Antidiarrheal Medications Quiz
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Questions and Answers

What is the primary reason for combining diphenoxylate with atropine in antidiarrheal treatment?

  • To increase the effectiveness of diarrhea control
  • To enhance absorption of the active ingredients
  • To minimize potential recreational use of opiates (correct)
  • To reduce the risk of respiratory depression

Which of the following adverse effects is associated with opiate antidiarrheal medications?

  • Increased bleeding time
  • Urinary retention
  • Dry skin
  • Drowsiness and sedation (correct)

What interaction can occur with adsorbent antidiarrheals?

  • Decreased absorption of certain antibiotics (correct)
  • Increased effectiveness of anticoagulants
  • Enhanced effects of anticholinergics
  • Increased absorption of digoxin

Which nursing implication is essential when caring for a patient on antidiarrheal treatment?

<p>Perform hand hygiene as per protocol (C)</p> Signup and view all the answers

What type of effect can result from large dosages of diphenoxylate combined with atropine?

<p>Extreme anticholinergic effects (A)</p> Signup and view all the answers

What is the primary mechanism of action for antacids?

<p>Neutralize stomach acid (A)</p> Signup and view all the answers

Which type of drug is specifically classified as an anti-emetic?

<p>Ondansetron (A)</p> Signup and view all the answers

Which of the following is not classified as an acid-controlling drug?

<p>Laxatives (A)</p> Signup and view all the answers

What role does bicarbonate play in the stomach?

<p>It helps buffer the acidic properties of HCl (A)</p> Signup and view all the answers

Which additional substance is secreted along with mucus to provide gastric protection?

<p>Prostaglandins (A)</p> Signup and view all the answers

What is a common side effect of magnesium-based antacids?

<p>Diarrhea (A)</p> Signup and view all the answers

Which combination product is composed of aluminum and magnesium to balance side effects?

<p>Maalox (C)</p> Signup and view all the answers

What condition is primarily treated with laxatives?

<p>Constipation (C)</p> Signup and view all the answers

What is the primary reason Proton Pump Inhibitors (PPIs) are prescribed for gastroesophageal reflux disease (GERD)?

<p>To reduce acid reflux into the esophagus (A)</p> Signup and view all the answers

Which of the following is NOT a recommended use for Proton Pump Inhibitors?

<p>Asthma treatment (D)</p> Signup and view all the answers

What is the recommended duration for short-term use of Proton Pump Inhibitors?

<p>4-8 weeks (D)</p> Signup and view all the answers

What should be assessed before administering Proton Pump Inhibitors?

<p>Allergies and history of liver disease (B)</p> Signup and view all the answers

Which Proton Pump Inhibitor is specifically noted for parenteral administration?

<p>Pantoprazole (D)</p> Signup and view all the answers

Which of the following is a recommended lifestyle modification for patients with Gastroesophageal Reflux Disease (GERD)?

<p>Avoiding caffeine (D)</p> Signup and view all the answers

What is the primary goal of nursing management for acute gastritis?

<p>To manage and prevent symptoms (D)</p> Signup and view all the answers

Which of the following drugs is NOT commonly used for Peptic Ulcer Disease management?

<p>Antidepressants (D)</p> Signup and view all the answers

What should be monitored for patients experiencing upper gastrointestinal bleeding?

<p>Hematocrit levels (D)</p> Signup and view all the answers

Which symptom may NOT be the first indication of peptic ulcer disease in older adults?

<p>Abdominal pain (D)</p> Signup and view all the answers

What is the recommended head elevation for patients suffering from GERD?

<p>30 degrees (B)</p> Signup and view all the answers

In post-operative care for peptic ulcer disease, which condition involves the rapid emptying of the stomach?

<p>Dumping syndrome (A)</p> Signup and view all the answers

Which of the following factors is a common cause for stress ulcers?

<p>Severe trauma (A)</p> Signup and view all the answers

What is a primary reason for the higher morbidity and mortality rates associated with gastric ulcers in older adults?

<p>Increased concomitant health problems (D)</p> Signup and view all the answers

Which type of intestinal obstruction involves a physical blockage?

