*321 Exam 4 (Gi Drugs)

Front 1

Antacids
-What is their action? (3)

Back 1

-buffer or neutralize gastric acid
-increases gastric pH and neutralizes pepsin
-improves mucosal protection

Front 2

Antacids
-Used in what 3 conditions?

Back 2

GERD, gastritis, PUD

Front 3

-what is the only example of an magnesium based antacid?

-what are there 2 side effects?

Back 3

Milk of Magnesia

-Magnesium based may cause diarrhea & could cause magnesium toxicity in renal patients

-Rapid acting
-High acid neutralizing capabilities

Front 4

Amphojel
AlternaGEL
Alu-caps
Basaljel

are examples of what type of antacids?

what are the 2 side effects?

Back 4

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+

Front 5

Mylanta
Maalox/Maalox Plus

are what types of antacids?

Back 5

Magnesium-plus aluminum based

Front 6

Histamine antagonists (H2 blockers)

Action:

Back 6

-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

Front 7

-To identify H2 blockers, look at the word ____ at the end of the medication

Back 7

“tidine”

Front 8

Nursing Considerations for antacids
-Interfere with absorption of many po drugs – advise the patient to wait how long before taking other medications?

Back 8

at least 2 hrs to take other medications

Front 9

Nursing Considerations for antacids
-when should you tell them to take them in regards to meals?

Back 9

-Take 1-3 hours after meals and HS

Front 10

Nursing Considerations for antacids
-how do you instruct a patient to take these?

Back 10

-Chew tablets well and with 4-6 oz water

Front 11

Nursing Considerations for antacids
-do not give to pts with what type of medical issue?

Back 11

do not give to patients in renal failure or with renal dysfunction

Front 12

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)

Back 12

may cause confusion, agitation or coma

- long term use may use may cause gynecomastia, impotence, and diarrhea

Front 13

H2 blockers
-which drug is the safest drug to use with critically ill?

Back 13

famotidine (Pepcid)

Front 14

H2 blockers
-nizatidine (Axid) drug of choice for what?

Back 14

dueodenal ulcers
-rarely causes sweating, increased liver enzymes, nausea, urticaria

Front 15

Nursing Considerations for H2 blockers:
-can you give them with an antacid?
-what are you sure to avoid mixing this with?

Back 15

-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

Front 16

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)

Back 16

hypotension, bradycardia, and dysrhythmias

Front 17

Nursing Considerations for H2 blockers:

May inhibit the metabolism of drugs including po: (4)

Back 17

anticoagulants,
beta blockers,
benzodiazepines,
tricyclic antidepressants;
------may led to toxicity

Front 18

Nursing Considerations for H2 blockers:

when should a patient take this drug?

Back 18

-Take at HS if once a day dosing

Front 19

Nursing Considerations for H2 blockers:

Monitor for what 2 SE?

Back 19

-Monitor for neutropenia and hypotension

Front 20

H2 blockers are used to treat what 3 medical conditions?

Back 20

GERD, gastritis, PUD

Front 21

PPI (Proton Pump Inhibitor)
-Action:

Back 21

-reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid
-reducing gastric acid by stopping acid-producing proton pump

Front 22

PPI (Proton Pump Inhibitor) lansoprazole (Prevacid)

Side effects (4)

Back 22

abdominal cramping, diarrhea, constipation, nausea

Front 23

PPI (Proton Pump Inhibitor)

omeprazole (Prilosec)
Side effects (3)

Back 23

abdominal cramping, HA, diarrhea

Front 24

PPI (Proton Pump Inhibitor)

pantoprazole (Protonix)
Side effects:

Back 24

false positive urine for THC, chest pain, HA, dizziness, rash/purities, abdominal cramping, diarrhea, constipation, nausea, flu syndrome

Front 25

-generic names end in “zole”

Back 25

PPI (Proton Pump Inhibitor)

Front 26

Nursing Considerations:
PPI
-when should the pt take the meds?

Back 26

-Take before meals

-Do not crush tablets - Prevacid capsule can be opened and granules mixed with apple juice of applesauce

Front 27

Nursing Considerations:
PPI

-what lab tests should you be monitoring?

Back 27

-Monitor LFT for elevated AST, ALT, alkaline phosphatase, and bilirubin levels

Front 28

Misoprostol (Cytotec) is an example of what type of drug?

