Gi Pharm

Front 1

Aluminum hydroxide

Back 1

Amphojel - not absorbed - may cause constipation - used in pts with renal failure

Front 2

Calcium carbonate

Back 2

Tums - also used for calcium replacement - may cause constipation, renal calculi

Front 3

Calcium carbonate with magnesium hydroxide

Back 3

Mylanta, Rolaids - may cause constipation, don't give to renal pt, renal calculi

Front 4

magnesium hydroxide

Back 4

mom - milk of magnesia - laxative - don't give to renal pt

Front 5

magnesium hydroxide and aluminum hydroxide with simethicone

Back 5

mylanta, maalox plus, mag al plus - watch for diarrhea

Front 6

sodium bicarbonate

Back 6

alka seltzer, baking soda - fluid retention (r/t Na+) edema, abdominal distension, used IV form for metabolic acidosis

Front 7

antacids nrsg mgmt

Back 7

don't take > 2 weeks w/o dr permission
don't exceed maximum dose
keep record of stool
shake liquid suspension well
chew tablets well and follow with 8 oz water

Front 8

calcium carbonate and sodium bicarb may cause ___________

Back 8

rebound hyperacidity

Front 9

While taking aluminum based antacids increase fluids to ________. Why? _________

Back 9

2000 mL/day / help relieve constipation (unless contraindicated)

Front 10

do not use antacids in pts taking ____________

Back 10

tetracycline

Front 11

simethicone

Back 11

mylicon - antiflatulent - has defoaming action that disperses and prevents the formation of mucus-surrounded gas pockets in intestine

Front 12

charcoal

Back 12

absorbent that reduces amount of gas in intestine, can also pull fluid back into GI track in case of poisoning, OD

Front 13

Histamine H2 antagonist

Back 13

H2 receptor blockers - inhibit action of histamine at histamine H2 receptor cells of stomach, which reduces secretion of gastric acid

Front 14

H2 receptor blockers -uses

Back 14

GERD, ulcers, hypersecretory dz

Front 15

H2 blockers nrsg mgmt

Back 15

do not use if pregnant, breast feeding, and in children under 16 years of age
caution in pts with hepatic dz or renal dz
I&O ratio
monitor gastric pH
BUN, CBC, LFTs, creatinine, PT

Front 16

cimetidine

Back 16

tagamet - bad drug - dizziness, diarrhea, constipation, gynecomastia, some occasion of impotence, decreased effectiveness with smoking - elderly pts can develop problems with thought processes

Front 17

famotidine

Back 17

pepcid - best - HA, nausea, dry mouth, if given over period of time can cause neutropenia, if adm IVP too quickly can cause arrythmias

Front 18

ranitidine

Back 18

zantac - given with bismuth for H. pylori

Front 19

carafate

Back 19

sucralfate - sucrose + aluminum hydroxide - produces a thick barrier that coats and binds to ulcer. Does not effect secretion of acid. Used short term (8 wks) for active duodenal ulcers and for maintenance therapy.
adverse rxn: constipation

Front 20

carafate nrsg mgmt

Back 20

give other meds 1-2 hrs before or after dose
do not adm with antacid, tetracycline, or digoxin (decreased effect)
must be taken QID
*cannot crush

Front 21

cytotec

Back 21

misoprostol - synthetic prostaglandin - stimulates the production of protective mucus and inhibits gastric acid secretion
used to prevent nsaid induced gastric ulcers
adverse rxn: diarrhea

Front 22

cytotec nrsg mgmt

Back 22

Do not give to pregnant women!
adm 3-4X per day

Front 23

Pepto Bismol

Back 23

Bisumth subsalicylate - stimulates mucosal bicarbonate and prostaglandin production
used for dyspepsia, heartburn, and diarrhea
**inhibits H. pylori from adhering to ulcerated tissue
may be used in combo with bactrim, amoxicillin to treat H. pylori
may turn stool black/dark
may decrease absorption of tetracycline or any co-administered meds

