •Long duration of effects •Contains a lot of NA+ |
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Mylanta
Maalox/Maalox Plus are what types of antacids? |
Magnesium-plus aluminum based
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Histamine antagonists (H2 blockers)
Action: |
-decreases gastric acid output by blocking gastric histamine 2 receptors
-Limited to the blocking of histamine receptor on the surface of the parietal cell in the stomach so you decrease acid |
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-To identify H2 blockers, look at the word ____ at the end of the medication
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“tidine”
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Nursing Considerations for antacids
-Interfere with absorption of many po drugs – advise the patient to wait how long before taking other medications? |
at least 2 hrs to take other medications
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Nursing Considerations for antacids
-when should you tell them to take them in regards to meals? |
-Take 1-3 hours after meals and HS
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Nursing Considerations for antacids
-how do you instruct a patient to take these? |
-Chew tablets well and with 4-6 oz water
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Nursing Considerations for antacids
-do not give to pts with what type of medical issue? |
do not give to patients in renal failure or with renal dysfunction
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H2 blocker drugs - cimetidine (Tagemet)
Side effects -what may it cause to happen in the elderly or in patients with renal or hepatic insufficiency? -what may long term use cause: (3) |
may cause confusion, agitation or coma
- long term use may use may cause gynecomastia, impotence, and diarrhea |
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H2 blockers
-which drug is the safest drug to use with critically ill? |
famotidine (Pepcid)
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H2 blockers
-nizatidine (Axid) drug of choice for what? |
dueodenal ulcers
-rarely causes sweating, increased liver enzymes, nausea, urticaria |
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Nursing Considerations for H2 blockers:
-can you give them with an antacid? -what are you sure to avoid mixing this with? |
-Do not give an antacid within 1 hour before or after giving a H2-receptor blockers;
-don’t mix with vegetable juices – apple juice preferred choice |
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Nursing Considerations for H2 blockers:
IV route: do not mix with other drugs -administer slowly in 20-100 l over 15-30 minutes, bolus may cause (3) |
hypotension, bradycardia, and dysrhythmias
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Nursing Considerations for H2 blockers:
May inhibit the metabolism of drugs including po: (4) |
anticoagulants,
beta blockers, benzodiazepines, tricyclic antidepressants; ------may led to toxicity |
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Nursing Considerations for H2 blockers:
when should a patient take this drug? |
-Take at HS if once a day dosing
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Nursing Considerations for H2 blockers:
Monitor for what 2 SE? |
-Monitor for neutropenia and hypotension
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H2 blockers are used to treat what 3 medical conditions?
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GERD, gastritis, PUD
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PPI (Proton Pump Inhibitor)
-Action: |
-reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid
-reducing gastric acid by stopping acid-producing proton pump |
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PPI (Proton Pump Inhibitor) lansoprazole (Prevacid)
Side effects (4) |
abdominal cramping, diarrhea, constipation, nausea
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PPI (Proton Pump Inhibitor)
omeprazole (Prilosec) Side effects (3) |
abdominal cramping, HA, diarrhea
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PPI (Proton Pump Inhibitor)
pantoprazole (Protonix) Side effects: |
false positive urine for THC, chest pain, HA, dizziness, rash/purities, abdominal cramping, diarrhea, constipation, nausea, flu syndrome
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-generic names end in “zole”
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PPI (Proton Pump Inhibitor)
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Nursing Considerations:
PPI -when should the pt take the meds? |
-Take before meals
-Do not crush tablets - Prevacid capsule can be opened and granules mixed with apple juice of applesauce |
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Nursing Considerations:
PPI -what lab tests should you be monitoring? |
-Monitor LFT for elevated AST, ALT, alkaline phosphatase, and bilirubin levels
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Misoprostol (Cytotec) is an example of what type of drug?
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Anti-Ulcer Agents:
-synthetic prostaglandin Purpose: prevention of ulcers from NSAID agents |
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Sucralfate (Carafate) is an example of what type of drug?