<p>Mechanical obstruction (D)</p> Signup and view all the answers

What is a common nursing intervention for patients with acute pancreatitis?

<p>Intravenous hydration (B)</p> Signup and view all the answers

What does nonalcoholic fatty liver disease (NAFLD) primarily characterize?

<p>Accumulation of fat in the liver without liver inflammation (C)</p> Signup and view all the answers

Which nursing intervention is crucial for preventing hypovolemic shock in abdominal trauma management?

<p>Fluid replacement therapy (B)</p> Signup and view all the answers

What is a significant complication that needs to be assessed in patients after abdominal surgery?

<p>Atelectasis (C)</p> Signup and view all the answers

What is the goal of drug therapy in the management of hepatitis?

<p>Decrease viral load (C)</p> Signup and view all the answers

Which type of therapy is a common approach for managing cholecystitis?

<p>Surgical therapy (C)</p> Signup and view all the answers

What is a common symptom associated with acute abdominal pain that requires immediate evaluation?

<p>Severe, sudden pain (D)</p> Signup and view all the answers

What approach is taken in the nursing management of cirrhosis?

<p>Health Promotion and acute intervention (B)</p> Signup and view all the answers

What is a potential risk of using sodium bicarbonate for acid control?

<p>Metabolic alkalosis (D)</p> Signup and view all the answers

Which population should avoid antacids with high sodium content?

<p>Patients with heart failure (B)</p> Signup and view all the answers

What is a common adverse effect associated with magnesium-containing antacids?

<p>Diarrhea (B)</p> Signup and view all the answers

What condition is NOT typically treated with H2 antagonists?

<p>Rheumatoid Arthritis (B)</p> Signup and view all the answers

What effect does smoking have on the effectiveness of H2 antagonists?

<p>Decreases effectiveness (B)</p> Signup and view all the answers

What is the primary mechanism of action of H2 antagonists?

<p>Block histamine at H2 receptors (A)</p> Signup and view all the answers

Which condition primarily results from the action of proton pump inhibitors?

<p>Achlorhydria (A)</p> Signup and view all the answers

Which type of drug interaction can occur with antacids?

<p>Altered urinary pH (B)</p> Signup and view all the answers

What is a nursing implication when administering H2 antagonists?

<p>Give two hours after antacids (C)</p> Signup and view all the answers

What adverse effect is specifically associated with cimetidine?

<p>Impotence (B)</p> Signup and view all the answers

What does prolonged use of calcium carbonate antacids often lead to?

<p>Acid rebound (B)</p> Signup and view all the answers

What is a major contraindication for using antacids?

<p>Severe kidney failure (D)</p> Signup and view all the answers

What kind of pH changes can antacids induce?

<p>Increased stomach pH and urinary pH (B)</p> Signup and view all the answers

Which condition is associated with the use of proton pump inhibitors?

<p>Hypergastrinemia (B)</p> Signup and view all the answers

Which of the following is a benefit of sodium bicarbonate?

<p>Buffers the acidic properties of HCl (D)</p> Signup and view all the answers

What condition is treated with Proton Pump Inhibitors to reduce excessive acid secretion?

<p>Zollinger-Ellison syndrome (D)</p> Signup and view all the answers

What is a fundamental nursing implication when administering Proton Pump Inhibitors?

<p>Assess for allergies and history of liver disease (C)</p> Signup and view all the answers

For how long are Proton Pump Inhibitors typically recommended for short-term use?

<p>4-8 weeks (C)</p> Signup and view all the answers

Which Proton Pump Inhibitor is noted for being available for parenteral administration?

<p>Pantoprazole (D)</p> Signup and view all the answers

What is the primary mechanism of action of Proton Pump Inhibitors in the body?

<p>Inhibit acid secretion at the parietal cell level (D)</p> Signup and view all the answers

Which aspect of drug classification should students focus on for each medication?

<p>Pharmacology specifics (B)</p> Signup and view all the answers

What is included in the nursing considerations for drug therapy?

<p>Lab values and implementation (A)</p> Signup and view all the answers

Which of the following is a key element in the management of toxicity and overdose?