Front 24

Proton-pump Inhibitors

Back 24

act by blocking hydrogen, potassium, and ATPase - this enzyme acts as pump to release gastric acid (also called H+, or protons) on the surface of the GI mucosa.
Short-term tx of GERD - tx should last only 4 weeks
*activated by food intake - adm 20-30 min ac with first major meal of the day
beneficial effects cont for 3-5 d after d/c.
SE uncommon: HA, abd pain, diarrhea, n/v
preassess bowel sounds

Front 25

lansoprazole

Back 25

prevacid - used for GERD

Front 26

omeprazole

Back 26

prilosec - used in combo with antibiotics for H. pylori and GERD

Front 27

pantoprazole

Back 27

protonix - can be given IV - GERD

Front 28

anticholinergics/antispasmodics

Back 28

scopolamine, ProBanthine, Robinul, Bentyl - dycyclomine
weak inhibitors of gastric acid secretion
doesn't heal ulcers
increase fiber intake, dry mouth
***contraindicated in galucoma and tachycardia
occasionally used for tx of peptic ulcers

Front 29

GI application for atropine

Back 29

preoperative drying agent - do not give with glaucoma or tachycardia

Front 30

anticholinergics/antispasmodics nrsg mgmt

Back 30

adverse effects: constipation, dry mouth, drowsiness, dizziness
Urinary retention or hesitancy: instruct on importance of monitoring for
monitor I&O
blurred vision may interfere with activities

Front 31

gastrointestinal stimulants

Back 31

reglan - metaclopromide
GERD, gastric stasis
causes muscles in upper stomach to contract causing faster emptying
decreases esophageal relaxation and blocks food from entering esophagus - GERD
given parenterally to prevent n/v associated with cancer chemo and to prevent n/v during the immediate postoperative period
adverse rxn: drowsiness, fatigue, confusion, insomnia
uncommon: pseudoparinsonism

Front 32

Ilopan

Back 32

increases the rate at which stomach and intestines move during digestion. Increases rate at which your stomach empties into your intestines
may be given immediately after major abd surgery to reduce risk of paralytic ileus

Front 33

oioids (antidiarrheals)

Back 33

diphenoxylate with atropine (lomotil)
loperamide (imodium)
slows peristalsis
*atropine -ACHN! BS HR glaucoma
SE: drowsiness, nausea, dizziness, dry mouth, paralytic ileus, constipation

Front 34

bismuth subsalicylate

Back 34

kaopectate, pepto bismol)
binds and absorbs toxins
SE: constipation, nausea, tinnitus

Front 35

octreotide

Back 35

sandostatin - prevents release of serotonin and other active peptides that promote diarrhea. Also inhibits intestinal secretions and enhances absorption
SE: nausea diarrhea, abd pain

Front 36

pro-biotics

Back 36

lactobacillus, live cultures foods
replaces normal flora in intestinal tract
used in tx of diarrhea associated with antibiotic and antineoplastic tx.

Front 37

antidiarrheals local-acting

Back 37

charcoal, pectin, psyllium - used for tx of bacterial diarrhea

Front 38

antidiarrheals systemic-acting

Back 38

lomotil, imodium

Front 39

metamucil

Back 39

tx for constipation

Front 40

Bulk forming laxatives

Back 40

calcium polycarbophil (fibercon)
methylcellulose (citracel)
psyllium mucilloid (metamucil)
absorbs water and adds to fecal mass
onset - 24-48 hrs
should be given at HS with at least 8 oz water
*don't give with other meds
SE: abd fullness or cramping, esophageal or GI obstruction if not taken with enough fluid, gas

Front 41

Saline cathartics/osmotics

Back 41

*strong
magnesium hydroxide (MOM)
polyethylene glycol (miralax)
sodium biphosphate (fleet phospho-soda)
lactulose
magnesium citrate
go-LYTELY
increase water content of stoll and softens stool, poorly absorbed in intestine, pull water into fecal mass, produce BM quickly 1-6 hrs onset
*do not give miralax at the same time as other meds
*risk for fluid & lyte imbalance
SE: abdominal cramping, diarrhea
lactulose may also be given for high levels of ammonia.
*never serve warm: causes severe abd cramping (mag citrate)

