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68 Cards in this Set

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What are three uses of antacids?
Tx of hyperacidity
Tx of peptic ulcers
Calcium carbonate replacement in menopausal women for osteoporosis
Action of Antacids
Neutralization of gastric acid
Name four adverse reactions of antacid use?
Aluminum containing antacids -constipation
Magnesium- diarrhea/dehydration
Calcium- renal calculi &/or hypercalcemia
Sodium bicarb--metabolic alkalosis
Aluminun containing antacids may cause:
Constipation
Magnesium containing antacids may cause:
Diarrhea
Calcium containing antacids may cause:
Acid rebound effect
renal calculi &/or hypercalcemia
Dumping Syndrome
Physiologic response to rapid emptying of the gastric contents into the jejunum, manifested by nausea, weakness, sweating, palpitations, syncope, & possibly diarrhea. Occurs in pts who have had partial gastrectomy & gastrojejunostomy.
Name four contraindications of antacid use
Do not use if severe abdominal pain of unknown cause
Sodium base- don't give in HTN, CHF or Na+ restriction Ca+ based- don't give in hypercalcemia, renal calculi Use caution with pts with renal impairment
Name 3 nursing responsibilities for antacid use?
Give 1 hour before meals and hs --after admin of other drugs;
Shake well before admin,
Chew thoroughly and follow with full glass of H20 or milk.
Antacids-Client teaching
Do not use drug indiscriminately;
Chew tablets thouroughly follow with H20 or milk
Effervecent allow tab to dissolve completely
Take 2 hours before or after other drugs;
If pain worsens, stools are black or coffee ground vomitus occurs contact MD. Stat.
Antacids may make stool white (normal)
Taking too much may cause rebound acidity
Name three antacid meds?
Calcium carbonate
MOM milk of magnesia
Tums
Anticholinergics-action on parietal cells of the stomach
Blocks acetylcholine (vagal) stimulation of parietal cells
Decreases gastric acid secretion
decreases motility
Examples of anticholinergics
Pro-Banthine
Banthine (Propantheline)
Uses of anticholinergics
Used to tx peptic ulcer Not used alot anymore
List 6 adverse reactions of anticholinergics
dry mouth
blurred vision
urinary retention & hesitancy
N/V
Headache
Palpitations
Contraindications of use of anticholinergics list 6
Glaucoma- they increase intraoccular pressure which can lead to blindness; MI, CHF, Benign Prostatic Hyperothrophy, HTN
Nursing responsibilities for use of anticholinergics (list 2)
Have pt void before taking med if pt @ risk for urinary retention/hesitancy; safety precautions (blurred vision)
Educate pt and family of anticholinergics
If aversion to light occurs wear shades, keep rooms dimly lit and schedule outdoor activities before 1st dose. If dry mouth take frequent sips of cool water before drugs and during meals. Avoid constipation push fluids; Drowsiness, schedule alert activities before first dose in early am
Antiemetic/GI Stimulants Action
To increase motility of upper GI tract & accelerates gastric emptying.
Blocks dopamine in receptors in CNS
2.       Blocks dopamine receptors in CNS
Name two examples of GI stimulants?
Reglan
Reclomide (Metoclorpramide)
Reclomide (Metoclorpramide)
GI stimulants Uses
GERD, Gastric Stasis; Used IV to prevent immediate post operative N/V or used in chemo related N/V.
What are the uses of Reglan
Reglan improves post op nausea by causing lower esophageal sphincter to tighten, thus preventing reflux in GERD
What are the uses of Reclomide (Metoclorpramide)
Reclomide (Metoclorpramide) decreases the risk of paralytic ileus (intestines paralize after GI surgery)
Adverse effects of GI stimulants Reglan
Reglan prolonged use CNS symptoms drowsiness, dizzines, Parkinson's symptoms (mask-like face shuffling gait, drool)
Adverse effects of GI stimulants-- Reclomide (Metoclorpramide)
Reclomide (Metoclorpramide)- Itching, difficulty breathing
Contraindications of GI stimulants
Do not give if GI obstruction, gastric perforation or hemorrhage
Do not use in laction, excreted in breast milk
do not use in lactation because it is excreted in breast milk
Nursing responsibilities of GI stimulants
Admin PO Reglan 30 min before each meal
Teach pts that intestinal colic may occur within 30 min not abnormal it will soon get better.