<p>Monitoring vital signs continuously (B)</p> Signup and view all the answers

What role does pharmacokinetics play in understanding drug actions?

<p>Understanding absorption and metabolism (A)</p> Signup and view all the answers

What is an important factor to consider when planning patient and family teaching?

<p>Cultural beliefs and practices (B)</p> Signup and view all the answers

What factor contributes to higher morbidity and mortality rates associated with gastric ulcers in older adults?

<p>Presence of concomitant health problems (A)</p> Signup and view all the answers

Which of the following is NOT a symptom of peritonitis?

<p>Diarrhea (C)</p> Signup and view all the answers

What is the primary focus of emergency management in abdominal trauma?

<p>Establishing a patent airway and adequate breathing (B)</p> Signup and view all the answers

Which type of intestinal obstruction does NOT involve a physical blockage?

<p>Nonmechanical obstruction (C)</p> Signup and view all the answers

What characterizes nonalcoholic fatty liver disease (NAFLD)?

<p>Hepatic steatosis not caused by alcohol or other liver diseases (C)</p> Signup and view all the answers

In nursing management for hepatitis, which intervention is essential for acute intervention?

<p>Nutrition assessment and rest (C)</p> Signup and view all the answers

What is the goal of drug therapy for liver conditions such as hepatitis?

<p>Decrease viral load and liver enzyme levels (D)</p> Signup and view all the answers

What nursing implementation is critical after a patient undergoes abdominal surgery?

<p>Monitoring for complications such as fever and fluid imbalance (A)</p> Signup and view all the answers

Which condition is specifically treated with nutritional therapy in gallbladder disease?

<p>Cholecystitis (C)</p> Signup and view all the answers

What lifestyle change is recommended for patients with GERD to avoid reflux?

<p>Elevating the bed at least 30 degrees (D)</p> Signup and view all the answers

Which medication class is typically used for managing Peptic Ulcer Disease?

<p>Proton Pump Inhibitors (D)</p> Signup and view all the answers

In the older adult population, what might the first symptoms of peptic ulcer disease be?

<p>Gastric bleeding (B)</p> Signup and view all the answers

Which is a potential serious complication that can occur with Peptic Ulcer Disease?

<p>Gastric perforation (B)</p> Signup and view all the answers

What is a recommended dietary recommendation for managing acute gastritis?

<p>Eating small, frequent meals to reduce irritation (C)</p> Signup and view all the answers

What intervention is important to evaluate in patients receiving drug therapy for GERD?

<p>Effectiveness and side effects of medications (D)</p> Signup and view all the answers

Which endoscopic intervention could be recommended for upper gastrointestinal bleeding?

<p>Endoscopic band ligation (B)</p> Signup and view all the answers

Which of the following drugs is NOT typically used for managing gastric ulcers?

<p>Antidepressants (C)</p> Signup and view all the answers

What effect can prochlorperazine (Stemetil) cause in patients?

<p>Orthostatic hypotension and tachycardia (C)</p> Signup and view all the answers

Why is careful monitoring important for older adult patients experiencing nausea and vomiting?

<p>They may have cardiac or renal insufficiency. (C)</p> Signup and view all the answers

Which class of antidiarrheals operates by decreasing intestinal muscle tone?

<p>Antimotility agents - anticholinergics (B)</p> Signup and view all the answers

What is the primary function of intestinal flora modifiers?

<p>To supply missing bacteria to the GI tract (B)</p> Signup and view all the answers

What potential issue arises from excessive replacement of fluids in older adults with heart failure?

<p>Fluid overload and electrolyte imbalance (C)</p> Signup and view all the answers

Which mechanism is employed by adsorbent antidiarrheals?

<p>Coat the gastrointestinal tract walls (C)</p> Signup and view all the answers

Which of the following is a characteristic of opiate antidiarrheal medications?

<p>They slow the movement of fecal matter. (A)</p> Signup and view all the answers

What condition might require the administration of probiotics?

<p>Bacterial diarrhea (D)</p> Signup and view all the answers

Which of the following is a potential consequence of rehydration therapy in older adults?

<p>Electrolyte imbalance (A)</p> Signup and view all the answers

When are antiemetics typically administered to patients receiving chemotherapy?