Front 42

stimulant laxatives

Back 42

bisacodyl (correctol, dulcolax)
castor oil (vit deficiencies)
phenolphthalein (ex-lax)
promote peristalsis by irritating bowel
onset 6-12 hrs
Do not use routinely r/t dependency, used for bowel preps
se: abd cramping, nausea, diarrhea

Front 43

stool softeners/surfactant

Back 43

docusate sodium (colace)
docusate calcium (surfak)
cause more water and fat to be absorbed into stool.
rx: for pts at risk of constipation
onset 24-48 hrs
abd cramping, diarrhea
*check Na+ and Ca+

Front 44

herbal agent laxatives

Back 44

senna - sennacot
stimulate bowel and increases peristalsis
*abd cramping

Front 45

mineral oil

Back 45

lubricates intestinal wall and softens stool
onset 24-48 hours
SE: diarrhea, nausea, nutritional deficiencies

Front 46

Never admin laxative to pt experiencing ___ ___, ____, ____, without consulting MD

Back 46

abd pain, nausea, vomiting

Front 47

antiemetics: anticholinergics, antihistamines

Back 47

dramamine, benadryl, vistaril, antivert, transderm scop
use: motion sickness
SE: drowsiness, dry mouth
*Z-track when giving vistaril IM - can cause tissue sloughing
*never admin >25 mg phenergan IV
*phenergan given pre-op for peds

Front 48

marinol

Back 48

cannabinoid - inhibit pathway to vomiting center
use: chemo, increase appetite
SE: dizziness, drowsiness, confusion, decrease sensory awareness

Front 49

glucocorticoids

Back 49

dexamethasone (decadron)
methylprednisolone (solu-medrol)
used to prevent chemo and post-op nausea
SE: wt gain, nausea, fld retention, insomnia, neutropenia, mask s/s infection, hyperglycemia

Front 50

phenothiazines

Back 50

prochlorperazine (compazine)
promethazine (phenergan)
chemo, general illness
se: drowsiness, dry mouth, photosensitivity

Front 51

serotonin antagonist

Back 51

ondansetron (zofran)
general illness, hyperemesis gravidarum, chemo
SE: HA, drowsiness, fatigue

Front 52

Emetics

Back 52

ipecac syrup
causes vomiting by irritating effect on stomach as well as by stimulation of the vomiting center of medulla
can be used as expectorant
adverse effect: hypovolemic shock
*must know what pt took before admin
can be used as expectorant at 1/10 recommended dose for emetic

Front 53

digestive enzymes

Back 53

lipase and protease are two that are manufactured and secreted by the pancreas and are responsible for the breakdown of fats, starches, and proteins.
available in oral form
used as replacement therapy for cystic fibrosis, chronic pancreatitis, ca of pancreas, malabsorption syndrome, surgical removal of all or part of the stomach, surgical removal of all or part of pancrease

Front 54

gallstone solubizing agents

Back 54

suppress the manufacture of cholesterol and colic acid by liver which decreases size of gallstones
nonsurgical tx of gallstones
asacol, dipentum, azulfindine
asacol - tx of ulcerative colitis
azulfidine - chron's dz and ulcerative colitis - a sulfonamide

Front 55

vermox

Back 55

antihelmintic - Gi irritation, HA, dizziness, numbness (rare)
may chew, crush, or swallow whole
for best results take with high fat meal
f/u exam important
identify close contact for possible infestation and tx
good hand washing and hygiene
change linen dly
clean fingernails, cut short, mitten socks to prevent scratching
do not allow dogs to play in sandbox

Front 56

pediculicide/scabicide

Back 56

lindane (kwell)
permethrin (nix)
may cause neruotoxicity
follow directions for use
prior to application of lotions or creams
wash area, allow to dry
apply enough to cover entire body surface with thin layer, leave on 6-8 hrs
cut long hair, come with fine-toothed comb dipped in vinegar to remove nit
discard comb after use
educate on use of others hygiene items
launder bed linens, towels, clothes
wear gloves