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205 Cards in this Set

  • Front
  • Back
When can you start to use antimetics
after you find the cause
What are antimetics used for:
N/V
What is bad about antimetics
can mask cause of vomiting
What stage of pregnancy can antimetics not be given
1st trimester
Examples of nonpharmacologic for N/V
weak tea
carbonated drinks
gatorade
pedialyte
What centers control N/V
cerebral centers
What does CTZ stand for
chemoreceptor trigger zone
Where is CTZ located
near medulla
What happens when the CTZ stimulated
vomiting
CTZ is affected most by
drugs
toxins
vestibular center of the ear
Where does the vomiting center lie
medulla
What happens when the vomiting center is stimulated
vomiting
What is the vomiting center most affected by
sensory:
smell
taste
gastric mucosal
What effects do nonprescription antimetics have on N/V
minimal effects
Nonprescription antimetics are good for
motion sickness
When should you take motion sickness meds
30 mins before travel
4 Examples of motion sickness meds:
dramamine
marezine
antivert
benadryl
pepto-bismol
emetrol
How does pepto-bismol work
coats gastric mucosa
How does emetrol work
changes gastric pH
Common SE of antimetics
drowsiness
dry mouth
constipation
How do antihistamines & anticholinergics work
primarily on vomiting center
decrease stimulation of CTZ & vestibular pathways
Do not use antihistamines or anticholinergics on
glaucoma patients
4 examples of antihistamines & anticholinergics
Vistaril
Atarax
Phenergan
Transderm-Scop
What is transderm-scop for
severe motion sickness
How is transderm-scop administered
put behind ear and can wear for several days
SE of anthihistamines & anticholinergics
drowsiness
dry mouth
blurred vision
tachycardia
How do dopamine antagonists
block dopamine receptors in CTZ
Largest group of dopamine antagonists
Phenothazine antimetics
What are phenotazine antimetics used for
severe N/V
motion sickness
What is a SE of phenotazine antimetics
drowsiness
4 examples of phenothazine antimetics
Thorazine
Compazine
Phenergan
Trilifon
What kind of drug is butyrohenones
dopamine antagonists
What is butyrophenones used for
post op N/V assoc. with toxins chemo & radiation
Examples of butyrophenones
haldol
inapcine
Extrapyramidal of butyrophenones
muscle rigity
tremors
diff. walking (usually after long term use)
What time of drug is Reglan
butyrophenones, dopamine antagonists
What is reglan used for
post op emesis, chemo & radiation
High doses of reglan can cause
sedation & diarrhea
When should reglan not be given
GI obstruction
hemorrhage
perforation
What do benzodiazepens do
treat N/V associated with chemo
1 Example of benzodiazepens
ativan
Serotonin receptor antagonists treat
N/V assoc. with chemo
How do serotonin receptor antagonists work
block serotonin receptors in the CTZ & vagal nerve terminals in the upper GI tract
Why do serotonin receptor antagonists no have EPS
doesnt block dopamine receptors
SE of serotonin receptor antagonists
HA
Diarrhea
Dizziness
Fatigue
3 examples of serotonin receptor antagonists
zofran
kytril
anzemet
What do glucocorticoids (corticosteroids) do
N/V related to chemo
2 examples of glucocorticoids
decadron
solu-medrol
What is cannabinoids
marijuana
What is cannabinoids used for
alleviate cancer related to cancer tx
When cannabinoids prescribed
when other drugs dont respond
Why is cannabinoids used with AIDS patients
stimulates appetite
1 example of cannabinoids
marinol
SE of cannabinoids
mood changes
HA
What needs to be done for patients with N/V
monitor bowel sounds
provide mouth care
Why cant alcohol be taken with meds that treat n/v
interferes with sedative
You can't take anti n/v in what part of the pregnancy
1st trimester
You can not have phenothiazines if you have
liver disease
What are emetics used for
induce vomiting after ingestion of certain toxic substances
If take caustic substances take
activated charcoal
What kind of drug is ipecac
emetic
What form of ipecac can you use
syrup not liquid
What does ipecac do
induce vomiting by stim. CTZ & acting directly on gastric mucosa
What should you take with ipecac
with water NOT milk or carbonated beverages
When do you repeat an ipecac dose