<p>30 minutes to 1 hour before chemotherapy (D)</p> Signup and view all the answers

What is an important consideration when administering sucralfate?

<p>Other medications should be given at least 2 hours before sucralfate. (D)</p> Signup and view all the answers

What effect do PPIs have on the serum levels of certain medications?

<p>They may increase serum levels of diazepam or phenytoin. (C)</p> Signup and view all the answers

What condition is misoprostol primarily used to prevent?

<p>NSAID-induced gastric ulcers. (C)</p> Signup and view all the answers

Which mechanism is utilized by anticholinergic drugs in preventing nausea?

<p>Blocking acetylcholine receptors. (D)</p> Signup and view all the answers

What adverse effect is commonly associated with the therapeutic doses of misoprostol?

<p>Abdominal cramps. (A)</p> Signup and view all the answers

Which class of medication includes ondansetron as a representative drug?

<p>Serotonin blockers. (A)</p> Signup and view all the answers

What is the primary action of prokinetic drugs in the gastrointestinal tract?

<p>Stimulation of peristalsis and gastric emptying. (D)</p> Signup and view all the answers

Which of the following is NOT a function of misoprostol?

<p>Increasing gastric acid production. (B)</p> Signup and view all the answers

What common side effect may result from long-term use of PPIs?

<p>Increased chance for bleeding when used with warfarin. (D)</p> Signup and view all the answers

What type of drug is sulcralfate classified as?

<p>Cytoprotective agent. (C)</p> Signup and view all the answers

What characteristic effect does dronabinol have on the body?

<p>Alters mood and perception. (C)</p> Signup and view all the answers

How do H1 receptor blockers primarily work in the prevention of nausea?

<p>By blocking histamine receptors. (A)</p> Signup and view all the answers

Which interaction can occur with the use of certain antiemetics?

<p>They may increase the anticoagulant effects of warfarin. (B)</p> Signup and view all the answers

Flashcards

Proton Pump Inhibitors (PPIs)

Drugs that reduce stomach acid production

Gastroesophageal Reflux Disease (GERD)

Acid reflux into the esophagus

Peptic Ulcer Disease (PUD)

Sores in the stomach or duodenum lining

Zollinger-Ellison Syndrome

Hypersecretion of stomach acid due to gastrin-secreting tumors

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Pantoprazole

Parenteral PPI, can be given intravenously

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Diphenoxylate with atropine

A combination drug used to treat diarrhea. Diphenoxylate is a weak opioid, and atropine (a small amount) reduces opiate abuse.

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Anticholinergic adverse effects

Side effects from anticholinergic drugs. Includes dry mouth, blurred vision, and abdominal pain.

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Antidiarrheal interactions

How different medications interact when used together to treat diarrhea. Some decrease absorption of certain drugs, some increase bleeding time, and some antacids decrease antidiarrheal effects.

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Contact isolation

A method of preventing the spread of contagious diseases by keeping the patient separated from others.

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Hand hygiene protocol

The standard procedures for hand washing to prevent the spread of infection by germs.

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Acid-Controlling Drugs

Drugs used to reduce stomach acid production or neutralize stomach acid.

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Antacids

Drugs that neutralize stomach acid.

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H2-receptor antagonists

Drugs that reduce stomach acid production by blocking histamine which triggers acid production .

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Aluminum salts (Antacids)

Antacids containing aluminum. They neutralize stomach acid.

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Magnesium salts (Antacids)

Antacids containing magnesium. Help neutralize stomach acid.

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Stomach Acid (HCl)

Hydrochloric acid, a key component of gastric juice, is important for digestion.

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Hyperacidity

An excess of stomach acid that causes discomfort or damage to the digestive system.

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Gastric Ulcer Morbidity in Older Adults

Older adults have higher rates of illness and death from gastric ulcers due to pre-existing conditions and weaker bodies.

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Acute Abdominal Pain

Sudden, severe pain in the abdomen needing urgent medical attention.

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Abdominal Trauma

Injury to the abdominal organs.

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Peritonitis

Inflammation of the lining of the abdominal cavity.

