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Pharm- GI
GI pharm
| Question | Answer |
|---|---|
| 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
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