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Pharm- GI

GI pharm

1. In stomach, resposible for hydrogen production via proton pump. 2. production of intrinsic factor Parietal cells
1. Histamine2 H2, timulation provides energy to proton pump to produce the H+. 2. Acetylcholine and gastrin-much less influence. Receptors
Drugs for Gastric acid neutralization-antacids Milk of Magnesia and TUMS
MOM and TUMS- indication Heartburn, gastritis, PUD
MOM and TUMS- side effects 1. Magnesium preps: diarrhea, increase Mg++ in renal failure 2. Aluminum and calcium preps: constipation 3. Rebound hyperacidity when used long term 4. metabolic alkalosis
Gastric acid neutralization-antacids Mechanism of action 1. Neutralize acid in stomach 2. Stimulate mucous, prostaglandin, and bicarbonate secretion from cells in gastric glands stimulate: a. mucous: protective barrier b. Prostaglandin: prevents histamin binding on parietal cells c. bicarbonate: buffer HCl
Gastric acid neutralization-antacids Therapeutic Heartbun, gastritis, PUD
Gastric acid suppression Indications 1. GERD 2. PUD 3. H. Pylori infection 4. Gastritis 5. Erosive esophagitis 6. PRophylaxis: other drugs, stress ulcer
Gastric acid suppression Types (3) 1. H2 receptor blocker or antagonists 2. Proton pump inhibitor 3. Gastric barrier
H2 receptor blockers or antagonists Drug Pepcid
Pepcid Side effects 1. Abdominal cramping 2. Thrombocytopenia 3. Increase BUN, and Creatinine
H2 receptor blocker or antagonist Therapeutic 1. Decrease HCl acid production 2. Decrease heartburn/pain symptoms
H2 receptor blocker or antagonist Contraindications and Precautions (Pepcid) C 1. Allergy P 1. Renal insufficiency P 2. Thrombocytopenia
H2 receptor blockers or antagonists Mechanism 1. Bind to H2 receptor 2. Decrease energy production-- decrease proton pump activity
Proton pump inhibitor Drug 1. Prevacid 2. Prilosec 3. Protonix
Prevacid, Prilosec, Protonix Side effects 1. Possible GI infection 2. Relationship to hip fracture
Proton pump inhibitor Contraindications and precautions (Prevacid, Prilosec, Protonix) C-- 1. Severe hepatic impairment P-- 1. Hepatic disease
Proton pump inhibitor Mechanism 1. Irreversibly blocks the proton pump 2. Stops HCl production
Proton pump inhibitor Therapeutic 1. Decrease HCl produciton 2. Decrease heartburn and pain/symptoms
Gastric barrier Drug Carafate
Carafate Side effects 1. Constipation, nausea
Gastric barrier Contraindications and precautions (Carafate) C--1. Allergy P-- 1. May decrease absorption of other drugs
Gastric barrier Mechanism 1. Adheres to gastric mucosa 2. Binds to ulcer/erosion surface
Gastric barrier Therapeutic 1. Decreases heartburn/pain symptoms
Emetic agents Drugs 1. Ipecac syrup 2. Activated charcoal
Ipecac syrup and activated charcoal Indications 1. Poisoning
Emetic agents Contraindications and Precautions (Ipecac syrup and activated charcoal) C-- 1. Lethargic or comatose client 2. Absences of gag reflex P-- 1. Must ensure cause of poisoning
Ipecac syrup and activated charcoal Side effects 1. CNS depression, dysrhythmias, diarrhea
Emetic agents Mechanism 1. Action locally on gastric mucosa 2. Action centrally on chemoreceptor trigger
Emetic agents Therapeutic 1. Induce vomiting
Anti emetic agents Types (5) 1. Anticholinergic agents 2. Antihistamines (phenothizines) 3. Neuroleptic 4. Serotonin receptor antagonists 5. Tetrahydrocannabinol THC
Anti emetic agents Side effects 1. Drowsiness, sedation-depending on drug 2. Confusion 3. Hypotension
Anticholinergic agents Contraindications and Precautions (Transderm-Scop) C/P-- 1. Glaucoma
Anticholinergic agents Mechanism 1. Bind receptors in the inner ear 2. Block stimulation of the chemoreceptor trigger zone
Anticholinergic agents Therapeutic/Indications 1. Motion sickness
Anticholinergic agents Drugs 1. Transderm-Scop
Antihistamines Category Anti emetic agent
Antihistamines Drug 1. Phenergan
Phenergan Side effects 1. Drowsiness, sedation 2. Confusion 3. Hypotension
Antihistamines Contraindications and Precautions (Phenergan) C/P-- 1. Phenergan IV route
Antihistamines Mechanism 1. H1 receptor blocker 2. Similar to anticholinergic agents
Antihistamines Therapeutic/ Indications 1. Vertigo 2. Nausea/vomiting
Neuroleptic Category Anti emetic agent
Neuroleptic Drug 1. Compazine
Compazine Side effects -neuroleptic 1. Drowsiness, sedation 2. Confusion 3. Hypotension
Neuroleptic Contraindications and Precautions (Compazine) C/P-- 1. Seizures, encephalopathy