Safety precautions (Parkinson's symptoms)
If paralytic ileus, monitor bowel sounds (wont be any sounds until it is resolved)
Teach pts that intestinal colic may occur within 30 min not abnormal it will soon get better.
Safety precautions (Parkinson's symptoms)
If paralytic ileus, monitor bowel sounds (wont be any sounds until it is resolved)
Pt teaching for GI stimulants
Reglan, take 30 min before meals; if drowsy/dizzy use caution driving or hazard tasks; Immediately report difficulty speaking or swallowing, mask like face; shuffling gait; rigidity; tremors and uncontrolled chewing/rolling of tongue
Gastric acid or proton pump inhibitor target site
(parietal cells)
Action of Gastric acid or proton pump inhibitor
Suppresses gastric acid secretion at surface of gastric parietal cells.
Acts in 1h, lasts 24-72h, Dose once daily for GERD, following esophagitis
Acts in 1h, lasts 24-72h, Dose once daily for GERD, following esophagitis
Types of Gastric acid or proton pump inhibitor
PP PAN
Protonix (Pantoprazole)-Delayed Release cap, swallow whole before meals
Prilosec, LoSec (Omerprazole )—
Prevacid (Lansoprazole)
Aciphex (Rabeprazole)- Delayed Release tab, swallow whole before meals
Nexium (Esomeprazole)- called the healing purple pill from acid churning up from the stomach and wearing away the delicate lining of the esophagus. condition called erosive esophagitis,
Protonix (Pantoprazole)-Delayed Release cap, swallow whole before meals
Prilosec, LoSec (Omerprazole )—
Prevacid (Lansoprazole)
Aciphex (Rabeprazole)- Delayed Release tab, swallow whole before meals
Nexium (Esomeprazole)- called the healing purple pill from acid churning up from the stomach and wearing away the delicate lining of the esophagus. condition called erosive esophagitis,
Side Effects of Gastric acid or proton pump inhibitor
Diarrhea, constipation, nausea, vomiting, headache, rash, abdominal pain.
Client teaching of Gastric acid or Proton Pump inhibitors
Long term use may cause gastric tumors & bacterial invasion
Histamine H2 Antagonists action
Inhibit histamine at the H2 receptor site which inhibits gastric acid secretion
Histamine H2 Antagonists types
TAPZ
Tagamet (Cimetidine)
Axid (Ranitidine)
Pepcid (Famotidine)
Zantac (Nizatidine)
Tagamet (Cimetidine)
Axid (Ranitidine)
Pepcid (Famotidine)
Zantac (Nizatidine)
Histamine H2 Antagonists SE
Muscle aches, confusion, gynecomastia, diarrhea, headache, dizziness, drowsiness,Agranulocytosis
agranulocytosis
Histamine H2 Antagonists client teaching
Zantac taken anytime
Others taken with meals & hs
Smoking may decrease effectiveness
Others taken with meals & hs
Smoking may decrease effectiveness
Protectant Example
Carafate (Sulcralfate)
Protectants-- Example
Protectants-Action of Carafate
Reacts with gastric acid to form a thick paste, selectively adhering to ulcer surface
Prevents digestion by pepsin
Use in duodenal ulcer, NOT gastric
Use in duodenal ulcer—NOT gastric
Protectants-SE
Constipation or nausea
Protectants-Client Teaching
Take on empty stomach 1h before or 2h after meals
Separate dose from antacids & H2 antagonists by 30 minutes
Separate dose from antacids & H2 antagonists by 30 minutes
Gastric Mucosal Protectant-action
Acts as a prostaglandin analog,(resembles hormone, controlling smooth muscle contraction, blood pressure, inflammation, and body temperature), decreasing gastric acid secretion & increasing production of protective mucus (cytoprotective effect)
Gastric Mucosal Protectant-type
Cytotec (Misoprostol)
Gastric Mucosal Protectant-SE
Diarrhea, cramping, including uterine cramping
Gastric Mucosal Protectant-Teaching
Pregnant nurse must wear gloves, causes abortions