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Intestinal Obstruction

Blockage in the intestines.

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Hepatitis

Inflammation of the liver.

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Acute Pancreatitis

Sudden inflammation of the pancreas.

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Cholelithiasis

Gallstones in the gallbladder.

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Nonalcoholic Fatty Liver Disease (NAFLD)

Liver disease from fat buildup not related to alcohol.

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Cirrhosis

Severe scarring of the liver.

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GERD Management

Avoid factors like smoking, lying down after eating, and late-night meals; elevate the head of the bed 30 degrees; and monitor medication effects.

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Acute Gastritis Nursing Management

Requires diagnostic studies and management of the acute situation, including supportive care.

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Peptic Ulcer Disease Diagnostics

Involves diagnostic studies and collaborative care, encompassing conservative and prophylactic therapies (drugs like H2-blockers, proton pump inhibitors, antibiotics, antacids, etc.).

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Upper GI Bleeding Diagnostics

Includes diagnostic studies (e.g., endoscopy) and potential therapies like endoscopic or surgical interventions, along with drug therapy.

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Peptic Ulcer Disease Nursing Implementation

Includes health promotion, acute interventions (e.g., hemorrhage control), ambulatory and home care, and evaluation.

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Age-related Peptic Ulcer Considerations

Increased incidence in elderly patients, often related to NSAID use. Pain may not be the initial symptom, and bleeding may be the first presentation.

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Stress Ulcers

Ulcers that develop due to stress, often requiring conservative and prophylactic therapy, such as drug therapy with histamine blockers, proton pump inhibitors, and antibiotics.

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Collaborative Care in Ulcers

A combination of both medication and surgery in handling the disease, especially when dealing with complications like hemorrhage, perforation, and obstruction; nutritional therapy is also necessary.

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Sodium Bicarbonate (Baking Soda)

A highly soluble antacid that quickly buffers stomach acid but has a short duration of effect.

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Metabolic Alkalosis

A condition resulting from excessive bicarbonate intake that disrupts the body's acid-base balance.

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Drug Interactions (Antacids)

Antacids can affect the absorption of other drugs, impacting their effectiveness or safety.

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Aluminum Antacids

Antacids containing aluminum, often linked to constipation.

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Calcium Carbonate Antacids

Antacids containing calcium carbonate, often associated with gas and belching.

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Magnesium Antacids

Antacids containing magnesium, often associated with diarrhea.

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H2 Antagonists

Drugs that reduce stomach acid production by blocking histamine receptors.

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Parietal Cells

Stomach cells that produce hydrochloric acid.

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Acid Rebound

A potential side effect of some antacids where stomach acid increases after the antacid's effect wears off.

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Histamine-2 Receptor

A receptor which histamine bonds to; blocking the receptor prevents acid production

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Achlorhydria

A condition in which the stomach produces no hydrochloric acid

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GERD

Gastroesophageal reflux disease, a condition where stomach acid flows back up into the esophagus, causing heartburn and other symptoms.

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What are PPIs used for?

PPIs are used to treat several conditions, including GERD, peptic ulcer disease (PUD), Zollinger-Ellison syndrome, and erosive esophagitis.

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How should PPIs be taken?

PPIs are typically taken on an empty stomach, usually before meals, to maximize their effectiveness.

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What does Diphenoxylate do?

Diphenoxylate, combined with atropine, is used to treat diarrhea. It is a weak opioid that slows down the movement of the intestines.

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Anticholinergic side effects

Anticholinergic drugs can cause side effects like dry mouth, blurred vision, and constipation due to blocking signals to certain glands and muscles.

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What is 'Acid Rebound'?

When the effect of some antacids wears off, the stomach can produce more acid than usual, called 'acid rebound.'

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What are H2-receptor antagonists?

H2-receptor antagonists are drugs that reduce stomach acid production by blocking histamine receptors in the stomach.

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GERD Management: Smoking

Smoking worsens GERD by relaxing the lower esophageal sphincter, allowing stomach acid to backflow. Quitting smoking is crucial for managing GERD.

