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pharm gastro
| Question | Answer |
|---|---|
| Antiulcer Drugs | Include antacids, Histamine Antagonists, |
| Antacids | Neutralize gastric acid |
| Histamine (H2) Receptor Antagonist | Inhibit production of gastric acid |
| Mucosal Protectants | Protect gastric mucosa by coating wall of stomach or ulcer crater |
| Gastric Acid (Proton Pump) Inhibitors | Suppress gastric acid secretion at final step of production process |
| Helicobacter Pylori | Bacteria associated with about 65% of all peptic ulcers |
| Laxative | Used to treat constipation |
| Stool Softener | Used to prevent constipation |
| Antiemetic | Used to prevent or treat vomiting |
| Emetic | Used to induce vomiting |
| Regurgitation | backward flowing of solids or fluids to the mouth from the stomach |
| Dyspepsia | Indigestion |
| Flatulence | Excess gas |
| Heartburn | Burning sensation under sternum often due to GERD |
| Gastroesophageal reflux disease(GERD) | Gastric contents re-enter esophagus; can cause esophageal erosion with risk of strictures |
| Erosive Esophagitis | Inflammation of the esophagus with tissue damage; associated with increased risk of cancer |
| Diarrhea | liquid consistency of stool; May be due to food poisoning, side effect of medications such as lactose intolerance, laxatives, antibiotics, etc. or symptoms of disease condition; culture for Clostridium difficle or other pathogens |
| Constipation | hard, dry consistency of stool; May be due to inactivity, lack of fluid intake, or side effect of medications such as opioids for analgesia |
| ANTIEMETIC Drugs ondansetron (Zofran), prochlorperazine (Compazine), promethazine (Phenergan), dimenhydrinate (Dramamine), scopolamine (Trans-derm Scop), trimethobenzamide (Tigan), droperidol (Inapsine), chlorpromazine (Thorazine) | |
| ANTIEMETIC NC | nasogastric tube for decompression (NG to LIS) should be assessed for patency prior to administering an antiemetic. Provide mouthcare after emesis; Eating dry crackers may reduce vomiting; Monitor fluid and electrolyte balance; If client is taking digoxin |
| ANTIULCER AGENTS | Antacids, Histamine-Receptor Antagonists, Mucosal Protective Medications, Gastric Acid Pump Inhibitors |
| ANTACIDS Action | Neutralize gastric acidity by a local effect, except sodium bicarbonate which is absorbed and can cause systemic electrolyte imbalance |
| Uses | Relief of heartburn, gas, and indigestion; treatment of peptic ulcers |
| ANTACIDS Adverse Effects | Aluminum-based cause constipation; magnesium-based cause diarrhea; sodium-based increase risk of edema/ CHF Caution |
| ANTACIDS NC | Simethicone reduces flatulence; Avoid long-term use of antacids; Liquid suspensions must be shaken well before administration; Chewable tablets should be chewed well and followed with 8 oz. of water |
| Antacid Mixtures | Combination of aluminum and magnesium antacids minimize adverse GI reactions of each |
| ANTACIDS Common Drugs | calcium carbonate (Tums), aluminum hydroxide (Amphojel, AlternaGel or Milk of Magnesia), aluminum hydroxide with magnesium hydroxide (Maalox), aluminum hydroxide with magnesium hydroxide and simethicone (Mylanta) |
| HISTAMINE-RECEPTOR ANTAGONIST Action | Inhibits both daytime and nocturnal basal gastric acid secretion and inhibits gastric acid stimulated by food, stress, smoking, caffeine, and certain drugs by occupying H2 receptor sites on parietal cells |
| *Uses* | Active gastric and duodenal ulcers; Prevention of hyperacidity in hospitalized client |
| HISTAMINE-RECEPTOR ANTAGONIST NC | Monitor gastric ph (normally below 5); Monitor CBC due to possible blood dyscrasias; Antacids decrease effectiveness; Evaluate improvement of symptoms Client teaching |
| HISTAMINE-RECEPTOR ANTAGONIST Drugs | cimetidine (Tagamet) , rantitidine (Zantac) famotidine (Pepcid) |
| MUCOSAL PROTECTION AGENTS Action | Protect mucosal lining from acid, but do not inhibit acid production; coats surface of ulcer. *Uses* |
| MUCOSAL PROTECTION AGENTS | Drugs |
| NC | Do not crush to dissolve; dissolves in water to form slurry |
| GASTRIC ACID INHIBITOR or PROTON PUMP INHIBITOR Action | Blocks final step in gastric acid production to suppress gastric acid secretion |
| *Uses* | Treatment of active ulcers, GERD, and erosive esophagitis; prevention of peptic ulcer |
| NC | Reconstitute IV Protonix immediately before administration; Do Not Crush delayed-release capsules |
| GASTRIC ACID PUMP INHIBITOR Drugs | omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix) |
| Antiemetic, cholinergic, & GI stimulant (without increasing acid secretion); used in treatment of ? gastroparesis in DM; administered before meals | |
| metoclopramide HCl (Reglan) (Urecholine) stimulates ? smooth muscle of bowel or urinary bladder to promote emptying | |
| GI ANTICHOLINERGICS Drugs | atropine sulfate (Atropine), dicyclomine HCl (Bentyl), propantheline bromide (Pro-Banthine) |
| Action | anticholinergic action on smooth muscles of GI tract |
