Gastro Pharma

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Grapefruit juice & St. John's wort may reduce the effectiveness of...

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aprepitant (Emend)

Take the drug 1 hr. before chemo & every morning for the next 2 days to prevent nausea and vomiting (has multiple GI side effects )

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Associate H. pylori growth with

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An acidic environment, peptic ulcer disease

A proton pump inhibitor such as Prilosec is prescribed along with a macrolide antibiotic [clarithromycin (Blaxin XL)] and a broad spectrum antibiotic [metronizadole (Flagyl)]

No ibuprofen

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When administering promethazine (Phenergan)...

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The normal dosage is 12.5-25 mg intravenous push (IVP)

Monitor for respiratory depression

Instruct client to request assistance before ambulating

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omeprazole (Prilosec) may cause

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An increase in liver enzyme levels such as AST, ALT, and bilirubin

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To prevent postoperative nausea and vomiting

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administer Scopolamine transdermal (Transderm-Scop)

*sustained released patch that has a peak of 20-60 minutes with a duration of 2-7 days

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Phenergan IV onset/duration

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5 min onset with a duration of 2-8 hours. Is prescribed every 3-6 hrs

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IV metoclopramide onset/duration

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onset of 1-4 minutes with a duration of 1-3 hours

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Ondansetron onset/duration

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onset of 1-1.5 hours and is prescribed q8 hours

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For a client with a PCN allergy scheduled for a percutaneous transhepatic cholangiography (PTC) using an iodinated dye, administer

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Corticosteroids such as hydrocortisone to prevent an allergic reaction

*A client with a penicillin allergy is at risk for an allergic response to iodine

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For a stomach lesion resembling an open crater (in a Pt with peptic ulcer disease (PUD)...

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Sucralfate (Carafate)

*protects the ulcer surface from the acid that is produced, which promotes healing of the ulcer

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For optimal effect, antacids should

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be chewed well, ingested, and followed by ingestion of 4 ounces of water

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Reglan is an appropriate drug for clients with

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glaucoma

*associate Reglan with "regular" pressure in the inner eye

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Celebrex, a NSAID, is

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contraindicated in peptic ulcer disease

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Nystatin (Mycostatin) is

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an antifungal suspension used to treat fungal stomatitis

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For achalasia (decreased ability of the esophagus to move food toward the stomach)

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Botulinum toxin type A (Botox) is injected directly into the esophagus and acts to denervate cholinergic nerves, resulting in a more regular contraction pattern or rhythm

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Herbal remedy for peptic ulcer disease (PUD)

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Slippery elm

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For a Pt with chronic pancreatitis

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pancrelipase (Lipancreatin)

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pancrelipase (Lipancreatin) aids in

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the digestion of fats, carbohydrates, and proteins via enzyme replacement

*hydrolysis of fats 12 times greater than normally secreted enzymes, and 4 times greater than normally secreted enzymes for metabolism of starches, and proteins

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Symptoms which may suggest pathological diarrhea after taking loperamide (Imodium) for 24 hours

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Fever, abdominal pain, and dehydration

The health care provider should be contacted for further evaluation

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Because of the salicylate content, the drug could result in Reye's syndrome in a child less than 3-years-old

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bismuth subsalicylate (Pepto-Bismol)

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Preferred drug for the client with irritable bowel syndrome (IBS) (a motility disturbance)

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Methylcellulose (Citrucel)

bulk-forming cellulose that absorbs intestinal fluids resulting in a more regular, rhythmic peristalic contraction pattern, which results in prevention of constipation and reduction or elimination of diarrhea

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Associate Citrucel with

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regulation of the GI tract, preventing either constipation or diarrhea

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misoprostol (Cytotec) is ranked Pregnancy Category:

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X

May cause an abortion. Misoprostol should be discontinued. While the client is using misoprostol, the couple should be especially diligent in using pregnancy prevention techniques

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Frequent use of bisacodyl, a stimulant laxative, may cause

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diarrhea that would result in fluid and electrolyte imbalance. Sodium is likely to be lost via diarrhea

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Associate bisacodyl with

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diarrhea

*associate diarrhea with hyponatremia

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For pain associated with irritable bowel syndrome (IBS)

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Amitriptyline (Elavil)

*a tricyclic antidepressant, believed to increase plasma levels of opoid analgesia and enhance natural analgesia

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This medication may increase sensitivity to high temperatures, which could lead to dizziness

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dicyclomine hydrochloride (Bentyl)

*antispasmodic drug - S/E: hot, flushed, dry skin, hyperthermia, and intolerance to high temperatures, manifested by dizziness. If exposed to high temperatures, the client should drink a large amount of nonalcoholic fluids

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Does not require swallowing of the solid tablets because a dissolving form is available

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lansoprazole (Prevacid)

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Consider Tetracycline (for Helicobacter pylori infection)

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an adversary to the fetus - will cause permanent staining of the teeth in a child < 8 years

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Side effect of bismuth subsalicylate (Pepto-Bismol)

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transient darkening of the stool

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Take Dramamine

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30 minutes before departure and 30 minutes before meals

*drug peaks at 30-60 minutes

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the primary clinical manifestations of GERD include

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pyrosis related to entering of gastric contents into the esophagus

Give omeprazole (Prilosec) to decrease stomach acid

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These symptoms indicate a possible intestinal obstruction

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A Pt who is bloated and has not had a stool for 7 days

***the client needs to be examined rather than utilizing self treatment

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1-10 days after ingesting ampicillin, clindamycin, or cephalosporin (the penicillin group)...

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Pseudomembranous colitis caused by Clostridium difficile may occur

*Diagnosis is established by sigmoidoscopy and C. difficile assay

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How does diphenoxylate (Lomotil) help stop diarrhea?

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It slows down the motility of the intestine thereby increasing fluid absorption

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The optimal type of laxative for a client with chronic constipation

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Psyllium (Metamucil)

*less addictive

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Instructions about self-administration of omeprazole (Prilosec)

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Delayed peak, adversary to the bladder, and drowsiness

Report blood in urine

During initial therapy, avoid activities such as driving

It may take 5 days to reach initial effectiveness