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Ch:47
Drugs that affect the Upper Gastrointestinal System
| Question | Answer |
|---|---|
| Antacids(Acid Neutralizers) | Neurtalizes or reduces acidity of stomach and deuodenal contents by combining with HCI and increasing the pH of the stomach acid. |
| Antacids used in treatment of: | hyperacidity caused by heartburn, acid indigestion, sour stomach, GERD, peptic ulcer. |
| Histamine H2 antagonists,PPIS, and Misc. acid reducing agents | Reduce the production and release of HCI |
| PPIs are important in treatment of: | Helicobacter pylori infection in patients with active duodenal ulcers |
| H.pylori causes: | type of chronic gastritis, some peptic and duodenal ulcers. |
| GI stimulents factilitate: | emptying of stomach contents into sm. intestine and used as ulcer treatments and as antiemetics. |
| Antiemetics are used: | to treat and prevent nausea and vomiting. |
| Adv reaction Aluminum | constipation,intestinal impaction,anorexia,weakness,tremors and bone pain. |
| Adv reaction Magnesium | severe DIARRHEA,dehydration,hypermagnesemia. |
| Adv. reaction Calcium | rebound hyperacidity,metabolic alkalosis,hpercalcemia,vomiting,confusion,headache,renal calculi,neurologic impairment. |
| Adv. reaction Sodium bicarbonate | metabolic alkalosis,edema,CHF,hypercolemic,hypernatremia,HTN. |
| Antacids are contradicted in patients: | With sever abd. pain of unknown cause and during lactation. |
| Sodium containing antiacids are contraindicated in: | patients with cardiovascular problems and sodium restricted diets. |
| Calcium containing antacids are contraindicated in: | patients with renal calculi or hypercalcemia. |
| Aluminum containg antacids are used catiously in: | patients with gastic outlet obstruction and upper GI bleeding |
| Magnesium and aluminum used catiously: | in patients with decreased kidney func. |
| Calcium containing antacids used catiously: | in patients with respiratory insufficiency, renal impairment, and cardiac disease. |
| Digoxin, isoniazid, phenytoin, and chlorpromazine: | decrease absorption of the interactant drugs, results in a decreased effect on those drugs. |
| Tetracycline | decreases effectiveness of antiinfective |
| Corticosteroids | decrease effectiveness of antiimflammatory properties. |
| Salicylates | interact with pain reliever is excreted from urine rapidly |
| Quinidine and amphetamines | Interactant drugs are excreted slowly from the urine. |
| Aluminum/Magnesium compounds | Maalox |
| Sodium bicarbonate | Alkaseltzer |
| Calcium carbonate | Tums |
| Magnesium hydroxide | MOM |
| Aluminum carbonate treats: | hyperphosphatemia asso. with chronic renal failure. |
| Calcium carbonate treats: | calcium deficiency, menopause, osteoprosis. |
| Magnesium oxide treats: | malnutrition ETOH |
| Sodium bicarbonate treats: | gout and kidney stones(makes urine less acidic) |
| Histamine H2 antagonists(dine's): | inhibits the action of histamine at H2 receptor cells of stomach, which then reduces secretion of gastic acid. |
| Histamine H2 antagonists treat: | heartburn, acid indigestion, sour stomach, GERD, gastic ulcer, gastic hypersecretory conditions. |
| Adverse reactions H2: | dizziness,somnolence,headache,confustion,hallucinations,diarrhea, and reversible impotence. |
| H2 antagonists contraindicated in patients: | with known hypersensitiviy to drugs. |
| H2 antagonists used catiously in patients: | with renal or hepatic impairment, severly ill, elderly, or debilitated patients. |
| Cimetidine used cautiously: | in patients with diabetes. |
| H2 antagonists used with cation: | during pregnancy and lactation. |
| Antacids and metoclorpramide: | decrease absorption of H2 antagonists. |
| Carmustine: | decrease in WBC count. |
| Opioid analgesics: | increased risk for respiratory depression. |
| Oral anticoagulants: | increased risk for bleeding. |
| Digoxin: | May decrease serum digoxin levels. |
| Proton Pump inhibitors(zoles): | suppresses gastric acid screation by inhibition of hydrogen potassium adenosine triphosphatase enzyme of the gastric parietal cells. |
| PPI'S used in: | treatment of gastric and duodenal ulcers, GERD, and erosice esohagitis, pathologic hypersecretory cond. |
| Adverse reactions PPI'S: | headache,nausea,diarrhea,abd. pain. |
| PPI's contraindicated in patients: | who are hypersensitive to any of drugs |
| PPI's used cautiously in: | older adults and in patients with hepatic impairment. |