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GERD Management: Bed Elevation

Elevating the head of the bed 30 degrees helps prevent acid reflux by promoting gravity-assisted stomach emptying.

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GERD Management: Post-Meal Lying

Avoid lying down for 2-3 hours after eating to prevent acid reflux. This gives the stomach time to digest food.

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Peptic Ulcer Disease: Collaborative Care

Managing peptic ulcers often involves a team approach, utilizing medications like H2-blockers, proton pump inhibitors, antibiotics, and antacids.

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Upper GI Bleeding: Diagnostic Studies

Finding the source of upper GI bleeding involves various tests, often including endoscopy, which allows visualization of the digestive tract.

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Peptic Ulcer Disease in Older Adults: Considerations

Peptic ulcer disease is more common in older adults, often linked to NSAID use. Pain may not be the primary symptom, and bleeding could be the first indication.

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Antiemetics for Chemotherapy

Antiemetic medications (like prochlorperazine) are typically administered 1 hour to 30 minutes before chemotherapy drugs to prevent nausea and vomiting.

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Older Adults & Nausea

Older adults experiencing nausea and vomiting need careful assessment and monitoring due to higher risks of dehydration and electrolyte imbalances.

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Antidiarrheal Categories

Antidiarrheal medications can be classified into three main categories: adsorbents, antimotility agents (which include anticholinergics and opiates), and probiotics/intestinal flora modifiers.

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Adsorbents: Mechanism

Adsorbent antidiarrheals, such as activated charcoal and bismuth subsalicylate, work by coating the GI tract and binding to bacteria or toxins, which are then eliminated in the stool.

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Antimotility Agents: Action

Antimotility agents, like anticholinergics and opiates, slow down the movement of stool through the GI tract, allowing for more water and electrolyte absorption.

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Probiotics: Role

Probiotics, like Lactobacillus acidophilus, supplement the GI tract with beneficial bacteria, suppressing diarrhea-causing bacteria and restoring balance.

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Opiates: Mechanism

Opiate antimotility agents, like loperamide and diphenoxylate, reduce bowel motility, relieve rectal spasms, and decrease transit time, aiding water reabsorption.

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Anticholinergics: Action

Anticholinergic antimotility agents, like atropine and hyoscyamine, decrease intestinal muscle tone and peristalsis, slowing down bowel movement.

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Traveler's Diarrhea

Traveler's diarrhea is a common issue when traveling to different regions, often due to exposure to unfamiliar microbes.

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Acute Diarrhea: Causes

Acute diarrhea, a sudden onset of frequent loose stools, can be caused by various factors, including infections, food poisoning, and medications.

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Cytoprotective Drugs

Drugs that protect the stomach lining from injury or damage.

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Sucralfate (Sulcrate)

A cytoprotective drug that binds to ulcers and erodes, forming a protective barrier against pepsin, which breaks down proteins.

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Misoprostol

A synthetic prostaglandin that protects the gastric mucosa by stimulating mucus and bicarbonate production, promoting cell regeneration, and maintaining blood flow.

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Vomiting Center (VC)

A brain region that triggers the vomiting reflex when stimulated.

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Chemoreceptor Trigger Zone (CTZ)

A brain region that receives signals from the GI tract and triggers the vomiting reflex.

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Antiemetic Drugs

Drugs that prevent or reduce nausea and vomiting.

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Anticholinergic Drugs

Antiemetics that block acetylcholine receptors in the inner ear labyrinth and CTZ, reducing nausea and vomiting.

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Antihistamine Drugs (H1 blockers)

Antiemetics that block histamine receptors, preventing cholinergic stimulation in vestibular and reticular areas, reducing nausea and vomiting.

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Neuroleptic Drugs

Antiemetics that block dopamine receptors on the CTZ, reducing nausea and vomiting.

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Prokinetic Drugs

Antiemetics that block dopamine in the CTZ, desensitize it to stimuli, stimulate GI peristalsis, and enhance stomach emptying.

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Serotonin Blockers

Antiemetics that block serotonin receptors in the GI tract, CTZ, and VC, reducing nausea and vomiting.

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Tetrahydrocannabinoids

Antiemetics that have inhibitory effects on the reticular formation, thalamus, and cerebral cortex, altering perception and reducing nausea and vomiting.

