Gi Medications

Front 1

What are three uses of antacids?

Back 1

Tx of hyperacidity
Tx of peptic ulcers
Calcium carbonate replacement in menopausal women for osteoporosis

Front 2

Action of Antacids

Back 2

Neutralization of gastric acid

Front 3

Name four adverse reactions of antacid use?

Back 3

Aluminum containing antacids -constipation
Magnesium- diarrhea/dehydration
Calcium- renal calculi &/or hypercalcemia
Sodium bicarb--metabolic alkalosis

Front 4

Aluminun containing antacids may cause:

Back 4

Constipation

Front 5

Magnesium containing antacids may cause:

Back 5

Diarrhea

Front 6

Calcium containing antacids may cause:

Back 6

Acid rebound effect
renal calculi &/or hypercalcemia

Front 7

Dumping Syndrome

Back 7

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.

Front 8

Name four contraindications of antacid use

Back 8

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

Front 9

Name 3 nursing responsibilities for antacid use?

Back 9

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.

Front 10

Antacids-Client teaching

Back 10

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

Front 11

Name three antacid meds?

Back 11

Calcium carbonate
MOM milk of magnesia
Tums

Front 12

Anticholinergics-action on parietal cells of the stomach

Back 12

Blocks acetylcholine (vagal) stimulation of parietal cells
Decreases gastric acid secretion
decreases motility

Front 13

Examples of anticholinergics

Back 13

Pro-Banthine
Banthine (Propantheline)

Front 14

Uses of anticholinergics

Back 14

Used to tx peptic ulcer Not used alot anymore

Front 15

List 6 adverse reactions of anticholinergics

Back 15

dry mouth
blurred vision
urinary retention & hesitancy
N/V
Headache
Palpitations

Front 16

Contraindications of use of anticholinergics list 6

Back 16

Glaucoma- they increase intraoccular pressure which can lead to blindness; MI, CHF, Benign Prostatic Hyperothrophy, HTN

Front 17

Nursing responsibilities for use of anticholinergics (list 2)

Back 17

Have pt void before taking med if pt @ risk for urinary retention/hesitancy; safety precautions (blurred vision)

Front 18

Educate pt and family of anticholinergics

Back 18

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

Front 19

Antiemetic/GI Stimulants Action

Back 19

To increase motility of upper GI tract & accelerates gastric emptying.
Blocks dopamine in receptors in CNS

Back 20

2.       Blocks dopamine receptors in CNS

Front 21

Name two examples of GI stimulants?

Back 21

Reglan
Reclomide (Metoclorpramide)

Back 22

Reclomide (Metoclorpramide)

Front 23

GI stimulants Uses

Back 23

GERD, Gastric Stasis; Used IV to prevent immediate post operative N/V or used in chemo related N/V.

Front 24

What are the uses of Reglan

Back 24

Reglan improves post op nausea by causing lower esophageal sphincter to tighten, thus preventing reflux in GERD

Front 25

What are the uses of Reclomide (Metoclorpramide)

Back 25

Reclomide (Metoclorpramide) decreases the risk of paralytic ileus (intestines paralize after GI surgery)

Front 26

Adverse effects of GI stimulants Reglan

Back 26

Reglan prolonged use CNS symptoms drowsiness, dizzines, Parkinson's symptoms (mask-like face shuffling gait, drool)

Front 27

Adverse effects of GI stimulants-- Reclomide (Metoclorpramide)

Back 27

Reclomide (Metoclorpramide)- Itching, difficulty breathing

Front 28

Contraindications of GI stimulants

Back 28

Do not give if GI obstruction, gastric perforation or hemorrhage
Do not use in laction, excreted in breast milk

Back 29

do not use in lactation because it is excreted in breast milk

Front 30

Nursing responsibilities of GI stimulants

Back 30

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)

Back 31

Teach pts that intestinal colic may occur within 30 min not abnormal it will soon get better.

Back 32

Safety precautions (Parkinson's symptoms)

Back 33

If paralytic ileus, monitor bowel sounds (wont be any sounds until it is resolved)

Front 34

Pt teaching for GI stimulants

Back 34

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

Front 35

Gastric acid or proton pump inhibitor target site

Back 35

(parietal cells)

Front 36

Action of Gastric acid or proton pump inhibitor

Back 36

Suppresses gastric acid secretion at surface of gastric parietal cells.
Acts in 1h, lasts 24-72h, Dose once daily for GERD, following esophagitis

Back 37

Acts in 1h, lasts 24-72h, Dose once daily for GERD, following esophagitis

Front 38

Types of Gastric acid or proton pump inhibitor

Back 38

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,

Back 39

Protonix (Pantoprazole)-Delayed Release cap, swallow whole before meals

Back 40

Prilosec, LoSec (Omerprazole )—

Back 41

Prevacid (Lansoprazole)

Back 42

Aciphex (Rabeprazole)- Delayed Release tab, swallow whole before meals

Back 43

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,

Front 44

Side Effects of Gastric acid or proton pump inhibitor

Back 44

Diarrhea, constipation, nausea, vomiting, headache, rash, abdominal pain.

Front 46

Client teaching of Gastric acid or Proton Pump inhibitors

Back 46

Long term use may cause gastric tumors & bacterial invasion

Front 47

Histamine H2 Antagonists action

Back 47

Inhibit histamine at the H2 receptor site which inhibits gastric acid secretion

Front 48

Histamine H2 Antagonists types

Back 48

TAPZ
Tagamet (Cimetidine)
Axid (Ranitidine)
Pepcid (Famotidine)
Zantac (Nizatidine)

Back 49

Tagamet (Cimetidine)

Back 50

Axid (Ranitidine)

Back 51

Pepcid (Famotidine)

Back 52

Zantac (Nizatidine)

Front 53

Histamine H2 Antagonists SE

Back 53

Muscle aches, confusion, gynecomastia, diarrhea, headache, dizziness, drowsiness,Agranulocytosis

Back 54

agranulocytosis

Front 55

Histamine H2 Antagonists client teaching

Back 55

Zantac taken anytime
Others taken with meals & hs
Smoking may decrease effectiveness

Back 56

Others taken with meals & hs

Back 57

Smoking may decrease effectiveness

Front 58

Protectant Example

Back 58

Carafate (Sulcralfate)

Front 59

Protectants-- Example

Front 60

Protectants-Action of Carafate

Back 60

Reacts with gastric acid to form a thick paste, selectively adhering to ulcer surface
Prevents digestion by pepsin
Use in duodenal ulcer, NOT gastric

Back 61

Use in duodenal ulcer—NOT gastric

Front 62

Protectants-SE

Back 62

Constipation or nausea

Front 63

Protectants-Client Teaching

Back 63

Take on empty stomach 1h before or 2h after meals
Separate dose from antacids & H2 antagonists by 30 minutes

Back 64

Separate dose from antacids & H2 antagonists by 30 minutes

Front 65

Gastric Mucosal Protectant-action

Back 65

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)

Front 66

Gastric Mucosal Protectant-type

Back 66

Cytotec (Misoprostol)

Front 67

Gastric Mucosal Protectant-SE

Back 67

Diarrhea, cramping, including uterine cramping

Front 68

Gastric Mucosal Protectant-Teaching

Back 68

Pregnant nurse must wear gloves, causes abortions