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110 Cards in this Set
- Front
- Back
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What are the two types of PUD?
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Gastric and Duodenal
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What is a gastric ulcer characterized by?
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Defective ability of the gastric mucosa to protect and repair itself
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What is a duodenal ulcer characterized by?
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Hypersecretion of gastric acid leading to the erosion of the mucosa
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What is the most common type of PUD and who gets it more frequently?
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Duodenal; young males.
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What is the name of the bacteria that can cause PUD?
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Helicobacter pylori (H. pylori)
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What are the common causes of PUD?
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-H. pylori
-NSAIDS/ASA -Increases acid/pepsin -Smoking |
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What are the 5 antibiotics that are used to treat H. pylori?
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-bismuth (Pepto-Bismol)
-clarithromycin (Biaxin) -amoxicillin (Amoxil) -tetracycline (Achromycin V) -metronidzole (Flagyl) |
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What is the indication for bismuth (Pepto-Bismol)?
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PUD pts with confirmed H. pylori
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How does bismuth (Pepto-Bismol) work?
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acts topically to disrupt cell wall of H. pylori, leading to lysis and death
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What are the side effects of bismuth (Pepto-Bismol)?
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*Black discoloration of tongue and stool
*Tinnitus -N, V, D |
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What is the indication and side effects for clarithromycin (Biaxin)?
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PUD pts with confirmed H. Pylori
SE: N/V/D |
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What is the indication and side effects for amoxicillin (Amoxil)?
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PUD pts with confirmed H. Pylori
SE: N/V/D |
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What is the indication and side effects for tetracycline (Achromycin V)?
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PUD pts with confirmed H. Pylori
SE: N/V/D |
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What is the indication and side effects for metronidazole (Flagyl)?
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PUD pts with confirmed H. Pylori
SE: N/V/D |
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What is the drug of choice to treat PUD?
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H2RBs ("-tidines")
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What 2 things are potent stimulators of gastrin release?
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Caffeine and Alcohol
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What is the indication for cimetidine (Tagamet)?
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-PUD
-GERD -ZE |
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What is the indication for ranitidine (Zantac)?
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-PUD
-GERD -ZE |
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What is the indication for famotidine (Pepcid)?
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-PUD
-GERD -ZE |
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What is the indication for nizatidine (Axid)?
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-PUD
-GERD -ZE |
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What is important to know about the "-tidines"?
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Onset of action is delayed.
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What are the side effects for cimetidine (Tagamet)?
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*Antiandrogen effects
-Confusion, depression, hallucinations (elderly) -lethargy -GI upset, constipation -HA -Rash |
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What are the contraindications for cimetidine (Tagamet)?
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-warfarin
-phenytoin -theophylline -lidocaine (d/t increased drug levels) Also: smoking, antacids |
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What are the nursing implications for cimetidine (Tagamet)?
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-Best taken at bedtime
-Give one hour apart from antacids -Take for 4-6 weeks -Educate pts about signs of GI bleeding |
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What are the side effects for ranitidine (Zantac)?
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-Confusion, depression, hallucinations (elderly)
-lethargy -GI upset, constipation -HA -Rash |
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What are the contraindications for ranitidine (Zantac)?
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-warfarin
-phenytoin -theophylline -lidocaide (d/t increased drug levels) Also: smoking, antacids |
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What are the nursing implications for ranitidine (Zantac)?
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-Best given at bedtime
-Give one hour apart from antacids -Take for 4-6 weeks -Educate pts about signs of GI bleed |
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What are the side effect for famotidine (Pepcid)?
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-Confusion, depression, hallucinations (elderly)
-lethargy -GI upset, constipation -HA -Rash |
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What are the contraindications for famotidine (Pepcid)?
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-warfarin
-phenytoin -theophylline -lidocaide (d/t increased drug levels) Also: smoking, antacids |
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What are the nursing implications for famotidine (Pepcid)?
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-Best given at bedtime
-Give one hour apart from antacids -Take for 4-6 weeks -Educate pts about signs of GI bleed |
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What are the side effects for nizatidine (Axid)?
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-Confusion, depression, hallucinations (elderly)
-lethargy -GI upset, constipation -HA -Rash |
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What are the contraindications for nizatidine (Axid)?
