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86 Cards in this Set

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  • Back
Antacids: Core Drug Knowledge Related to Aluminum Hydroxide with Magnesium Hydroxide.
Trade name- Milanta
Lower level phosphate in drugs given after meals.
Antacids Pharmacotherapeutics
Acid Indigestion
Antacids Pharacokinetics
Minimally Absorbed
Onset of 30 minutes
Duration of 20 to 60 minutes (if taken on empty stomach); 3 hours (if taken after meal)
Should be taken after meal.
Inhibit gastric Emptying
Antacids Pharmacodynamics
Contraction of gastric smooth muscle inhibitied, ingibiting gastric emptying (aluminum)
Promotino of gastric emptying (magnesium)
Antacids Adverse Effects
Cat C Pregnancy- Notify Doctor
Antacids Drug Interactions
Hydantoins- Dyalantin- Dont take with Antacids 30 min 2 hours apart
Antacids Assesment
Why they are taking antacids and other drugs.
Antacids Planning Intervention Minimizing adverse effects
Give 2 hours after giving other drugs.
Antacids Providing patient and family education
Caustion not to use antacid for longer than 2 weeks unless directed by health care provider.
Drugs clostly related to aluminum hydroxide with magnesium hydroxide
Aluminum Compounds- Amphagel
Magnesium Compounds- Milk of Magnesia
Calcium Carbonate- Tums
Drugs significatly different from aluminum hydroxide with magnesium hydroxide
Not an antacid
Treatment of duodenal ulcers
Does not lower gastric acidity
Usually have heart burn cause some side effects
Coat lining of ulcer
Given 30 min before eating.
H2 Receptor Antagonists: Core Drug Knowledge related to famotidine
Pepcid Slow down the production of acid.
H2 Receptor Antagonists Pharmacotherapeutics
Relapsing, Nonerosive GERD
Erosive esophagitis
Upper GI Bleeding
OTC Formulation for heartburn, indigestion, and sour stomach.
H2 receptor Antagonists Pharacokinetics
Duration of 10-12 hours (dose and regiment dependent)
Take 2x a day
First pass metabolism (approximately 30%)via liver
Bound to plasma proteins
Widely distribted
Renal Excretion 30% unchanged
Also administered parenterally, can be given IV if stress ulcer.
H2 receptor Antagonishts Precations
Hepatic (cirrhosis) or renal impairment.
H2 receptor Antagonists Adverse effects
H2 receptor antagonists Lifestyle, Diet, and Habits
Alcohol use
H2 receptor antagonists planning and intervention Maximizing Therapeutic Effects
Give drug 2 hours after antacid
H2 receptor antagonists Providing patient and family education
Instruct to take drug exactly as prescribed for entire course of therapy even if symptoms subside and space drug with antacids by 2 hours.
Encourage smoking cessation, avoidance of alcohol and caffeine, spicy foods, and products containing aspirin
H2 receptor antagonists Drugs closely related to famotidine
Proton Pump Inhibitors
Omeprazole- Prilosec
Lansoprasole- Previcid
Proton Pump Pharmacotherapeutics
Gastroesophageal reflux disease (GERD)
Severe erosive esophagitis
Treatment of active duodenal ulcers
Pathologis hyper secretory conditions
Stop Acid before production
Proton Pump Pharmacodynamics
It blocks the final step of acid production
Lower dose OTC, then more severe need prescribed.
Proton Pump Adverse Reactions
CNS: Headache Dizziness
GI: Diarrhea, abdominal pain, vomiting, nausea, constipation, flatulence
Resp: URI
Integ: Rash
Misc: Back Pain
Proton Pump Contraindications
Bioavailability increased in the elderly
Precautions: Pregnancy, lactation, children
Proton Pump Nursing Considerations
Administer before eating.
Do not crush.
GI Stimulants: Core Drug knowledge related to Metoclopramide
GI Stimulants Pharmacotherapeutics
Diabetic gastroparesis
Postoperative or chemotherapy associated nausea and vomiting
Pre-endoscopy or pre-bowel intubation
GI Stimulatns Pharmacokinetics
Crosses blood brain barrier.
GI Stimulants Pharmacodynamics
Believed to sensitize tissue to acetylcholine's effects
Cholinergic like effect on upper GI tract
Motility stimulated.
GI Stimulants Adverse Effects
CNS Effects
GI Stimulants Drug Interactions
Cyclosproine- Sandmone Immune Booster
Used to remove subsaolin after surgery.
GI Stimulants Planning and Intervention
Administer IM injection near end of surgery
Contract peralyzing effects.
