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25 Cards in this Set
- Front
- Back
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loperamide
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structural analog of meperidine; has opioid-like actions on gut that inhibits gastric motility
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lansoprazole (prevacid)
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MOA: suppress gastric acid secretion by blocking the proton pump that pumps hydrogen ions into the secretory surface of the gastric parietal cells.
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cimetidine
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tagamet
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cimetidine
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food decreases the rate of absorption but not the extent of absorption
-- eliminated intact by kidneys |
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cimetidine (tagamet)
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adverse effects include CNS effects (dizziness, H/A, confusion, hallucinations, letharygy) ESPECIALLY IN ELDERLY becuase it crosses BBB at high doses
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cimetidine (tagamet)
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antiandrogenic effects (binds to androgen receptors, producing receptor blockade) that lead to impotence (inability to maintain erection) and decrease in libido (sexual drive), gynecomastia (excessive dev of breasts in male)
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cimetidine
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inhibits hepatic drug metabolizing enxymes that interferes with metabolism of many other drugs; also inhibits first pass effect of ethnol
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lansoprazole
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prevacid
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lansoprazole
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may affect vitamin B12 absorption, no absolute contraindications, generally well-tolerated. ADVERSE EFFECTS: diarrhea, abd pain, Nausea, h/a, vomiting
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lansoprazole
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proton pump inhibitor - suppress gastric acid secretion by blocking the proton pump that pumps hydrogen ions into the surface of the gastric parietal cells
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misoprostol (Cytotec)
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inhibits secretion of gastric acid and stimulates secretion of mucus, providing cytoprotective effects on the integrity of the gastric mucosa
-replace prostoglandins - used with mifepristone to induce abortion |
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misoprostol
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unlabeled uses: postpartum hemorrhage, induction of labor
ADVERSE EFFECTS: diarrhea, nausea, abd discomfort, fever BLACK BOX: not to be used in women of childbearing potential unless capable of complying with effective contraceptive measures |
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sucralfate (carafate)
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a mucosal protective drug, aluminum hydroxide and sulfated sucrose, aids healing of ulcers, used for long term prevention of ulcer recurrence
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sucralfate
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forms a viscous, sticky gel that adheres to normal and necrotic mucosa, forming a protective coating over the eroded stomach lining
--creates a barrier that impairs diffusion of HCl and prevents degradation of mucus by pepsin and acid |
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sucralfate
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MAIN SIDE EFFECTS: GI related; constipation, dry mouth, nausea
ADVERSE EFFECTS (RARE): can decrease absorption of some other drugs NURSING CONSIDERATIONS: use caution when renal failure is present educate patients: take with water on empty stomach, 1 hour before or 2 hours after meals, take any other medications at least 2 hours before, may cause constipation |
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bisacodyl (Dulcolax)
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indicated for acute constipation, bowel prep for surgical procedures
ADVERSE EFFECTS: n/v, cramps, F&E imbalance administer PO, PR NURSING CONSIDERATIONS: do not use long term, contraindicated in bowel obstruction or abdominal pain of unknown origin, for best effect take full glass of water on empty stomach and do not take within 1 hour of antacid or milk |
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bisacodyl
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MOA: produce propulsive movements by direct chemical irritation and stimulation of intestinal wall and mesenteric plexus, increase fluid and electrolytes within the intestinal lumen
NOT FOR LONG TERM USE! because it may induce loss of normal bowel function and laxative dependence |
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psyllium (Metamucil)
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made from dried seed
contraindicated with intestinal obstruction or fecal impaction; acute abdomen of unknown origin MOST COMMON ADVERSER EFFECTS: bloating, flatulence, cramps |
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psyllium (Metamucil)
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pull water into stool and form an emollient gel causing fecal matter to increase in bulk; the bulky mass increases peristalsis and decreases transit time
- must be taken with plenty of water to avoid fecal impaction - may cause bloating and flatulence but usually well-tolerated --used for acute or chronic constipation, only laxative indicated for long-term use |
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docusate sodium (Colace)
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*has a detergent action on the surface of the intestinal bolus that decreases surface tension and makes the stool softer, it does not stimulate peristalsis
RELATIVELY FREE FROM SIDE EFFECTS: flatulence, diarrhea, abdominal cramps, safe for elderly, may take up to 3 days to work - most effective in preventing straining in high risk patients - |
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aluminum hydroxide (Amphojel)
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- neutralizes gastric activity
- also used for hyperphosphatemia in chronic renal failure - decreases effectiveness of H2 RAs, tetracyclines, digoxin, phenytoin, warfarin (separate by at least 2 hours) S/E: constipation, fecal impaction/obstruction, hypophosphatemia |
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loperamide (Imodium)
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INDICATIONS: 1) acute or chronic diarrhea 2) reduce the volume of discharge from ileostomy
MOA: structural analog of meperidine. has a direct effect on the nerves of the intestinal wall: slows peristalsis. -decreases volume, increase viscosity of the stool, decreases fluid and electrolyte loss |
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loperamide (Imodium)
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- poorly absorbed & poorly crosses the BBB
- ADVERSE EFFECTS:abdominal cramps, constipation - contraindicated in diarrhea caused by infections that penetrate intestinal mucosa or pseudomembraneous colitis --use cautiously in patient with hepatic impairment: encephalopathy --do not give to patients iwth abdominal pain of unknown origin |
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promethazine (phenergan)
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antiemetic, antihistamine
-- MOA: antiemetic effects: D2 blockade in CTZ --antimotion sickness effects:anticholinergic effects --antihistamine effects: antagonist of H1 receptors |
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promethazine
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antiemetic, antihistamine
used for antihistamine, sedative, antimotion-sickness/vertigo, antiemetic properties, moderate muscarinic and dopamine receptor blocking effects. FDA ALERT: medicines containing this should NOT be given to children less than 2 years old because of possible breathing problems. |
