Question 1

Upper GI:

Accepted Answer

Antacids, 
H2 Blockers,
 PPIs, 
Antiemetics, 
and GI Stimulants

Question 2

Lower GI:

Accepted Answer

Antidiarrheals,
 Anti-flatulents, 
and Laxative Classes 
(Bulk, Stimulant, Osmotic, Emollient, Softeners)

Question 3

Nursing Priorities:

Accepted Answer

Administration Timing, Neuro Risks, and Electrolyte Safety

Question 4

The "Cardiac" Stool Softener:

Accepted Answer

In cardiac patients (especially post-MI), Stool Softeners (Docusate) 
are the priority to prevent the Valsalva maneuver (straining), which can trigger dangerous bradycardia or arrhythmias.

Question 5

Lactulose & Ammonia:

Accepted Answer

While used as an osmotic laxative, Lactulose is specifically used in liver failure (Cirrhosis) to pull ammonia from the blood into the colon to be excreted. 
A therapeutic effect is indicated by improved mental status.

Question 6

Lipid Pneumonia Risk:

Accepted Answer

Emollient laxatives (mineral oil) carry a severe risk of Lipid Pneumonia if aspirated.
 They should be avoided in patients with dysphagia (swallowing difficulties), the elderly, or those who are bedridden.

Question 7

Bismuth & Reye’s Syndrome:

Accepted Answer

Bismuth subsalicylate (Pepto-Bismol) contains a salicylate structure similar to aspirin.
 It should be avoided in children/teenagers with viral symptoms due to the risk of Reye's Syndrome and in adults with aspirin allergies.

Question 8

Laxative Dependency:

Accepted Answer

Stimulant laxatives (Bisacodyl/Senna) should only be used short-term. 
Chronic use can lead to "lazy bowel" where the colon loses its natural peristaltic ability.

Question 9

The "Antacid Gap":

Accepted Answer

Antacids interfere with the absorption of other drugs.
 Space them at least 1–2 hours apart.

Question 10

GI Motility & Neuro Safety:

Accepted Answer

GI Stimulants (Metoclopramide)
 can cause Extrapyramidal Symptoms (EPS) and Tardive Dyskinesia.

Question 11

Extrapyramidal Symptoms (EPS):

Accepted Answer

Involuntary tremors or restlessness; a side effect of Metoclopramide.

Question 12

Tardive Dyskinesia:

Accepted Answer

A serious, often permanent condition characterized by uncontrollable facial movements (eye blinking, lip-smacking); associated with long-term GI stimulant use.

Question 13

Lipid Pneumonia:

Accepted Answer

A specific type of lung inflammation caused by the inhalation of oil-based substances (like mineral oil lubricants) into the lungs.

Question 14

Hypomagnesemia:

Accepted Answer

Low magnesium; a complication of long-term PPI therapy that can lead to tremors and arrhythmias.

Question 15

Ototoxicity:

Accepted Answer

Hearing loss or tinnitus; a risk when Loop diuretics are pushed IV too rapidly.

Question 16

Gastroesophageal Reflux Disease (GERD):

Accepted Answer

A primary indication for nearly all upper GI drug classes.

Question 17

Why is mineral oil contraindicated in a patient with a high risk of aspiration?

Accepted Answer

it can cause Lipoid Pneumonia

Question 18

A patient is prescribed an antibiotic and an antacid. How should the nurse schedule these to ensure maximum absorption?

Accepted Answer

antibiotic 1st and then and should be given 1 hour before or 2 hours after the antacid to prevent binding causing poor absorption

Question 19

Which Upper GI medication class requires the nurse to monitor for C. difficile associated diarrhea?

Accepted Answer

PPI's-Omeprazole – Prilosec
Esomeprazole – Nexium; Lansoprazole – Prevacid
Dexlansoprazole – Dexilant; Pantoprazole – Protonix
Rabeprazole – AcipHex

Question 20

Why is it critical to screen for depression and movement disorders before administering Metoclopramide?

Accepted Answer

movement d/o like Tardive Dyskinesia can be permanent and depression can worsen because it blocks dopamine

Question 21

Compare the timing of administration: When do you give PPIs vs. Antacids relative to meals?