Digestive Enzymes Pharmacodynamics
Consisting of lipase, protease, and amylase
Responsible for fat, protein, and starch breakdown in duodenum and first portion of jejunum
Digestive Enzymes Contraindications and Precaustions
Acute Pancreatitis- NPO, TPN, No food no release of Enzymes
Prgnancy risk category C- Some Danger.
Digestive Enzymes Adverse Effects
Abdominal Cramps
Hyperuricosuria (high doses)
Hyperuricemia (high doses)
Poor digestion of drugs no affect on them
Decrease Absorption
Digestive Enzymes Assesment
Made from pork
Allergy to pork
If lack cystic Fibrosis
Clay color stool
Orthodox Jews
Monitor for decreased steatorrhea and weight gain.
Digestive Enzymes Planning and Intervention Maximizing Therapeutic Effects
Administer immediately before or with meals and snacks.
If want to absorb lower antacid in stomach.
Administer antacid or H2 receptor antagonist if prescribed can have both.
Antiflatulents: Core Drug knowledge related to Simethicone
Anything related to gas bubbles and makes them larger and easier to expel
Antiflatulents Pharmacotherapeutics
Post operative gastric distention
Antiflatulents Pharmacokinetics
No interference with absorption of water or nutrients or secretion of mucus in GI tract Better not drink water
Given infants
Antiflatulents Pharmacodynamics
Gas bubbles combining into larger ones
Larger bubbles more easily eliminated
Antiflatulents Adverse Effects
None Significant
Runs through system
Antiflatulents Planning and Intervention Maximizing Therapeutic Effects
Administer after meals and at bedtime
Have patient chew tablet throughly or let tablet dissolve in month.
If suspension form, shake container prior to adminstering
Use calibrated dropper to ensure accurate dose.
Mix with 30 mL of suitable liquid for infants.
Antidiarrheals Core drug knowledge related to diphenoxylate HCL with Atropine Sulfate
Anticolenegic, dry things up
Antidiarrheals Pharmacokinetics
Hepatic metabolism
Excreted via feces as active metabolite; tiny amount renally excreted as unchanged drug
Synthetic carcotic
Slowing of intestinal motility slow GI tract
Prolongation of intestinal transit time
Increased reabsorption of fluid
Antidiarrheals Precautions
Ulcerative colitis- Dont want stop diarrhea, have them expel it. If have like c.diff.
Antidiarrheals Adverse Effects
Paralytic ileus- Stop paristalsis
Toxic Megacolon
CNS effects
Dry Mouth- Colonergtic effect, drying out cause diarrhea.
Antidiarrheals Drug Interactions
Antidiarrheals Planning and Intervention Minimizing Adverse Effects
Monitor stools for decrease to decrease dosage
If no improvement in 10 days with maximum daily dose, unlikely that drug will be effective
Monitor for adverse effects especially with maximum daily dose
Observe for possible atropine toxicity: dry mouth flushing, hyperthermia, tachycardia, and urinary retention
Encourage adequate fluid intake to rpevent dehydration
Warn about dry mouth; suggest use of gum, ice chips, or hard candy
Drugs Closely related to diphenoxylate HCL with Atropine Sulfate
Difenoxin- Same thing without Atropine lemodal without Atropine
Loperamide- Imodium
Drugs Significantly different diphenoxylate HCL with Atropine Sulfate
Bismuth subsalicylate- Peptobismal
Association with Reye's syndrome in children and adolescents
Kaolin and Pectin
Treatment of mild diarrhea
Non selective adsorbent action
Laxatives Bulk-Forming
Act like natural fiber foods; absorb water into the intestine which increases bulk and distends the bowel to initiate reflex peristalsis and bowel evacuation
Used to help prevent constipation and diarrhea
Polycarbophil (FiberCon)- Tablet takes alot of water.
Psyllium (Metamucil)- Safest used for both constipation and diarrhea.
Methylcellulose (Citrucel)
Laxatives Adversse Effects
Impaction, abdominal bloating, abdominal cramps make not be drinking enough fluids
Laxatives Nursing Implications
Effective treating patients that should avoid straining with bowel movements (after MI; increased intracranial pressure; rectal surgery, TURP)
Administer with a full glass of water and follow with an additional glass of liquid
Coats the internal lumen of the bowel and the outside diameter of the stool with a lubricant film to enhance passage of stool through intestines; keeps water content within the stool and helps soften it
Lubricant Mineral Oil Adverse Effects
Lipid pneumonia; fat soluble vitamin deficiency
Lubricant Nursing Implications
(A,D,E,& K) Dificiencies may occur if taken with meals. Separate by at least 2 hours- Blocks Absorption, limited amount of time
Lubricant Drug Interactions
Concurrent administration with stool softner can increase absorption of mineral oil.