Back 28

Anti-Ulcer Agents:
-synthetic prostaglandin

Purpose: prevention of ulcers from NSAID agents

Front 29

Sucralfate (Carafate) is an example of what type of drug?

Back 29

Anti-Ulcer Agents:

Front 30

Anti-Ulcer agent
-Misoprostol (Cytotec)

Reduces what?
Protects what?
Increases what?

Back 30

reduces gastric acid secretion
-protects gastric mucosa from ulcerogenic agents;
-increases mucus productions and bicarbonate levels

Front 31

Misoprostol (Cytotec)

Side effects (3)

Back 31

-diarrhea
- cramping
-uterine cramping

Front 32

Nursing Considerations: Misoprostol (Cytotec)

-what can you tell the pt to do to help manage the GI side effects?

Back 32

-take with food to reduce gastric effects

Front 33

Nursing Considerations: Misoprostol (Cytotec)

advise the patient not to take if there is a chance of:

Back 33

-advise pt not to take if there is a chance of becoming pregnant
-use contraceptives

Front 34

Sucralfate (Carafate)

Action:

Back 34

-with gastric acid, this creates a thick paste which adheres to the gastric mucosa

Front 35

Sucralfate (Carafate)

Inhibits what?

Back 35

-inhibits acid and forms a protective coating over mucosa

Front 36

Sucralfate (Carafate)

2 Side effects?

Back 36

-constipation
-nausea

Front 37

Sucralfate (Carafate) & Nursing Considerations:

when do you tell them to take this?

Back 37

-Give 1 hour before and 2 hours after meals and HS,

Front 38

Teaching about Sucralfate (Carafate)

Do not give within how long of taking antacids or other drugs?

Do not crush

Back 38

Do not give within 30 minutes of antacids or other drugs

Front 39

Sucralfate (Carafate) & Nursing Considerations:

What do you tell them to do to help with the SE?

-notify the doctor if what occurs?

Back 39

-Increase intake of fluids and dietary fiber to prevent constipation
-notify doctor if tinnitus occurs

Front 40

metoclopramide (Raglan) is what type of drug?

Back 40

Promotility Agent
-helps with N/V too

Front 41

metoclopramide (Raglan)

action:

Back 41

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

Front 42

metoclopramide (Raglan)

Side effects:

Back 42

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

Front 43

metoclopramide (Raglan)
-Nursing Considerations:

-Tell me about patient safety?
-avoid what 2 substances while taking this

Back 43

-maintain safety because can cause drowsiness
-avoid ETOH or CNS depressants when taking

Front 44

what drugs are given to eradicate H. pylori bacteria? 3

Back 44

tetracycline, amoxicillin, metronidazole (Flagyl)

(antibiotics and antimicrobials)

Front 45

Bismuth Salts
-what is an example of this drug?

-what is the action?

Back 45

Pepto-Bismol

Action: used with antibiotics to suppress H. pylori bacteria in the gastric mucosa and assist with the healing of mucosal lesions

Front 46

psyllium (Metamucil) is an example of what type of laxative?

-when does this drug produce results?

Back 46

bulk forming

1-3 days

Front 47

psyllium (Metamucil)

-Action:

Back 47

-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.

Front 48

Nursing Indications
-psyllium (Metamucil)

Complication:
-what do you do to prevent

Back 48

-take with a full glass of water or juice; can cause obstruction if not enough fluid

Front 49

doucasate (Colace, Ex-Lax, Liqui-Gels) is what type of laxative?

when does it product results?

Back 49

Laxative – Surfactant

1-3 days

Front 50

Laxative – Surfactant
-doucasate (Colace, Ex-Lax, Liqui-Gels)

Action:

Back 50

Action:
-work in small and large intestine;
-surfactant action softens stool by facilitating penetration of water;

Front 51

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?

Back 51

stimulant

6 – 12 hours;

bisacodyl suppositories act in 5 – 60 minutes

Front 52

senna (Ex-Lax, Senokot) is what type of laxative?

when do you see results?

what is the side effect?

Back 52

stimulant

6 – 12 hours

– can cause urine to turn pink

Front 53

Laxative
- Lactulose:

Action:

Back 53

-enhance intestinal excretion of ammonia, retains ammonia in the colon by producing osmotic effects. Promotes increased peristalsis, bowel evacuation (expelling ammonia from colon)

Front 54

Laxative
- Lactulose:

2 common side effects:

Back 54

flatulence and cramping common