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-warfarin
-phenytoin -theophylline -lidocaine (d/t increased drug levels) Also: smoking, antacids |
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What are the nursing implications for nizatidine (Axid)?
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-Best given at bedtime
-Give one hour apart from antacid -Assess GI pain using scale -Administer for 4-6 weeks -Educate pts about signs of GI bleeding |
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What are the indications for lansoprazole (Prevacid)?
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-PUD
-esophagitis with GERD -ZE syndrome -Pts who fail to respond to H2RA -Heal peptic ulcers more rapidly than "tidines" |
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What are the indications for omeprazole (Prilosec)?
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-PUD
-esophagitis with GERD -ZE syndrome -Pts who fail to respond to H2RA -Heal peptic ulcers more rapidly than "tidines" |
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What are the indications for rabeprazole (Aciphex)?
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-PUD
-esophagitis with GERD -ZE syndrome -Pts who fail to respond to H2RA -Heal peptic ulcers more rapidly than "tidines" |
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What are the indications for esomeprazole (Nexium)?
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-PUD
-esophagitis with GERD -ZE syndrome -Pts who fail to respond to H2RA -Heal peptic ulcers more rapidly than "tidines" |
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What are the indications for pantoprazole sodium (Protonix)?
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-PUD
-esophagitis with GERD -ZE syndrome -Pts who fail to respond to H2RA -Heal peptic ulcers more rapidly than "tidines" |
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What are the side effects of the PPIs?
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-HA
-N/V/D -Abdominal pain |
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What are the side effects of the "-prazoles"?
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-HA
-N/V/D -Abdominal pain |
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What are the nursing implications for lansoprazole (Prevacid)?
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-Increased gastric pH
*Increased absorption of warfarin, phenytoin, diazepam which increases drug toxicity -Give immediately before meals *Do not chew |
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What are the nursing implications for omeprazole (Prilosec)?
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-Increased gastric pH
*Increased absorption of warfarin, phenytoin, diazepam which increases drug toxicity -Give immediately before meals *Do not chew |
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What are the nursing implications for rabeprazole (Aciphex)?
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-Increased gastric pH
*Increased absorption of warfarin, phenytoin, diazepam which increases drug toxicity -Give immediately before meals *Do not chew |
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What are the nursing implications for esomeprazole (Nexium)?
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-Increased gastric pH
*Increased absorption of warfarin, phenytoin, diazepam which increases drug toxicity -Give immediately before meals *Do not chew |
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What are the nursing implications for pantaprazole sodium (Protonix)?
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-Increased gastric pH
*Increased absorption of warfarin, phenytoin, diazepam which increases drug toxicity -Give immediately before meals *Do not chew |
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How does sucralfate (Carafate) work?
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-Viscid, sticky gel that adheres to ulcer crater
-Creates a protective barrier against acid and pepsin -Hastens healing of mucosa by protecting for up to 6 hours |
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What is the indication for sucralfate (Carafate)?
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Duodenal ulcers
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What are the side effects for sucralfate (Carafate)?
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*Constipation
-Systemic effects absent! |
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What are the contraindications for sucralfate (Carafate)?
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*Antacids (by raising the pH above 4 decreases the effects of Carafate)
-Warfarin, phenytoin, theophylline, digoxin, ciprofloxacin DECREASE drug absorption (causing them not to work as efficiently and stay in the body longer) *Renal failure (d/t aluminum in drug) |
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What are the nursing implications for sucralfate (Carafate)?
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*No meals!
-Administer antacids and Carafate 30 min apart -Administer contraindicated drugs and Carafate 2 hours apart *Do not chew |
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What are the indications for aluminum carbonate (Basaljel)?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What are the indications for Mylanta?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What are the indications for Maalox?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What are the indications for Alka-Seltzer?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What are the indications for Tums?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What are the indications for Milk of Magnesia?
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-PUD
-GERD -Heartburn, hiatal hernia -Prophylaxis of stress-induced ulcers |
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What drugs are contraindicated with antacids?
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ALL DRUGS
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How do antacids affect basic drugs?
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INCREASED absorption - leading to toxicities
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How do antacids affect acidic drugs?
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DECREASED absorption - leading to decreased efficiency of drug
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How long to effects last if antacids are taken on an empty stomach?