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Anti-Ulcer Agents:
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Anti-Ulcer agent
-Misoprostol (Cytotec) Reduces what? Protects what? Increases what? |
reduces gastric acid secretion
-protects gastric mucosa from ulcerogenic agents; -increases mucus productions and bicarbonate levels |
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Misoprostol (Cytotec)
Side effects (3) |
-diarrhea
- cramping -uterine cramping |
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Nursing Considerations: Misoprostol (Cytotec)
-what can you tell the pt to do to help manage the GI side effects? |
-take with food to reduce gastric effects
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Nursing Considerations: Misoprostol (Cytotec)
advise the patient not to take if there is a chance of: |
-advise pt not to take if there is a chance of becoming pregnant
-use contraceptives |
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Sucralfate (Carafate)
Action: |
-with gastric acid, this creates a thick paste which adheres to the gastric mucosa
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Sucralfate (Carafate)
Inhibits what? |
-inhibits acid and forms a protective coating over mucosa
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Sucralfate (Carafate)
2 Side effects? |
-constipation
-nausea |
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Sucralfate (Carafate) & Nursing Considerations:
when do you tell them to take this? |
-Give 1 hour before and 2 hours after meals and HS,
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Teaching about Sucralfate (Carafate)
Do not give within how long of taking antacids or other drugs? Do not crush |
Do not give within 30 minutes of antacids or other drugs
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Sucralfate (Carafate) & Nursing Considerations:
What do you tell them to do to help with the SE? -notify the doctor if what occurs? |
-Increase intake of fluids and dietary fiber to prevent constipation
-notify doctor if tinnitus occurs |
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metoclopramide (Raglan) is what type of drug?
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Promotility Agent
-helps with N/V too |
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metoclopramide (Raglan)
action: |
Action:
- acts on CNS chemoreceptor trigger zone and enhances the response to acetycholine of upper GI tissue by blocking dopamine and serotonin (in high doses) to stimulate gastric motility and gastric emptying |
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metoclopramide (Raglan)
Side effects: |
EPS
-difficulty speaking, swallowing, loss of balance, gait disruptions, twitching or twisting movement, weakness of arms/legs -tardive dyskinesia (uncontrolled rhythmic facial movements, lip smacking, tongue rolling, restlessness, drowsiness, sleepiness, diarrhea |
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metoclopramide (Raglan)
-Nursing Considerations: -Tell me about patient safety? -avoid what 2 substances while taking this |
-maintain safety because can cause drowsiness
-avoid ETOH or CNS depressants when taking |
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what drugs are given to eradicate H. pylori bacteria? 3
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tetracycline, amoxicillin, metronidazole (Flagyl)
(antibiotics and antimicrobials) |
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Bismuth Salts
-what is an example of this drug? -what is the action? |
Pepto-Bismol
Action: used with antibiotics to suppress H. pylori bacteria in the gastric mucosa and assist with the healing of mucosal lesions |
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psyllium (Metamucil) is an example of what type of laxative?
-when does this drug produce results? |
bulk forming
1-3 days |
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psyllium (Metamucil)
-Action: |
-work in the small and large intestine by absorbing water, thereby softening and enlarging the fecal mass;
-a fecal mass stretched the intestinal wall to stimulate peristalsis and passage of a soft-formed stool in 1-3 days. |
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Nursing Indications
-psyllium (Metamucil) Complication: -what do you do to prevent |
-take with a full glass of water or juice; can cause obstruction if not enough fluid
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doucasate (Colace, Ex-Lax, Liqui-Gels) is what type of laxative?
when does it product results? |
Laxative – Surfactant
1-3 days |
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Laxative – Surfactant
-doucasate (Colace, Ex-Lax, Liqui-Gels) Action: |
Action:
-work in small and large intestine; -surfactant action softens stool by facilitating penetration of water; |
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bisacodyl (Correctol,
Ducolax, Feen-a-mint) is what type of laxative? when do you see results if given PO? -what do you see results if it is a suppository? |
stimulant
6 – 12 hours; bisacodyl suppositories act in 5 – 60 minutes |
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senna (Ex-Lax, Senokot) is what type of laxative?
when do you see results? what is the side effect? |
stimulant
6 – 12 hours – can cause urine to turn pink |
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Laxative
- Lactulose: Action: |
-enhance intestinal excretion of ammonia, retains ammonia in the colon by producing osmotic effects. Promotes increased peristalsis, bowel evacuation (expelling ammonia from colon)
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Laxative
- Lactulose: 2 common side effects: |
flatulence and cramping common
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