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GI Digestive Drugs
Pharmacology Test III
| Question | Answer |
|---|---|
| The primary NT that governs GI activity is? | Acetylcholine |
| What is the effect of muscarinic stimulation on the GI tract and secretory glands? | Increased GI motility and secretions |
| What happens to GI and secretory activity when muscarinic receptors are blocked? | Decreased GI motility and secretions. |
| What has to be triggered and stimulated for an emetic to induce vomiting? | CTZ detects the noxious stimuli, triggers ANS to activate vomiting center, and gastric contents are ejected. |
| If f & e disturbances occure from prolonged and/or severe vomiting, who is most at risk? | Older adults and children/infants |
| know defintion, action, and use of Emetics | induce vomiting; Action = stimulates CTZ, irritates stomach; Use = to eliminate harmful ingested substances |
| T/F: If a child ingests bleach or a drainage cleaner, inducing vomiting would be the best decision. | False: B/c harsh chemicals like those will burn the esophagueal tissue going down. If vomiting is induced, the esophageal tissue will be damaged again going back up. |
| why would a nurse not induce vomiting if petroleum products are ingested? | If petroleum products are aspirated into the lungs, the compounds cling to the lung tissue thus coating it more which can lead to lipid pneumonia. |
| Unconsciousness and ppl who have seizure should or should not be induced to vomit given a circumstance that deems it necessary for contents in stomach to be removed? | Do not induce vomiting because of risk of aspiration. |
| What are the adverse/side effects of Ipecac syrup? | Respiratory and CV stimulation, depresssion after vomiting. |
| who is at risk for the use of Ipecac? | Elderly |
| Nursing assessment if ingestion occurs? | know what chemical is was, how much was consumed, seek emergency guidance, find out when it was ingested. Look at Pt: are they conscious, get vitals, look at pupils...etc. Call poision control, save container. |
| What are nursing interventions that pertain to the use of ipecac? | No milk, activated charcoal, or carbonated beverages with ipecac because ipecac will not work. |
| What will happen to a Pt who has already been given carbonated sodas or milk then given ipecac? | Ipecac will not work and an acculation of gas will lead to major discomforts of the Pt. |
| Why are alternative to emetics given? | To promote or cause vomiting |
| What is the action of activated charcoal? | absorbs toxins from intestines by binding. Charcoal stays in GI but toxic material is bound to the charcoal |
| Indications of activated charcoal? | Not all products will bind to activated charcoal. With most substances this will work, but not all. |
| Side effects of activated charcoal? | black stool, diarrhea, nausea, constipation. It will take a couple days for this to clear from the body. |
| What will determine if a Pt gets a PO or NG tube administration of activated charcoal? | When the chemical was ingested! |
| Chathartics | strong laxative |
| milk of magnesia is an example of which type of drug? | cathartics |
| What is the purpose of milk of magnesia and what can happen with a lg dose? | lg dose can cause watery stool – powerful laxative |
| Whole bowel irrigation | . Has to be consumed in intervals. This is not absorbed and stays in GI tract --> distention of intestines --> excretion of bowels |
| What is the antidote for barbituates? | There are no antidotes for barbituates |
| What is the antidote for benzodiazepams? | Mazipam |
| Note the use, action, and common side/adverse effects of Antiemetics. | Use: to prevent or treat nausea and vomiting. Action: suppresses CTZ. Common side/adverse effects: CNS depression or drowsiness (crosses blood-brain barrier --> increased ICP. Anticholinergic effects. |
| What are the contraindictions with antiemetics? | containdictions with ppl who have glaucoma |
| What are the anticholinergic effectss of antiemetics? | blurred vision, tachcardia, urinary retention, constipation, dry mouth |
| What is the number one side effect of antiemetics? | CNS depression i.e. drowsiness |
| Antiemetics are given as a ..... measure b/c n/v is hard to control once it starts if doing a procedure that commonly causes n/v. | Preventative |
| What type of drug is procholperazine (Compazine)? | phenothiazines |
| What are the side effects of Compazine? | anticholinergic effects (dry mouth, tachycardia, blurred vision, urinary retention, and constipation); extrapyramidal |
| Extrapyramidal | abnormal movements of muscle or tightening (lip smacking, sticking tongue out, or neck pulled back to one side, and grimace) |
| Compazine...long or short term effects? Long or short term therapy? | Long term effects from long term therapy. |
| What is unique about the drug effects with Compazine? | the drug effects may not go away even after the medication is discontinued |
| What kind of drug is phenergan? | A phenothiazine |
| What kind of drug is dimenhydrinate (Dramamine)? | An Antihistamine |
| What are the side effects of Dramamine? | anticholinergic side effects: BCDPT (tachycardia, urinary rentention, dry mouth, constipation, blurred vision) |