| HELICOBACTER PYLORI ULCERS | Many peptic ulcers are caused by a bacteria that can be detected with a culture of the gastric lining or by other diagnostic tests Adequate treatment with antimicrobials can cure the peptic ulcer disease and prevent re occurrence, |
| Two weeks of 3 drug treatment cures up to 90% of patients | omeprazole (Prilosic) clarithromycin (Biaxin), Metronidazole (Flagyl) Treatment for other 10% includes additional drug treatment with |
| STIMULANT LAXATIVES | irritate intestinal mucosa NC |
| STIMULANT LAXATIVES Drugs | cascara sagrada, bisacodyl (Dulcolax), senna (Ex-Lax or Senokot) |
| BULK FORMING LAXATIVES | absorbs water and stimulates peristalsis |
| NC | May cause abdominal distention and flatulence |
| BULK FORMING LAXATIVES Drugs | polycarbophil (Fibercon), psyllium (Metamucil) |
| HYPEROSMOTIC LAXATIVES | prevent reabsorption of water from stool; also prevents absorption of ammonia and promotes excretion of ammonia in hepatic encephalopathy NC |
| HYPEROSMOTIC LAXATIVES Drugs | Lactulose (Chronulac), polyethylene glycol/electrolyte (Go Lytely) |
| EMOLLIENTS OR LUBRICANTS | Lubricant Laxatives soften fecal mass |
| NC | May impair absorption of fat-soluble vitamins; swallow carefully to avoid lipid pneumonia |
| EMOLLIENT LAXATIVES Drugs | Mineral oil , Castor oil, Fleets Mineral Oil Enema |
| SALINE LAXATIVES | draw water into intestinal contents |
| NC | Administer Fleets PhosphoSoda over ice due to salty taste; Shake Milk of Magnesia thoroughly prior to administration |
| LAXATIVES Common Drugs | sodium phosphate (Fleets Phosphosoda), magnesium hydroxide (Milk of Magnesia) or MOM |
| STOOL SOFTENERS | moisten stool; used to prevent constipation, especially when straining is contraindicated such as post myocardial infarction or pelvic surgery |
| STOOL SOFTENERS Drugs | docusate calcium (Surfak), docusate sodium (Colace), docusate sodium and casanthranol (Pericolace) is stool softener and laxative |
| ANTIDIARRHEAL AGENTS | Diarrhea is characterized by frequent defecation of loose, watery stools. Symptom, not a disease. May be caused by infection, intoxication, allergy, malabsorption, inflammation, tumors of GI tract, food poisoning, and by certain medications.Diarrhea is be |
| ANTIDIARRHEAL AGENTS NC | Monitor potassium level; OTC antidiarrheals may be used without determining cause of diarrhea |
| ABSORBENT ANTIDIARRHEALS OTC's drugs | bismuth subsalicylate (Pepto-Bismol) kaolin mixture with pectin (Kaopectate), loperamide HCl (Imodium) |
| OPIATE-RELATED ANTIDIARRHEAL AGENTS Prescription Drugs | diphenoxylate HCL with atropine (Lomotil) {Schedule V controlled drug} paregoric { Schedule II controlled drug} |
| ANTIDIARRHEAL AGENTS Probiotic | Promotes Normal Flora Restoration, Lactobacillus acidophilus (Lactinex), Yogurt |
| ANTIINFLAMMATORY MEDICATIONS USED FOR INFLAMMATORY BOWEL DISEASES | 5-Acetylsalicylic Acid Medications (1st Line Treatment for Crohn's Disease or Ulcerative Colitis, sulfasalazine (Azulfidine), mesalamine (Asacol or Rowasa), Anti-Inflammatory Corticosteroids (Acute Exacerbation), prednisone |
| Immune Modulating Agents | azathioprine (Imuran) |
| Biologic Agents | infiximab (Remicade)May not have normal immune response to infection. Monitor closely for signs of infection and reduce risk of infection through universal precautions |
| EMETIC | induce vomiting for overdose of oral drugs or certain poisons. Contraindicated of unconscious or semi-conscious or if caustic substance such as lye or acid or petroleum-based substance such as gasoline or kerosene. Recent research questions appropriatenes |
| EMETIC Drugs | Ipecac Syrup followed with full glass of water causes vomiting within 30 minutes, Activated Charcoal may be used to absorb toxic agents from the GI tract without causing vomiting |
| Procoagulant for decreased production of clotting factors in liver failure- Vitamin K or Aqua Mephyton, Liver failure causes other problems such as malnutrition, hypoglycemia, hepatomegaly, splenomegaly, ascites, epistaxis, hepatic encephalopathy with con | |
| Ammonia-Lowering Agents to treat Hepatic Encephalopathy | neomycin (Aminoglycoside antibiotic), kanamycin (Aminoglycoside antibiotic), lactulose/ Chronulac (Laxative) |
| Diuretics to treat ascites | cironolactone/ Aldactone (Potassium-Sparing) |
| Immune Agents used to force virus into remission | Interferon alfa-2b, recombinant |
| Immunosuppressive Agents used to prevent rejection of transplanted organs | Cyclosporine, Tacrolimus (Prograf) |
| PANCREATIC ENZYME | used to promote digestion and fat, protein, and CHO absorption |
| Action | Replaces exocrine secretions of pancreas in cystic fibrosis, chronic pancreatitis, etc.; acts directly in GI tract |
| NC | Given with meal or snack (immediately prior to eating food) |
| PANCREATIC ENZYME Drug | pancrelipase (Pancrease) |
| LACTOSE INTOLERANCE | Lactose (milk sugar) requires the enzyme lactase for digestion. Symptoms include bloating, cramping, or diarrhea. |
| CELIAC DISEASE | Also called nontropical sprue or gluten sensitivity Symptoms include diarrhea, weight loss, and malnutrition. Cause is unknown. Rx |
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