Osmotic Agents ( cathartic, purgative)
Hyperosmotic solutions that pull water into the stool contents causing distention of the bowel, increased peristalsis and bowel evacuation.
Cause watery diarrhea
Lactulose (Cephulac)
Used to treat constipation and also used to prevent absorption of ammonia (adjunct in treatment of cirrohosis associated with hepatic encephalopathy(Amonic in blood)
Intestinal contents and can lead to skin breakdown in incontinent patients; mix with fruit juices to improve palatability
Polyethlene glycol/electolyte (GoLYTELY)
Complete evacuation occurs within 4 hours; patient is to drink 8 ounces every 10 minutes until the 4 liters are consumed (rapid drinking of the 8 ounces is preferred over slipping slowly; cooling the solution can increase palatability of this tasting solution); may cause diarrhea and abdominal cramping.
Glycerin Suppositories-
Will cause bowel evacuation in 15-30 minutes; mild laxative and ofent used in children
Saline Laxatives (cathartic, purgative)
Draw water into the stool contents, causing bowel distention, increasing peristalsis and bowel evacuation.
Causes watery diarrhea
Magnesium Citrate (Citrate of Magnesia) Prior to bowel surgery
Magnesium Hydroxide (MOM) Milk of Magnesia- Mild/no cramping pain.
Magnesium Sulfate (Epsom salt)
Phosphate/biphosphate (fleet Enema, Fleet Phospho-Soda)
Saline Laxatives Drug Interactions
May Decrease absorption of some antibiotics (tetracyclines, fluoroquinolones)
Stimulants (cathartic, purgative)
Induce intestional peristalsis
Most likely laxative to cause dependence
Bisacodyl (Dulcolax)
Casanthrano (Cascara) often combined with MOM
Senna (Senokot) Given cancer patient high doses of narcotics
Phenolphthalein (ExLax)
Phenolphthalein (ExLax)Adverse Effects
Abdominal cramping, diarrhea, hypokalemia protein loss with chronic use, hypocalcemia with chroinic use high doses of Narcotics
Phenolphthalein (ExLax)
Drug Interactions; laxative effectiveness is decreased if taken with antacids or H2 blockers
Stool Softners
Decrease the surface tension of the stool and allows water to enter fecal mass and soften the stool .
Used to prevent constipation in patients that should otstrain with stooling
Docusate sodium (Colace)(Pericolace)
Docusate calcium (Surfak)
Docusate potassium (kasof)
Stool Softners Nursing Implications
TURP to avoid straining with stooling
Stool Softners Drug Interactions
Avoid taking with H2 blockers, antacids, or other laxatives.
Drugs used to treat nausea and vomiting
Vomiting can be induced by direct stimulation of the vomiting center (abdominal distention or irritation; unpleasant olfactory or visual stimuli; pain; emotional factors; increased intracranial pressure; migraine headaches; vestibular disturbances)
Antiemtic drugs either decrease stimulation of the chemoteceptor trigger zone (CTZ), decrease stimulation of the vomiting center, and/or decrease vestibular input into the CNS.
Hydroxyzine (vistaril, atarax)
Promethazine (Phenergan)
Prochlorperazine (Compazine)
Thiethylperazine (Torecan)
Serotonin (5-HT3) Antagonists
Prevention of nausea and vomiting related to chemotherapy, radiation, and surgery
Ondansetron (Zofran)
Given 30-60 min prior to chemo to prevent nausea and vomiting given IV
Nausea and Vomiting Miscellaneous drugs
Metoclopramide (Reglan)- increases gastric emptying
Trimethobenzamide (Tigan)
Nausea and Vomiting Adverse Effects
Drowsiness, sedation, dry mouth, hypotension, respiratory depression
Monitor for dehydration- number of vomiting episodes and the amount and consistency of vomitus
Nausea and Vomiting Drug Interactions
Additiveeffect when used with other CNS depressants higher reaction of narcotic
Drugs used to treat motion sickness
Scopolamine (Scopolaine Transdermal Patch)- apply behind ear 4 hours prior to event, change every 3 days
Dimenhydrinate (Dramamine) - Dizziness and motion Sickness
Meclizine (Antivert)
Drugs Used to treat Acute Drug Overdose
Ipecac Syrup
Ipecac Syrup
Used to induce vomiting in poisons ingestion; use only yunder direction of poison control. Not really used
Used to bind toxins, drugs, or chemicals that have been ingested due to overdose/suicide attempts and allows them to be evacuated in the stool
Prevents absorption of toxic agents
Will cause black stools.