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42 Cards in this Set

  • Front
  • Back
What is an antacid?
Neutralizes acid (increases pH)

*Hcl needed to keep suspension pH at 3.5 for 10 min
must neutralize >5mEq of HCl.
What category of antacid raises ph more?
Carbonates are better than Hydroxides
What are the classes of antacids?
Hyrdroxides, carbonates
What is the prototypes of hydroxides?
Aluminum hydroxide (amphogel) + magnesium hydroxide (milk of magnesia) = Maalox, mylanta, Gelusel, Di-Gel
What are the classes of carbonates?
calcium bicarbonate (tums), sodium bicarbonate (Alka seltzer)
What are antacids used for?
To decrease acid and to relieve pain.
What is the mechanism of action for hydroxides?
1)Change the pH of the stomach.
2) Also makes blood and urine more alkaline.
3) DOES Not coat the stomach.
4) Increases tone of esophageal sphincter
5) Slows gastric motility
6) Improves absorption of meds harmed by acid
7) Decreases absorption of meds needing acid
What are ADEs of Aluminum hydroxide?
constipation
hypophospahtemia
Don't take more than 2 weeks
Contact PCP if: abd pain persists, black tarry stools, vomit, diarrhea, constipation.
What are some specific uses of hydroxides?
AlOH is used to prevent hyperphosphatemia from renal disease.
Maintenance for duodenal ulcers.
NOT for bleeds.
What is a contraindication for hydroxides?
GI Bleed and
renal insufficiency for MgOH as it can cause hypermagnesemia
What are signs and symptoms of hypermagnesemia?
Muscle dysfunction (weakness), mental status change
What are nursing interventions for antacids?
Take PO
Take tablets with water
Take 2 hours before or after other drugs
Take 1-3 hrs after meals
Monitor electrolytes
How long do antacids work?
30-60 minutes on empty stomach, 3 hrs with food
What is the therapeutic use of Sucralfate/Carafate?
Ulcer adherent, coats the lining of the stomach and is an antipeptic
What is the course of action for Sucralfate/Carafate?
Aluminum anion splits off and forms paste that lines stomach/ulcer
Works in acidic environment
Also interferes with digestion
What are ADEs of sucralfate?
Nausea, Constipation, dry mouth, metallic taste, interferes with meds
What is a contraindication for sufcralfate?
Can't use with H2 receptor blockers
What are nursing interventions of sucralfate?
Tell patient to take before meals
Take 2 hrs before or after meals
Take 4-8 weeks
What is the therapeutic use of Tagamet (Cimetidine)?
Treat and prevent ulcers
esophagitis GERD
What is the mechanism of action for Histamine 2 Receptor blockers?
Decrease gastric acid production by blocking H2 receptors
Metab by liver and excreted by kidney
rapid absorption PO
What is the Histamine 2 receptor blocker prototype?
Cimetidine (Tagamet),
Others include Zantac, Pepsid
What are the contraindications for Tagamet (Cimetidine)?
Pregnancy/breastfeeding
Taking with antacids
Drug interactions with many
What are the ADEs for H2 receptor blockers?
Headache, dizziness, nausea, diarrhea
What are nursing interventions for H2 receptor blockers?
6-8 weeks, no longer (GI cancers can go unnoticed)
Give w/o regard to meals
Quit smoking
Assess for ADEs
Give 2 hrs apart from antacids
Check liver, kidney fxn
What is the prototype for Proton Pump Inhibitors?
Omeprazole (Prilosec)
What is the therapeutic use of Prilosec?
First drug of choice for peptic ulcer treatment
What is mechanism of action for proton pump inhibitors?
Prevent or stop the “pumping” or release of gastric acid
Metab liver, exc kidney
What are the administration recommendations for proton pump inhibitors?
Take between 8-12 weeks
Take with meals, well absorbed PO
What are the common ADEs for proton pump inhibitors?
Nausea, Diarrhea,
headache,
interferes with calcium absorp (bone fractures)
Incr risk of C Diff
Decrease absorption of nutrients
Interferes with meds
Rebound in acid produciton
What is the prototype for H Pylori?
2 of 4 antibiotics: Amoxicillin, Biaxin (erythromycin), flagyl, tetracyclin
Usually used with proton pump inhibitors
Previpak: 1 PPI and Amoxicillin and Biaxin
What meds are used for constipation?
Bulk-forming, surfactant (stool softener), saline cathartic, stimulant cathartic, lubricant laxatives
What are the prototypes for
Bulk-forming,
surfactant (stool softener),
saline cathartic,
stimulant cathartic,
lubricant laxatives?
metamucil
Colace
GoLYTELY (MOM)
Cascara, Senekot, Dulcalax
Mineral Oil
What would are the therapeutic uses for
Bulk-forming,
surfactant (stool softener),
saline cathartic,
stimulant cathartic,
lubricant laxatives?
relieve constipation
relieve straining (no valsalva maneuver)
Rapid bowel clean (eg. colonoscopy or surgery)
eliminate toxic substances (quick acting)
soften stool
What are ADEs for saline cathartics?
dehydration, electrolyte imbalance, cardiac problems
What are contraindications for laxatives/cathartics?
abdominal pain of unknown origin
What are nursing assessments/interventions for laxatives/cathartics?
Exercise/walking to stimulate normal bowel movement
Assess Medications (anticholinergics, etc)
Increase fluids
What drugs are used to treat diarrhea?
opiate derivative: Diphenyoxylate HCl w. atropine sulfate (Lomotil), Ioperamide (Immodium)
Non-specific: Bismuth subsalicylate (pepto-bismal, kaopectate)
Specific: antibiotics, digestive enzymes
What would you want to assess in patient who has been given antidiarrheal?
Stool quantity and quality
I&O
Skin turgor
Weight (Fluid Volume Deficit)
Pain
What are nursing interventions for antidiarrheals?
Identify cause of diarrhea (meds, bacteria)
Increase fluid intake
Handwashing
BRAT
Lactobacillus, probiotics
What drugs are used to treat nausea and vominting?
Anti-emetics:
- Phenothiazines: Thorazine, Compazine, Phergen
- ANtihistamine: Vistaril, Dramamine, Antivert
- Serotonin receptor antagonist: Ondansetron (Zofran)
- Benzodiazepines: Valium, Ativan
What are the therapeutic uses for each class of anti-emetics (phenothiazines, antihistamines, serotonin receptor antagonists, benzodiazepines)?
All used to treat nausea and vomiting. Antihistamines are often used for motion sickness. Benzos are usually added secondarily.
What are the administration recommendations for anti-emetics?
Give in the early am, before they puke!
Take needle off of phenothiazines as it can burn