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GI-test1
Question | Answer |
---|---|
Hydrochloric Acid [HCl] | secreted by parietal cells maintains stomach pH at 1 to 4 stimulants to secretion: large, fatty meals excessive amounts of ETOH emotional stress |
Antacids | Pharmacodynamics Agents used to reduce gastric hyperacidity large group Rx & OTC drugs |
Antacids | Pharmacotherapeutics Gastritis; indigestion; PUD; Reflux Esophagitis; phosphate binder in chronic renal failure (CRF) |
Drug Interactions Antacids | Tetracyclines; quinidine; flecanide; amphetamine Slows absorption of most oral medications |
Nursing Implications Antacids | Take medications 1 hour after meals Avoid taking antacids for 2 hours when taking other medications Monitor for adverse effects Reinforce need to alter life-styles to avoid/reduce hyperacidity; avoid spicy, greasy foods, alcohol Limit intake of ASA, |
Antiflatulents | drugs used to relief painful symptoms associated with gas gas in GIT results from: diverticulitis, dyspepsia, peptic ulcers, postoperative gaseous distention, spastic or irritable colon; paralytic ileus Major agent: simethicone |
nti-Ulcer Agents | Axid Pepcid Tagam |
H-2 Antagonists | histamine type 2 receptor [H-2] antagonist prototypical acid secretory antagonists reduce not abolish acid secretion one of most frequently Rx’d drugs efficacy & safety profile four FDA-approved: cimetidine [Tagamet] / famotidine [Pepcid] nizatidi |
Pharmacotherapeutics: H-2 Antagonists | proven effective: PUD = gastric & duodenal ulcer gastroesophageal reflux dz [GERD] upper GI bleed [GIB] may be effective: stress ulcers peptic esophagitis prevention & mgt allergic conditions |
Adverse Effects: H-2 Antagonists | overall low < 3% Specific: CNS: lethargy, confusion, depression, & hallucinations ENDO: impotence, increased prolactin, & gynecomastia HEME: thrombocytopenia |
PPI | omeprazole Prilosec lansoprazole Prevacid |
Proton Pump Inhibitors | General Description: omeprazole = first lansoprazole = newest [1995] Pharmacodynamics final common step in acid production energy needed to pump out H+ ions a.k.a. “Proton Pump” |
Pharmacotherapeutics Proton Pump Inhibitors | GERD unresponsive to conventional tx Erosive esophagitis endoscopically proven Zollinger-Ellison syndrome [ZE] PUD recurrent [Helicobacter pilori] |
Adverse Effects & Drug Interactions Proton Pump Inhibitors | Proton Pump Inhibitors similar to those of the H-2 antagonists low & uncommon |
Other Drugs | sucralfate Carafate & misoprostol Cytotec |
Nursing Implications sucralfate Carafate & misoprostol Cytotec | Teach patient best time to take meds: AC & HS Do not stop taking meds abruptly Avoid alcohol and other CNS depressants Avoid taking meds with antacids Monitor for drug interactions and adverse effects Reinforce alteration in life-styles t |
Diarrhea | defined as abnormal frequent passage of loose stools acute diarrhea sudden in onset in a previously healthy person lasts 3 to 14 days self-limiting resolves without sequelae chronic diarrhea lasts 3 to 4 weeks recurring diarrhea, fever, loss of |
Antidirrheal Agents | Description: Act systemically or locally to slow down or inhibit intestinal peristalsis Pharmacodynamics slows down the effects of the mesenteric plexus of the intestines inhibits intestinal peristalsis decreases expulsive contractions |
Pharmacodynamics Anticholinergics | decrease muscle tone of GIT& decrease Peristalsis |
Pharmacodynamics Absorbents | coat walls of GIT absorbing bacteria or toxins causing diarrhea and passing them out with stool |
Pharmacodynamics Intestinal Flora Modifiers | bacterial cultures Lactobacillus natural bacterial flora supplies missing bacteria suppresses growth of diarrhea causing bacteria |
Pharmacodynamics Opiates | decrease motility of bowel reduce pain assoc w/ rectal spasms decrease transit time / permit longer absorptive surface of bowel contact of intestinal contents with |
Prototype: Specific Agents | Adsorbents bismuth subsalicylate [Pepto-Bismol] attapulgite [Kaopectate] Anticholinergics belladonna alkaloids [Donnatal] Intestinal Flora Modifiers Lactobacillus acidophilus [Lactinex] Opiates (tincture of…) diphenoxylate & atropine [Lomotil] |
Adverse Effects bismuth subsalicylate | ncreased bleeding time constipation & dark stools hearing loss & tinnitus blue gums & black tongue |
Adverse Effects anticholinergics | urinary retention, hesitancy, & impotence HA dizziness, confusion, anxiety, & drowsiness dry skin, rash, and flushing blurred vision, photophobia, & inc. IOP |
Adverse Effects opiates | drowsiness, sedation, and lethargy n/v/anorexia and constipation respiratory depression urinary retention, flushing, rash, and urticaria |
Nursing Implications Antidirrheal Agents | Monitor closely for adverse effects and drug interactions Do not administer opium preparations to patients with conditions that contraindicate its use Teach patient/family that diarrhea is a symptom that should last only 48 hours. If it persists longe |
Antiemetics Pharmacotherapeutics | Indicated to relieve nausea and vomiting. All agents work at some site along the vomiting pathway leading to the vomiting center located within the brain. |
Antiemetics Major Drug Groups | Antihistamines Phenothiazines Anticholinergics Serotonin Blockers Prokinetic |
Antiemetics Pharmacokinetics | Absorbed well throughout the body Metabolized by the liver Excreted by the kidneys |
Antiemetics Pharmacodynamics | Motion sickness Vertigo Post-op nausea / vomiting Chemotherapy antiemetic |
Antiemetics Prototypes: Specific Agents | Antihistamines promethazine (Phenergan) Phenothiazines prochlorperazine (Compazine) Serotonin Blockers ondansetron (Zofran) Prokinetic metoclopramide (Reglan) |
Antiemetics Additional Agents | benzquinamide HcL (Emete-Con) scopolomine (Trans-Derm) ganisetron (Kytril) droperinol (Inapsine) dimenhydrinate (Dramamine) |
Antiemetics Adverse Effects | Antihistamine / Phenothiazines CNS reactions Anticholinergic effects Hypersensitivity reactions Blood dyscrasias Hypotension, tachycardia, orthostatic hypotension syncope and dizziness |
Antiemetics Nursing Implications | changes in V.S; LOC administered ½hr - 3hrs prior to chemotherapy for therapeutic effect monitor safety when taking antiemetics as they can cause changes in perception Administer antihistamine antiemetics with food or milk to minimize nausea |
Emetics Pharmacodynamics | Designed to stimulate the vomiting center in the medulla of the brain |
Emetics Prototype: Specific Agents | Ipecac syrup (Orally) High doses can lead to dysrythmias; overdose may lead to heart failure or death Apomorphine HcL (SQ) Used when ipecac is ineffective Activated charcoal (Orally) For use when caustic substances have been ingested |
Emetics Nursing Implications 1 | Do not administer emetics if patient has ingested lye or caustic substances Do not administer to semi-conscious patients or patient with loss of gag reflex; seizures If necessary, repeat initial dose in 30 minutes |
Emetics Nursing Implications 2 | Administer water or clear liquid following ipecac syrup to aid in absorption If caustic agent has been ingested, administer activated charcoal to neutralize agent prior to vomiting |