| What is kind of drug is atropine? | An anticholinergic that is sometimes used for pre op meds |
| What were phenothiazines originally used as? | They were originally used as a typical antipsychotic and still are today |
| What is a unique side effect of phenothiazines from long term use? | Shuffling walk |
| Prokinetic is defined as | pro: for kinetic: movement |
| What is the prototype of prokinetic agents? Know the action, uses, contraindications | Prototype: metoclopromide (Reglan), Action: increased gastric emptying rate by speeding up movement, Uses: diabetic gastroparesis (stomach paralysis)and chemo, Contraindications:obstruction b/c it can lead to a rupture in GI tract or very painful |
| Effects of Reglan? | Cholinergic effects: Promotes movement of contents i.e. diarrhea |
| Marijuana derivatives. Know prototypes, features. | dronabinol (Marinol), features: potential for abuse & appetite stimulant |
| A Pt that has AIDS or anorexia would most likely need which type of medication? | Marinol because it's an appetite stimulant and Pt's with AIDS have suppressed appetites. |
| What are the two prototypes for serotonin (5 HC3) Receptor antagonists? | palonosetron (Aloxil) & graisetron (Kytril) |
| What are Aloxil and Kytril used to treat? | nausea with chemotherapy |
| TRUE OR FALSE? Aloxil and Kytril may be used with a corticosteriod- better to take a lower dose with two drugs than a higher dose with one. | TRUE |
| T/F? Corticosteriods are approved for by the FDA for nausea? | False but they can be used to prevent nausea with chemotherapy |
| When do serious systemic effects develop with the use of corticosteriods? | With regular use |
| What are the systemic effects of prednisone? | Long term use will affect all parts of body. I.E. causes electrolyte imbalances or immunosuppresants. If Pt’s are already immunosuppressant that will be an issue if they are on steroids. And demineralizes bone. |
| What is the prototype of an NK-1 Receptor anatagonist? | aprepitant (Emend) |
| What is Emend taken with and for how long? | Is taken for 3 days with steroid and 5-HT3 Receptor anatagonist (aloxil and/or kytril) |
| Why would a Pt take Emend? | For acute and delayed nausea |
| What is bad about Emend? | Inhibits some liver enzymes (is important because the BP med, insulin med, arthritis med…these enzymes are inhibited so less effect and higher amnt in blood); enhances others |
| If liver enzymes are inhibited by a medication like Emend, what will happen to the level of the drug? What if the enzymes are increased? | decreased enzymes = increased level of drug; increased enzymes = decreased level of drug |
| Risk for deficient fluid volume r/t prolonged or severe vomiting is the nursing diagnosis. What are the nursing interventions? | Anticipate n/v Monitor fluid status Medicate promptly IV fluids as ordered Non-pharmacologic measures |
| Name all contributing factors of Peptic ulcer disease. | •Inadequate mucus •Excess acid •Helicobacter pylori•NSAIDs are most likely to cause PUD. Aspirin is one example. •Re-occurring •Most seen in older people; may have gotten from water •People with trauma can develop ulcers |
| Peptic ulcer disease treatment goals are.....? | •Decrease pain and acid •Promote healing •Prevent recurrence •Prevent acute stress ulcers •Prevent esophageal ulcers with GERD (gastro esophageal reflux disease) by reducing the acidic “juice” from damaging the esophagus |
| T/F helicobacter pylori is easily treatment with antibiotics? | Falso! H pylori is highly resistant |
| If a Pt experiences trauma, when would the administration of PUD drugs seem reasonable? | Early witin hospital stay |
| PUD drugs are aka... | gastric acid inhibitors |
| What are the uses for gastric acid inhibitors? | Treat PUD, prevent/tx esophagitis |
| What are the common/adverse effects of gastric acid inhibitors? | diarrhea, constipation, HA, nausea |
| Proton pump inhibitors are what type of drug? | Gastric acid inhibitors (PUD drugs) |
| What are the three prototypes of proton pump inhibitors, their action, and side effects? | Lansoprazole (Prevacid), Pantoprazole (Protonix), and Esomeprazole (Nexium). Action: Prevents acid release into the stomach. Side effects include diarrhea. |
| Histamine-2 receptor antagonists are what type of drugs? | Gastric acid inhibitors (PUD drugs) |
| What are the two prototypes of Histamine-2 Receptor anatagonists? Note which one is first generation and which one is second. | 1st generation cimetidine (Tagamet) and 2nd generation ranitidine (Zantac) |
| Actions of Tagamet and Zantac | reduces acid by blocking H-2 receptors on parietal cells; reduces pepsin If acid is reduced so is pepsin = your stomach will not be irritated) |
| Pepsinogen converting to pepsin = ? | (pepsinogen is converted to pepsin in the presence of acid. Pepsin breaks down protein – in which your stomach is made of. |
| Side effects of both Tagamet and Zantac? | Constipation |
| What is a personal side effect of cimetidine (Tagamet)? | inhibits metabolism of many other drugs meaning toxic levels are possible when taken with other drugs. Tagamet can cause confusion in the elderly |
| Ranitidine side effects? | Only constipation |