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20-40 min
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How long do effects of antacids last if taken one hour after meals?
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Up to 3 hours. (Take between meals and at bedtime)
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Which antacids cause diarrhea?
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Magnesium containing antacids
(Mylanta, Maalox, Milk of Magnesia) |
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Which antacids cause constipation?
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-Aluminum and Calcium containing antacids
(Basaljel, Tums) |
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What causes milk alkali syndrome and what are the symptoms?
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Calcium carbonate preparations.
-HA -Urinary frequency -N/V -Fatigue -Avoid milk products |
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What are the nursing implications of aluminum carbonate (Basaljel)?
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*Caution for renal failure pts
-Take one hour before or two hours after digoxin, tetracycline, phenothiazines, or enteric coated meds -Liquids neutralize acids better than tablets *interview client about OTC administration of antacids (check for OD) |
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What are the nursing implications for Mylanta or Maalox?
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*Caution for renal failure pts
-Take one hour before or two hours after digoxin, tetracycline, phenothiazines, or enteric coated meds -Liquids neutralize acids better than tablets *interview client about OTC administration of antacids (check for OD) |
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What are the nursing implications for sodium bicarbonate (Alka-Seltzer)?
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*Caution for renal failure pts
-Take one hour before or two hours after digoxin, tetracycline, phenothiazines, or enteric coated meds -Liquids neutralize acids better than tablets *interview client about OTC administration of antacids (check for OD) |
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What are the nursing implications for calcium carbonate (Tums)?
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*Caution for renal failure pts
-Take one hour before or two hours after digoxin, tetracycline, phenothiazines, or enteric coated meds -Liquids neutralize acids better than tablets *interview client about OTC administration of antacids (check for OD) |
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What are the nursing implications for magnesium hydroxide (MOM)?
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*Caution for renal failure pts
-Take one hour before or two hours after digoxin, tetracycline, phenothiazines, or enteric coated meds -Liquids neutralize acids better than tablets *interview client about OTC administration of antacids (check for OD) |
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What is catharsis?
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Prompt, fluid evacuation of the bowel. Fast/intense.
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What are the indications for laxatives?
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-Constipation
-Bowel prep before surgery -Soften stool (less straining) -Drug induced slowed intestinal motility |
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What are the side effects of Fleets Enema or MOM?
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Watery stools, cramping, dehydration
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What are the nursing implications for Fleets Enema?
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-Better effect on empty stomach
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What are the side effects for the contact stimulant cascara sagrada, senna (Senekot), castor oil, phenolphthalein (ExLax), or Bisacodyl (Dulcolax, Correctol)?
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Water stools, cramping, abuse (Decreased potassium)
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What are the nursing implications for the contact stimulant cascara sagrada, senna (Senekot), castor oil, phenolphthalein (ExLax), or Bisacodyl (Dulcolax, Correctol)?
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*Used as a bowel prep
-Do not crush -Give at night for an effects |
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What are the side effects for the bulk forming Methylcellulose plantago seed, Metamucil, Fiberall, Citrucel, or Fibercon?
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Fecal impaction or obstruction
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What are the nursing implications for the bulk forming Methylcellulose plantago seed, Metamucil, Fiberall, Citrucel, or Fibercon?
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-Increased daily fluids
*Decreased effects of anticoagulants and digoxin |
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What are the side effects for mineral oil?
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-Anal leakage
-lipid pneumonia |
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What are the nursing implications for mineral oil?
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*Not used for children or elderly bc aspiration of oil droplets
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What are the nursing implications for docusate sodium (Colace)?
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Avoid straining
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What is the indication for Hyperosmotic laxatives like polyethylene glycol (PEG, Miralax, Moviprep), goLYTELY, and lactulose (Chronulac)?
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Bowel Prep before surgery - 4 L at 240 mL every 10 min
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What is another use for lactulose (Chronulac)?
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drops the pH to increase osmotic pressure, which decreases ammonia levels in encephalopathy
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What is the indication for ondansetron (Zofran)?
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-Suppression of chemo-induced emesis
-Anticipatory nausea -Emesis from other causes (ex: postop n/v) |
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What is the indication for granisetron (Kytril)?
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-Suppression of chemo-induced emesis
-Anticipatory nausea -Emesis from other causes (ex: postop n/v) |
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What is the indication for dolasetron (Anzemet)?