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Aprepitant (Emend)

A selective antagonist at substance P/neurokinin 1 (NK1) receptors in the brain, used to prevent nausea and vomiting.

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Gastrointestinal (GI) Tract

The organs involved in digestion, including the esophagus, stomach, small intestine, and large intestine.

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What are the primary causes of increased gastric ulcer morbidity and mortality in older adults?

Older adults have higher rates of illness and death from gastric ulcers due to pre-existing health problems, like cardiovascular or pulmonary issues, and a reduced capacity to handle blood loss (hypovolemia).

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What is the primary concern in managing abdominal trauma?

The immediate priority is ensuring a clear airway, adequate breathing, restoring fluid balance, and preventing shock caused by blood loss (hypovolemic shock).

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What's peritonitis?

Peritonitis is an infection and inflammation of the peritoneum, the lining of the abdominal cavity. It can be caused by a variety of factors, including ruptured appendix, bowel perforation, or severe trauma.

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What are the primary types of intestinal obstructions?

The two main types are mechanical, caused by a physical blockage in the intestines, and nonmechanical, caused by a problem with the bowel's muscle function (like paralysis).

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What are the main goals of drug therapy for hepatitis?

The key objectives are to reduce the viral load, lower liver enzyme levels, and slow the progression of the disease.

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What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD is a range of conditions that involves fat buildup in the liver, not caused by alcohol, that can range from mild to severe liver scarring.

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What are the main diagnostic tools for cirrhosis?

Liver biopsy (taking a tissue sample) and noninvasive fibrosis markers (blood tests) are used to assess the extent of liver scarring.

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What are the main management strategies for acute pancreatitis?

Acute pancreatitis is treated with supportive care (pain control, fluids), intervention (removing gallstones), and drug therapy (antibiotics, pain medications).

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What are the two main treatment approaches to gallstones (cholelithiasis) and gallbladder inflammation (cholecystitis)?

Conservative therapy focuses on managing symptoms, while surgical therapy involves removing the gallbladder.

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What are the key assessments for a patient after abdominal surgery?

Post-surgical assessments include checking for lung complications (atelectasis), heart problems (hemodynamic instability), brain issues (cognitive dysfunction), pain, fluid imbalances, fever, nausea, urinary problems, and wound infections.

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Study Notes

Acid Controlling and Antiemetic Drugs

  •  Nursing course 488, Fall 2024
  •  Presented by Catherine Fox, Bemi Lawal, Shelley de Boer, Hillary Selkirk, C. Seneviratne, K. Wollny, T. Ens, K. McCartney,

Student Preparation for N488 Class

  •  Students are responsible for knowing pharmacology specifics for each drug classification.
  •  Readings from Sealock & Seneviratne et al. (2021) text chapters are to be studied.
  •  Covered topics include generic name/trade names, classification, indications, mechanism of action (pharmacokinetics), contraindications/precautions, adverse reactions/side effects, toxicity, overdose management, drug-drug and food-drug interactions, and route/dosage.
  •  Nursing considerations and pharmacological interventions are part of the preparation.
  •  Patient and family teaching methods will be discussed.

Class Objectives

  •  Develop understanding of the nursing process for individuals with digestion alterations (diarrhea, nausea, vomiting).
  •  Explore, discuss, and identify common pharmacological interventions in digestion-related conditions, including acid-controlling drugs, anti-emetics, laxatives, and antidiarrheals.

Overview of Common GI Disorders

  •  Gastritis (acute)
  •  Upper gastrointestinal bleeding
  •  Peptic ulcer disease
  •  Stress ulcer
  •  Peritonitis
  •  Intestinal Obstruction
  •  Acute pancreatitis
  •  Cholelithiasis and cholecystitis
  •  Constipation
  •  Liver disease
  •  Crohn's disease, ulcerative colitis (IBD)
  •  GERD (Gastroesophageal Reflux Disease)

Classifications: GI Drugs

  •  Acid Controlling Drugs: Antacids, acid-reducing agents (PPIs), Hâ‚‚-receptor antagonists
  •  Antiemetics: ondansetron, metoclopramide
  •  Laxatives, Antidiarrheals, Antispasmodics (e.g., dicyclomine for IBS)
  •  Stomach secretes: hydrochloric acid (HCl), bicarbonate, pepsinogen (pepsin), intrinsic factor, mucus, prostaglandins (anti-inflammatory), and hyperacidity.