| What is the action, prototype, and adverse effects of Prostaglandin drugs? What type of drugs are Prostaglandin drugs? | Prostaglandin drugs are gastric acid inhibitors. Actions = decreases acid secretion, increases mucus, bicarbonate, mucosal blood flow. •Prototype: misoprostol (Cytotec) •Adverse effects: abortion or diarrhea |
| What is a guide to how effective treatment is going with gastric inhibitors? | Pain |
| Which drug will effect pregnancy in a way where abortion of the fetus could occur? | Cytotec |
| Maalox has Mg and Aluminum, why is this unique? | B/c one causes diarrhea and one causes constipation |
| Gastric acid neutralizers are aka as? | antacids |
| How are ways to assess gastric acid neutralizers? | Pain, GASTRIC pH, and STOOLS |
| What are the actions, uses, and side/adverse effects of gastric acid neutralizers? | Action: Neutralize acid & decrease pepsin. Uses: relieve pain, PUD, esophagitis/gastritis, GI bleeding, and stress ulcers. Side/adverse effects: constipation (Al, Ca), diarrhea (Mg), fluid rentention (Na), renal insufficiency (Mg, Al), & acid rebound (Ca) |
| When are antacid meds suppossed to be administered? | ATC 1 and 3 hours PC (after meals) and HS (at bedtime) |
| What is important about when to take antacids with other antacids? | take one hour before or after another antacid because they readily bind to each other. |
| How can a Pt experience an overdose with antacids? | Antacids are alkali and the stomach is acidic leading to metabolic alkalosis |
| Risk for constipation, excess fluid volume, or diarrhea r/t side effects of antacids; what are some proper nursing interventions? | Monitor elimination Prevent constipation Discourage Na antacids with cardiac or renal disease, hypertension |
| What is the prototype, goal, action, and side effects of cytoprotective agents? | Prototype: sucralfate (Carafate). Goal: prevent/heal peptic ulcers. Action: forms protective coating around ulcer. Side/Adverse effects: dry mouth and constipation. |
| Describe the protective coating of Carafate and when is it appropriate to take this medication? | when it comes in contact with an acid, it turns to gel to protect tissue lining. Take on an empty stomach. Must take repeatedly after eating or drinking because will lose affect. |
| How long should a Pt wait to take any other drugs after having already taken sucralfate (Carafate)? | Two hours |
| What way can a nurse explain to a Pt on how to decrease the common side effect of constipation with sucralfate (Carafate)? | Drinking adequate fluids |
| What is Prepac? | A combination antibiotic therapy for H pylori |
| What are the three antibiotics used in the Prevpac combination to treat H pylori? | lansoprazole (Prevacid), amoxicillin, clarithromycin. |
| Other than lansoprazole (Prevacid), amoxicillin, and clarithromycin....what are the other three drugs that are used to treat H Pylori? | omeprazole, metronidazole, tetracycline |
| What is the universal antidote? | activated charcoal |
| Before administering activated charcoal to a Pt who has ingested harmful chemicals, what needs to be mixed with the charcoal? | 240 mL of water |
| What are the two most specific things not to take in addition to activated charcoal? | do NOT give with dairy products or Ipecac |
| What type of specific antiemetics are preferred for motion sickness? | Antihistamines (dimenhydrinate/Dramamine) and anticholinergics (atropine) |
| Which drug has cholinergic effects and what are the effects? | metoclopromide (Reglan): speeds up passage of contents through intestional tract, dysrhythmias, hypotension, and sweating. |
| Name the category of drug that preventss nausea with chemo, can cause demineralization of bone and immunosuppression. What is the category of this drug? | Prednisone = Corticosteriod |
| Name the drug and category of drug that TREATS nausea with chemo, has mild side effects, and may be used with a corticosteriod. These two drugs are better to take with a steriod than a higher dose of one. | Serotonin receptor antagonists = palonosetron (Aloxil) and granisetron (Kytril) |
| Which drug am I describing? It's an antihistamine, and has anticholinergic side effects (BCDPT)??? | dimenhydrinate (Dramamine) |
| Name the drug and category of drug that causes anticholinergic side effects, and extrapyamidal (abnormal) movements such as: sticking out of the tongue, grimace, and smacking of lips? | prochlorperazine (Compazine) = Phenothiazines |
| which drug is selective to some drugs and non selective to others leading to a tolerance or toxicity? this drug also has a 3 day regimen with steriods and 5-HT3 RA and is used for acute and delayed nausea. This drug also has a long HALF LIFE? | apreritant (Emend) |
| What does it mean when a drug has a long half time? | The longer the half life the longer the drug stays in the body. |
| What is the drug of choice of other PUD drugs to prevent acid release into the stomach? (This is a drug category not a particular drug and will be the first option for PUD) | Proton pump inhibitors which are lansoprazole (Prevacid), pantoprazole (Protonix), and esomeprazole (Nexium) |
| The action of gastric acid inhibitors? | To INHIBIT the secretions of HCl in the stomach |
Created by:
jalvarez1210
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