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</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</p> Signup and view all the answers

    What is the primary mechanism of action for antacids?

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

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

    <p>Ondansetron</p> Signup and view all the answers

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

    <p>Laxatives</p> Signup and view all the answers

    What role does bicarbonate play in the stomach?

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

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

    <p>Prostaglandins</p> Signup and view all the answers

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

    <p>Diarrhea</p> Signup and view all the answers

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

    <p>Maalox</p> Signup and view all the answers

    What condition is primarily treated with laxatives?

    <p>Constipation</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</p> Signup and view all the answers

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

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

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

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

    What should be assessed before administering Proton Pump Inhibitors?

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

    Which Proton Pump Inhibitor is specifically noted for parenteral administration?

    <p>Pantoprazole</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</p> Signup and view all the answers

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

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

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

    <p>Antidepressants</p> Signup and view all the answers

    What should be monitored for patients experiencing upper gastrointestinal bleeding?

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

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

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

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

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

    Which type of intestinal obstruction involves a physical blockage?

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

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

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

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

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

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

    <p>Atelectasis</p> Signup and view all the answers

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

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

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

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

    What approach is taken in the nursing management of cirrhosis?

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

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

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

    Which population should avoid antacids with high sodium content?

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

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

    <p>Diarrhea</p> Signup and view all the answers

    What condition is NOT typically treated with H2 antagonists?

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

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

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

    What is the primary mechanism of action of H2 antagonists?

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

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

    <p>Achlorhydria</p> Signup and view all the answers

    Which type of drug interaction can occur with antacids?

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

    What is a nursing implication when administering H2 antagonists?

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

    What adverse effect is specifically associated with cimetidine?

    <p>Impotence</p> Signup and view all the answers

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

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

    What is a major contraindication for using antacids?

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

    What kind of pH changes can antacids induce?

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

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

    <p>Hypergastrinemia</p> Signup and view all the answers

    Which of the following is a benefit of sodium bicarbonate?

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

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

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

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

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

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

    <p>Pantoprazole</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</p> Signup and view all the answers

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

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

    What is included in the nursing considerations for drug therapy?

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

    What role does pharmacokinetics play in understanding drug actions?

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

    Which of the following is NOT a symptom of peritonitis?

    <p>Diarrhea</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</p> Signup and view all the answers

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

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

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

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

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

    <p>Cholecystitis</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</p> Signup and view all the answers

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

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

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

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

    Which endoscopic intervention could be recommended for upper gastrointestinal bleeding?

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

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

    <p>Antidepressants</p> Signup and view all the answers

    What effect can prochlorperazine (Stemetil) cause in patients?

    <p>Orthostatic hypotension and tachycardia</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.</p> Signup and view all the answers

    Which class of antidiarrheals operates by decreasing intestinal muscle tone?

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

    Which mechanism is employed by adsorbent antidiarrheals?

    <p>Coat the gastrointestinal tract walls</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.</p> Signup and view all the answers

    What condition might require the administration of probiotics?

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

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

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

    When are antiemetics typically administered to patients receiving chemotherapy?

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

    What condition is misoprostol primarily used to prevent?

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

    Which mechanism is utilized by anticholinergic drugs in preventing nausea?

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

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

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

    Which class of medication includes ondansetron as a representative drug?

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

    Which of the following is NOT a function of misoprostol?

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

    What type of drug is sulcralfate classified as?

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

    What characteristic effect does dronabinol have on the body?

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

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

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

    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), H₂-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 (H₂) 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 (H₂) Antagonists: Mechanism of Action

    •  Block histamine at the H₂ receptors of acid-producing parietal cells.
    •  Reduce hydrogen ion production, decreasing HCl production.
    •  Suppress acid secretion in the stomach.

    H₂ 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

    H₂ 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 H₂ blockers.

    H₂ 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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