in 20-30mins if dont vomit, if dont vomit then take to ER
What can ipecac cause
cardio rhythm changes, monitor with EKG
What is gastric lavage
pump stomach
Do not use antidiarrheals more than
48hrs or if have fever
Diarrhea can cause
F&E imbalances & severe dehydration
Loss of bicarbonate through diarrhea can cause
metabolic acidosis
clients with diarrhea should avoid
fatty foods & milk products
Nonpharmacologic measures used for diarrhea
clear liquids
oral solutions
IV electrolyte solutions
Traveler's diarrhea is usually caused by
e coli
If severe diarrhea use
antibiotics
immodium
Immodium works by
slowing peristalsis which can slow bacteria from exiting body
What kind of drug are opiates
antidiarrheals
How do opiates work
decrease intestinal motility & peristalsis
SE of opiates/antidiarrheals
constipation
5 examples of opiate antivirals
tincture of opium
paregoric
codeine
lomotil
imodium
What is bade about paregoric
bad SE
What is bad about hepatic impairment
dangerous drug
What kind of drug is somatostatin analog
antidiarrheals
How do somatostatin analog work
inhibit gastric acid secretions & decreases SM contractility
somatostatin analog is prescribed for
severe diarrhea for metastatic cancer
1 example of somatostatin analog
sandostatin
What kind of drug are adsorbents
antidiarrheals
How do adsorbents work
coat the wall of the GI tract & absorb the bacteria & toxins that cause diarrhea
2 examples of adsorbents
kaopectate
pepto-bismol
Cathartics promote
soft stool
SE of cathartics
cramping
What determines if it is a laxative or cathartic
dosage
What are purgatives
harsh cathartics that cause watery stool with abdominal cramping
Osmotic (Saline) laxatives include
salts or saline
lactulose
glycerin
Osmotic (saline) laxatives work by
pulling water into colon & feces to increase bulk with stim. peristalsis
Why is good renal function important with osmotic laxatives
excrete salts
What patients should not use osmotic (saline) laxatives
congested heart failures
4 types of osmotic (saline) laxatives
phospo-soda
MOM
K phosphate
Golytely
How much water is needed when taking osmotic (saline) laxatives
3-4liters
What needs to be used before osmotic (saline) laxatives
bowel preparations
Why are osmotic not absorable
not isotonic
Osmotic laxatives can be used in
renal & cardiac pts
How do lactulose & glycerin work
no absorbed
draw water into intestine
Diabetics should avoid
lactulose because glucose & fructose
How do stimulant laxatives work
increase peristalsis by irritating sensory never endings in the intestinal mucosa, commonly abused
6 examples of stimulant laxatives
ex lax
feen-a-mint
correctol
dulcolax
senokat
purgative
When shouldnt you use pergative
at bedtime
Continual use of laxatives can make you lose
urge to defecate
How do bulk-forming laxatives
natural fibrous substances that promote large soft stool by absorbing water inceasing bulk & promoting peristalsis
Are bulk-forming laxatives absorbed
no, systemically
When dose action of bulk-forming laxatives occur
8hrs-3days
Powdered forms of bulk-forming laxatives can be mixed with
liquid & drank immediately
Over use of bulk-forming laxatives can cause
obstruction
Benefit of bulk-forming laxatives
doesnt cause dependence
4 examples of bulk-forming laxatives
fibercon
citrucel
perdiem
metamucil
Why should one avoid inhallation of bulk forming laxatives
psyllium dust, main ingredient
What should be taught about swallowing bulk-forming laxatives
not in dry form
Emollients are used to
stool softners
Why are lubricants used with emollients
prevent constipation
What do emollients promote in stool
water accumulation
4 examples of emollient
surfak
dialose
colace
peri-colace
SE of emollients
N/V
diarrhea
cramping
Peptic ulcer is
ulcer occuring in esophagus,
stomach, duodenum
Peptic ulcer occur when
hypersection of hydrochloric acid & pepsin which errodes GI lining
GMB
gastic mucosal barrier- protects mucosa from acid
GERD
erosion of esophageal mucosa-gastro esophogeal reflux disease
Esophageal ulcer
continual reflux of acid into the esophagus-weak cardiac sphincter
Duodenal ulcer
hypersecretion of acid into duodenum-weak pyloric sphincter
Gastric ulcer
occurs due to breakdown of GMB
What is H.plylori
gram neg bacilli