Neuroleptic Mechanism 1. Blocks dopamine receptors in chemoreceptor trigger zone 2. Some anticholinergic activity
Neuroleptic Therapeutic/Indications 1. Nausea/vomiting
Serotonin receptor antagonist Category Anti emetic agent
Serotonin receptor antagonist Drug 1. Zofran
Zofran Side effects (Serotonin receptor antagonist) 1. Drowsiness, sedation 2. Confusion 3. Hypotension
Serotonin receptor antagonists Mechanism 1. Blocks 5-HT3 receptors in GI tract, chemoreceptor trigger zone
Serotonin receptor antagonists Therapeutic/Indication 1. Prophylaxis- chemotherapy related nause/vomiting 2. Prophylaxis/treatment- nausea/vomiting
Tetrahydrocannabinol THC Category Anti emetic agent
THC Drug 1. Marinol
Marinol Side effects (THC) 1. Drowsiness, sedation 2. Confusion 3. Hypotension
THC Contraindications and Precautions (Marinol) C/P-- 1. Cardiovascular disorders, HTN
THC Mechanism 1. Primary psychoactive component of marijuana 2. Inhibitory effects in CNS- alter bodys perception
THC Therapeutic/Indications 1. Nausea/vomiting associated with chemotherapy, AIDS 2. Clients unresponsive to conventional agents 3. Appetite stimulant
GI stimulants Category Prokinetic agent
Prokinetic agent Drug 1. Reglan
Reglan Side effects 1. Somnolence, fatigue, extrapyramidal reaction
Prokinetic agent Contraindications and Precautions (Reglan) C/P-- 1. Renal impairment
Prokinetic agent Mechanism 1. Stimulates peristalsis in GI tract
Prokinetic agent Therapeutic/Indication 1. Nausea/vomiting associated with chemotherapy, surgery 2. Delayed gastric emptying, diabetic gastroparesis
Gastric motility 1. Ungulating movement of intestinal tract 2. Moves contents through the system 3. Increase motility= diarrhea 4. Decrease motility= constipation Peristalsis
Laxatives Therapeutic Soften stool, increase stool formation, decrease straining
Laxatives Indications 1. Straing constipation 2. Avoid Valsalva
Laxatives Contraindications and Precautions 1. Fluid volume status, medications, PMH 2. GI disease, surgery
Laxatives Types (5) 1. Emollient (surfactant) 2. Bulk forming 3. Stimulant 4. Saline 5. Hyperosmotic
Emollient Drug (Laxative) 1. Colace
Colace Side effects (Emollient-laxative) 1. Abdominal cramping, diarrhea
Emollient Mechanism 1. Stool softener-- increaces water and fat in intestines, lubricates fecal matter
Bulk forming Drug (Laxative) 1. Metamucil
Metamucil Side effects 1. Esophageal obstruction, fecal impaction
Bulk forming Mechanism (Laxative) 1. Fiber--absorb water into the intestine to distend bowel
Stimulant Drug (Laxative) 1. Dulcolax
Dulcolax Side effects (Bulk forming-laxative) 1. Abdominal cramping
Stimulant Mechanism (Laxative) 1. Stimulates nerves leading to intestines-- increase fluid in stool 2. Increase bulk and softens stool
Saline Drug (Laxative) 1. MOM
MOM Side effects (Saline-laxative) 1. Nausea/vomiting, abdominal pain, electrolyte imbalance 2. Contra- with renal disease
Saline Mechanism (Laxative) 1. Increase osmotic pressure in small instestine-- increase watery stools
Hyperosmotic Drug (Laxative) 1. Chronulac 2. GoLytely 3. Sorbitol
Chronulac, GoLytely, Sorbitol Side effects (Hyperosmotic-laxative) 1. Nausea/vomiting 2. Hypovolemia
Hyperosmotic Mechanism (Laxative) 1. Increases water content in large intstine
Anti diarrheal agents Indications 1. Loose stools/diarrhea
Anti diarrheal agents Therapuetic 1. Decrease stool formation
Anti diarrheal agents Contraindications and Precautions C/P-- 1. Fluid volume status, medications, PMH 2. GI disease, surgery
Anti diarrheal agents Types (3) 1. Absorbent 2. Anticholinergic 3. Opiates
Absorbent Drug (Anti diarrheal) 1. Pepto-Bismol
Pepto-Bismol Side effects (Absorbent-antidiarrheal) 1. Abdomial cramping, constipation
Absorbent Mechanism (Anti diarrheal) 1. Coats GI tract, binds causative bacteria, eliminates from body
Anticholinergics Drugs (Anti diarrheal) 1. Lomotil (diaphenoxylate/atropine)
Lomotil Side effects (Anticholinergics- anti diarrheal) 1. Constipation, sedation, increase heart rate
Anticholinergics Mechanism (Anti diarrheal) 1. Inhibits parasympatetic nervous system to slow peristalsis
Opiates Drug (Anti diarrheal) 1. Immodium A-D 2. Lomotil (diphenoxylate/atropine)
Immodium A-D Lomotil Side effects (Opiates- anti diarrheal) 1. Constipation, sedation
Opiates Mechanism (Anti diarrheal) 1. Acts on smooth muscle, inhibits GI motility
Created by: erica9576