DRUGS - Anti-emetics and Anti-Acids
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| Proton Pump Inhibitors PPIs | newest class – given all the time in acute care settings – every patient is put on one in the hospital prophylactically - stress ulcers - works at the ATP pump. given before meals. Binds to an enzyme in the presence of acidic gastric pH, preventing the fi
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| Protonix is a | Proton Pump Inhibitors PPI - Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen - absorption occurs only after tablet leaves the stomach -
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| Maalox or Mylanta/ TUMS | Affects absorption of many meds, Give other meds 1 hour before or 2 hours after - Neutralizes acid in stomach, stimulates mucus, prostaglandin, & bicarbonate production
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| Pepcid | antiulcer, H2 histamine receptor antagonist - Onset 30-60 min, peak 1-3h, Duration 6-12h
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| Side effect of pepcid | confusion, dizziness, arrhythmias, AGRANULOCYTOSIS, APLASTIC ANEMIA
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| Side effects of protonix | CNS: headache GI: abdominal pain, diarrhea, eructation, flatulence Endo: hyperglycemia - Nursing Implications: Assess for epigastric or abdominal pain and GI bleed; May cause abnormal liver function tests, including increase AST, ALT, alkaline phos, bilir
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| What should you avoid when taking H2 – Proton Pump Inhibitors? | Avoid alcohol, aspirin or NSAIDs, and foods that cause an increase in GI irritation
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| Anticholinergics | Scopolamine transdermal - Used for motion sickness, secretion reduction before surgery & in terminally ill
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| SE of Anticholinergics | dizziness, drowsiness, dry mouth, blurred vision, difficult urination, constipation
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| Neuroleptic agents | block N&V by blocking dopamine receptor on the CTZ. Many also have anticholinergic activity. - Prototype: prochlorperizine (Compazine)
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| Prokinetic agents | block dopamine in the CTZ or stimulate ACh receptors in the GI tract & stimulates peristalsis - Prototype: metochlopramide (Reglan)
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| Serotonin blockers | Block Serotonin (5-HT3) receptors in the GI tract, CTZ & vomiting center - Prototype: Ondansetron (Zofran)
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| Tetrahydrocannibinoid | Inhibitory effect on reticular formation, thalmus, & cerebral cortex - Prototype: Marinol
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| Main SE of Cimetidine | confusion – H2 histamine receptor antagonist (tagamet)
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| Main SE of Famotidine/Pepcid | Headache, dizziness, dysrhythmias, constipation, thrombocytopenia, aplastic anemia - H2 histamine receptor antagonist (Mylanta AR, Pepcid)
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| Main SE of Ranitidine | headache, sleeplessness, hepatotoxicity, anaphylaxis (rare) - H2 histamine receptor antagonist (Zantac)
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| Main SE of Nizatidine | headache, dizziness, cyanide, thiocyanate toxiticity - H2 histamine receptor antagonist (Axid)
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| Main SE of Meclizine | drowsiness, hypotension – antiemetic, antihistamine – vertigo, motion sickness – blocks chemoreceptor trigger zone and acts on vomiting center – avoid alcohol (Antivert or Dramamine)
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| Main SE of diphenhydramine | dizziness, drowsiness, seizures, thrombocytopenia, agranulocytosis, hemolytic anemia, anaphylaxis – Antihistamine – H1 receptor antagonist (Benadryl, Diphenadryl, Nytol)
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| Main SE of Compazine | depression, euphoria, circulatory failure, tachycardia, respiratory distress – antiemetic and antipsychotic – Compazine
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| Main SE of Reglan | sedation, fatigue, restlessness, headache, suicide ideation, seizures – Cholinergic, antiemetic, central dopamine receptor antagonist
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| Main SE of Zofran | headache, dizziness, drowsiness, fatigue, diarrhea, bronchospasms, musculoskeletal pain – antiemetic – 5-HT3 receptor antagonist
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