| Omeprozole, Iansoprazole, rabeprazole, pantoprazole contraindicated: | during pregnancy and lactation. |
| Sucralfate | decreases abs. of the PPI |
| Ketoconazole and ampicillin: | decreased absorption of the anti-infective. |
| Oral anticoagulants | increase risk for bleeding |
| Digoxin | increased abs. of digoxin |
| Benzodiazepines, phenytoin | risk for toxic level of antiseizure drugs |
| Clarithromycin with omeprazole | risk for an increase in plasma levels of both drugs. |
| Cholinergic blocking drugs: | reduces gastric motility and decreases the amt. of acid secreted by stomach. |
| Pepsin inbibitor: | binds with protein molecules to form a ciscous substance which buffers acid and protects the mucosal lining. |
| Prostaglandin drug: | reduces the risk of nonsteroidal anti inflammatory drug induced gastric ulcers in high risk patients. |
| Gastrointestinal stimulants act to: | increase the motility of the upper GI tract w/o increasing the producation of scretions. |
| Gastrointestinal stimulants used: | in treatment of GERD, gastirc stasis |
| Higher doese of prolonged administration of Gastrointestinal stimulants | produce central nervous system symptoms |
| Dexpanthenol administration causes: | itching, difficulty breathing, and urticaria. |
| Gastrointestinal stimulants contraindicated: | in patients with known hupersensitivity to drugs, GI obs., gastric perforation, hemorrhage. |
| Dexpanthenol should not be used with patients with: | hemophilia |
| Gastrointestina stimulants catiously used: | in patients with diabates, cardiovascular disease |
| Matoclopramind and dexpanthenol used caution: | in patients during pregnancy or laction. |
| Cholinergic blocking rugs or opiod analgesics: | decreased effectiveness of metochopramide. |
| Cimeridine: | decreased absorption of cimetidine |
| Digoxin | decreased absorption of digoxin |
| Monoamine oxidase inhibitors (MAOIa) | increased risk for hypertensice episode |
| Levodopa | decreased effectivness of metoclopramide and levodopa |
| Antiemetics prevent: | vomiting caused by drugs, radiation, and metabolic disorders. |
| Antiemetics reduce(zine fam): | the non GI adverse effects |
| Antiemetics tested for use in: | irratable bowel syndrome |
| Common adverse reaction to antiemetics: | verying degrees of drowsiness |
| Antiemetics contraindicated: | known hypersensitivity to these drugs or with severe CNS depression. |
| Prochlorperazine contraindicated: | patients with bone marrow depression, blood dyscrasia, Parkinsons, or severe liver or cardiovascular diease. |
| Thiethylperazine contraindicated: | pregnancy |
| Cholinergic blocking antiemtics: | used catuously in patients with glaucoma, obructive diease of GI or genitourinary system. |
| Promethazine used cautiously: | patients with hypertension, sleep apnea, or elilepsy |
| Trimethobenzamide used catiously: | children with a viral illiness |
| 5-HT3 receptor antagonists used: | cautiously in patients with cardiac conduction(problems, heart block or prolonged QT), electrolyte imbalence. |
| Nursing process assessment: | type and intensity of symptoms, # of times patient has vomited and approximate amt loss. |
| CNS depressants | Increased risk for sedation |
| antacids | decreased absorption of antiemics |
| ridampin with 5-HT3 receptor antagonists | decresed effectiveness of 5-HT3 receptor antagonists |
| Lithuim and procholorperazine | increased risk for extrapramidal effects |
| Ongoing assessment | monitor cont. complaints of pain, sour taste, spitting blood or emesis like coffee grounds, s/s elcrolyte inmbalence, I&O,weigh daily |
| Planning | optimal response to drug thearpy, support of patient needs of adv. reactions, understanding drug regimin. |
| Implementation | certain adequate supply of water and cups for measureing doses, pill crushes or cap split?,prevent nausea, give before chemo, first does iv, and during thearpy, oral home, importance drug, imbalenced fluid vol, I&O q8h.,monitor and manage patient needs. |
| Implemenation | avoid driving drowsiness, correct method to take drug. |
| Evaluation | thearapeutic effect is achieved, nausea and pain controlled, adv. reactions idenitified, reported, and managed, no evidendence of fluid vol, deflict, nut. imblance, or electrolute imb. seen. |
| Evaluation | no injury, patient knows importance of complying with prescrived regims, demonstates and understands, |
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popeo45
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