H pylori is linked to
peptic ulcer formation
Meretek test
breath test to detect H. pylori
blood test checks for
antibodies to disease
how is h. pylori treated
multiple antibiotics
regimen for h pylori
2 antibiotics
proton pump inhibitor
14days
Zantac for 6more wks
GERD stands for
gastroesophageal reflux disease
What happens with GERD
acid refluxes in the esophagus
What are risk factors for GERD
obesity and smoking
Warning sign of GERD
heartburn
What drugs are effective for GERD
H2blockers & PPI drugs
Why are PPI better than H2
heal faster
GERD is less likely to occur with
PPI
Is GERD chronic
yes
What kind of drug is tranquilizers
antiulcer
How well do tranquilizers work on ulcers
minimal effects
how do tranquilizers treat ulcers
reduce vagal stimulation & decrease anxiety
2 examples of tranquilizers
librium
quarzan
How do anticholinergic work as antiulcer
relieve pain by decreasing GI motility & secretion
Why do anticholinergics that work as antiulcer work better on duodenum ulcers
delay gastric emptying time
When should anticholinergics used as antiulcer be taken
before meals
Why should anticholinergics that used as antiulcers not be taken with antacids
slow absorption
When should antacids be taken with anticholinergics that are used as antiulcers
2hrs after
SE of anticholinergics used as antiulcers
decreased secretions
tachycardia
urinary retention
constipation
Atacids promote
ulcer healing by neutralizing HCL acid & reducing pepsin activity
Antacids do not ___ ulcers
coat
systemic effect of antacids
acid rebound
Sodium bicarbonate is what kind of drug
antacids
sodium bicarbonate causes
hypernatremia
water retention
2 examples of sodium bicarbonate
bromo-seltzer
alka-seltzer
Calcium carbonate is used as an
antacid
calcium carbonate causes
hypercalcemia
2 examples of alkaline salts
aluminum
magnesium
SE of alkaline salts
diarrhea
constipation
Medicines that are alkaline salts
mylanta
maalox
When should you give antiulcer's
1-2hrs after other meds
Before giving antiulcer drugs you should do what to them
shake well
Histamine 2 blockers treat
ulcers, most popular choice
How do histamine 2 blockers work
prevent reflux in esophagus by blocking h3 receptors of parietal cells in the stomach which reduce gastric acid secretion
Example of histamine 2 blockers
tagamet
tagamet interacts with
lots of meds
need good ___to use tagamet
kidney function
When should antacids be taken if taking tagamet
1hr before or after
What kind of drugs are zantac or pepcid
H2 blockers
What kind of drug is axid
H2blockers
How does axid work
promote healing of ulcer, act longer, fewer SE
SE of axid
HA
dizziness
constipation
pruritis
rash
gynecomastia
decrease libido
impotence
What is important to eat with H2 blockers
B12
How do proton pump inhibitors work
suppress gastric acid secretion in the gastric parietal cells
Why are PPI better than H2 blockers
inhibit gastric acid secretion 90% more than H2
PPI block the final step of
acid production
PPI are used in the tx of
peptic ulcers
GERD
When should you take PPI
before meals
What kind of drug is priosec
PPI
What kind of drug is prevacid
PPI
Prevacid brings relief in
1wk
Prevacid decrease
theophylline levels
What kind of drug is aciphex
PPI
Aciphex is better for
duodenal ulcers
Aciphex is most effective for
GERD
What kind of drug is protonix
PPI
Protonix best for
short term erosive GERD
what kind of drug is nexium
PPI
Nexium heals
GERD
What do pepsin inhibitors do
protect mucosa of GI tract
How is pepsin inhibitor absorbed
nonabsorable
How does pepsin inhibitors work
forms a viscous substance that covers & protects from acid & pepcid
What kind of drug is sucralfate
pepsin inhibitor
Dose for sucralfate
1g qid (AC,HS)
Should you eat before sucralfate
no
When should antacids be taken when taking sucralfate
30min before and after
SE of sucralfate
few
What kind of drug is misoprotol
prostaglandin analogue antiulcer
How does prostaglandin analogue antiulcer
suppress gastric acid secretion & increase protective mucus in the GI tract
Misoprostol benefits clients with
gastric distress from NSAIDS
Misoprostol is recommended as long as
they use NSAIDS
misoprostol is contraindicated with
pregnancy and women of childbearing age