Acid Controlling Drugs-Antacids: Mechanism of Action

  •  Neutralize stomach acid.
  •  Promote gastric mucosal defense mechanisms
  •  Secretion of:
    • Mucus: protective barrier against HCl
    • Bicarbonate: helps buffer acidic properties of HCl
    • Prostaglandins: prevent activation of the proton pump

Types of Antacids and Their Uses

  •  Aluminum salts (e.g., Almagel, Maalox, Mylanta)
  •  Magnesium salts (e.g., Magmix, milk of magnesia, magnesium oxide, Gasulsol Tablets, Calmax, Maalox)
  •  Calcium salts (e.g., Tums)

Bicarbonate: Benefits and Risks in Acid Control

  •  Sodium bicarbonate (baking soda): Highly soluble, buffers HCl properties, quick onset but short duration, causes metabolic alkalosis, problems for patients with heart failure, hypertension, or renal insufficiency due to high sodium content.

Antacids: Contraindications and Adverse Effects

  •  Contraindications: known drug allergy, severe kidney failure, electrolyte disturbances, gastrointestinal obstruction
  •  Adverse Effects: minimal, depend on compound used; common issues: aluminum/calcium: constipation; magnesium: diarrhea, calcium carbonate: gas, belching; combining with simethicone reduces discomfort.

Antacids: Drug Interactions

  •  Altered Absorption: reduces ability of other drugs to be absorbed.
  •  Increased stomach pH: increases absorption of basic drugs; decreases absorption of acidic drugs.
  •  Increased urinary pH: increases excretion of acidic drugs; decreases excretion of basic drugs.

Antacids: Nursing Implications

  •  Assess for allergies and pre-existing conditions (fluid imbalances, pregnancy, renal disease).
  •  Use with caution with other medications due to drug-drug interactions.
  •  Most medications should be given 1–2 hours after an antacid.
  •  Monitor for adverse effects (nausea, vomiting, abdominal pain, diarrhea, constipation, acid rebound).
  •  Monitor for therapeutic response. Notify provider if symptoms aren't relieved.

Histamine-2 (Hâ‚‚) Antagonists

  •  Reduce acid secretion.
  •  Available OTC in lower dosage forms.
  •  Popular drugs for acid-related disorders.
    • Cimetidine (Tagamet)
    • Famotidine (Pepcid)
    • Nizatidine (Axid)
    • Ranitidine (Zantac)

Histamine-2 (Hâ‚‚) Antagonists: Mechanism of Action

  •  Block histamine at the Hâ‚‚ receptors of acid-producing parietal cells.
  •  Reduce hydrogen ion production, decreasing HCl production.
  •  Suppress acid secretion in the stomach.

Hâ‚‚ Antagonists: Indications

  •  Gastroesophageal reflux disease (GERD)
  •  Peptic ulcer disease (PUD)
  •  Erosive esophagitis
  •  Adjunct therapy in the control of upper GI bleeding
  •  Pathological gastric hypersecretory conditions

Hâ‚‚ Antagonists: Adverse Effects and Drug Interactions

  •  Adverse effects (very few): cimetidine may induce impotence and gynecomastia, headaches, lethargy, confusion, diarrhea, urticaria, sweating, flushing.
  •  Drug interactions: cimetidine binds to P-450 microsomal oxidase system, inhibits oxidation of many drugs, increases drug levels, inhibits absorption of drugs requiring an acidic GI environment, smoking decreases effectiveness of Hâ‚‚ blockers.

Hâ‚‚ Antagonists: Nursing Implications

  • Assess for allergies and impaired renal or liver function.
  • Use with caution in confused/disoriented patients and elderly.
  • Administer 1 hour before or after antacids.
  • Follow administration guidelines for IV doses.

(All other sections remain the same)

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