Accepted Answer

you give your PPI 30-60 minutes before meals and Antacids you give 1 hour after meals. As PPI's are activated by food and acids rise after eating therefore more beneficial to give antacids after eating.

Question 22

Why does Mineral Oil cause Lipoid Pneumonia

Accepted Answer

it is a lipophilic meaning it does not trigger strong cough reflex inhaled and if aspirated it can slip silently into the lungs and cause the LP

upper /lower GI MTGD

PHARMACY

Question	Answer
Upper GI:	Antacids, H2 Blockers, PPIs, Antiemetics, and GI Stimulants
Lower GI:	Antidiarrheals, Anti-flatulents, and Laxative Classes (Bulk, Stimulant, Osmotic, Emollient, Softeners)
Nursing Priorities:	Administration Timing, Neuro Risks, and Electrolyte Safety
The "Cardiac" Stool Softener:	In cardiac patients (especially post-MI), Stool Softeners (Docusate) are the priority to prevent the Valsalva maneuver (straining), which can trigger dangerous bradycardia or arrhythmias.
Lactulose & Ammonia:	While used as an osmotic laxative, Lactulose is specifically used in liver failure (Cirrhosis) to pull ammonia from the blood into the colon to be excreted. A therapeutic effect is indicated by improved mental status.
Lipid Pneumonia Risk:	Emollient laxatives (mineral oil) carry a severe risk of Lipid Pneumonia if aspirated. They should be avoided in patients with dysphagia (swallowing difficulties), the elderly, or those who are bedridden.
Bismuth & Reye’s Syndrome:	Bismuth subsalicylate (Pepto-Bismol) contains a salicylate structure similar to aspirin. It should be avoided in children/teenagers with viral symptoms due to the risk of Reye's Syndrome and in adults with aspirin allergies.
Laxative Dependency:	Stimulant laxatives (Bisacodyl/Senna) should only be used short-term. Chronic use can lead to "lazy bowel" where the colon loses its natural peristaltic ability.
The "Antacid Gap":	Antacids interfere with the absorption of other drugs. Space them at least 1–2 hours apart.
GI Motility & Neuro Safety:	GI Stimulants (Metoclopramide) can cause Extrapyramidal Symptoms (EPS) and Tardive Dyskinesia.
Extrapyramidal Symptoms (EPS):	Involuntary tremors or restlessness; a side effect of Metoclopramide.
Tardive Dyskinesia:	A serious, often permanent condition characterized by uncontrollable facial movements (eye blinking, lip-smacking); associated with long-term GI stimulant use.
Lipid Pneumonia:	A specific type of lung inflammation caused by the inhalation of oil-based substances (like mineral oil lubricants) into the lungs.
Hypomagnesemia:	Low magnesium; a complication of long-term PPI therapy that can lead to tremors and arrhythmias.
Ototoxicity:	Hearing loss or tinnitus; a risk when Loop diuretics are pushed IV too rapidly.
Gastroesophageal Reflux Disease (GERD):	A primary indication for nearly all upper GI drug classes.
Why is mineral oil contraindicated in a patient with a high risk of aspiration?	it can cause Lipoid Pneumonia
A patient is prescribed an antibiotic and an antacid. How should the nurse schedule these to ensure maximum absorption?	antibiotic 1st and then and should be given 1 hour before or 2 hours after the antacid to prevent binding causing poor absorption
Which Upper GI medication class requires the nurse to monitor for C. difficile associated diarrhea?	PPI's-Omeprazole – Prilosec Esomeprazole – Nexium; Lansoprazole – Prevacid Dexlansoprazole – Dexilant; Pantoprazole – Protonix Rabeprazole – AcipHex
Why is it critical to screen for depression and movement disorders before administering Metoclopramide?	movement d/o like Tardive Dyskinesia can be permanent and depression can worsen because it blocks dopamine
Compare the timing of administration: When do you give PPIs vs. Antacids relative to meals?	you give your PPI 30-60 minutes before meals and Antacids you give 1 hour after meals. As PPI's are activated by food and acids rise after eating therefore more beneficial to give antacids after eating.
Why does Mineral Oil cause Lipoid Pneumonia	it is a lipophilic meaning it does not trigger strong cough reflex inhaled and if aspirated it can slip silently into the lungs and cause the LP

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