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-Suppression of chemo-induced emesis
-Anticipatory nausea -Emesis from other causes (ex: postop n/v) |
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What are the side effects for ondansetron (Zofran)?
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*Bad HA
-Dizziness -Diarrhea -Weakness |
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What are the side effects for granisetron (Kytril)?
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*Bad HA
-Dizziness -Diarrhea -Weakness |
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What are the side effects for dolasetron (Anzemet)?
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*Bad HA
-Dizziness -Diarrhea -Weakness |
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What are the nursing implications for ondansetron (Zofran)?
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-Give 30 min prior to chemo IV, 1 hour prior po
-Give analgesic for HA relief -Offer quiet environment |
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What are the nursing implications for granisetron (Kytril)?
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-Give 30 min prior to chemo IV, 1 hour prior po
-Give analgesic for HA relief -Offer quiet environment |
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What are the nursing implications for dolasetron (Anzemet)?
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-Give 30 min prior to chemo IV, 1 hour prior po
-Give analgesic for HA relief -Offer quiet environment |
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What is the indication and side effects for prochlorperazine (Compazine)?
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Emesis associated with surgery, chemo, toxins.
SE: EPS reactions -anticholinergic -hypotension -sedation |
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What is the indication and side effects for promethazine (Phenergan)?
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Emesis associated with surgery, chemo, toxins.
SE: EPS reactions -anticholinergic -hypotension -sedation |
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What is the indication and side effects for haloperidol (Haldol)?
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Emesis associated with surgery, chemo, toxins.
SE: EPS reactions -hypotension -sedation |
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What is the indication and side effects for droperidol (Inapsine)?
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Emesis associated with surgery, chemo, toxins.
SE: EPS reactions -hypotension -sedation *dysrhythmias |
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What is the mechanism of action of metoclopramide (Reglan) in the body?
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*INCREASES the motility of upper GI tract
-increases stomach peristalsis -reverses motility that occurs with the vomiting reflex |
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What are the indications for metoclopramide (Reglan)?
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-Chemo-induced N/V
-Emesis from other causes -GERD -Diabetic gastroparesis |
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What are the side effects for metoclopramide (Reglan)?
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*sedation
-diarrhea -EPS reactions -Changes in BP -tachycardia |
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What are the nursing implications for metoclopramide (Reglan)?
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*Give slowly to avoid EPS
-Give oral prep 30 min before meals and bedtime -Protect from light -Warn of drowsiness |
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What is the indication for ipecac syrup?
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Induces vomiting to remove ingested poison from the stomach
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What should you do before administering ipecac syrup?
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Call poison control
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What is the indication for scopolamine transdermal (Transderm-scop)?
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Most effective drug for prophylaxis and treatment of motion sickness
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What are the side effects for scopolamine transdermal(Transderm-scop)?
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Anticholinergic effects:
-dry mouth -blurred vision -drowsiness -urinary retention -constipation |
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What are the nursing implications for scopolamine transdermal (Transderm-scop)?
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-Dilated pupil on side patch is worn
-tolerance can develop -apply 4 hours prior |
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What is the indication and side effects for diphenoxylate/atropine (LoMotil)
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Ind: Diarrhea
SE: drowsiness, dizziness, *tachycardia, dry mouth, hyperthermia, GI distress, agitation, rash |
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What is the indication and side effects for loperimide (Immodium)?
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Ind: Diarrhea
SE: drowsiness, dizziness, *tachycardia, dry mouth, hyperthermia, GI distress, agitation, rash |
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What are the indications for pancreatin (Entozyme, Donnazyme)?
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*Cystic fibrosis
-Pancreatic enzyme deficiency -Chronic pancreatitis, pancreatic tumors, obstruction, or removal |
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What are the indications for pancrelipase (Pancrease, Viokase)?
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*Cystic fibrosis
-Pancreatic enzyme deficiency -Chronic pancreatitis, pancreatic tumors, obstruction, or removal |
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What are the side effects of the pancreatic enzyme drugs?
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-GI upset
-Hypersensitivity |
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What are the nursing implications of the pancreatic enzyme drugs?
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*MUST take with meal/snack
-Monitor fat content of stool |
