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Questions and Answers
Which antacid will cause diarrhea?
Magnesium-based antacids
Which antacid will cause constipation?
Aluminum-based antacids
When is the best time to take an antacid?
At least 1 hour apart from other drugs
Which type of patient should be discouraged from using sodium based antacids?
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Besides GERD, for what other condition is aluminum hydroxide (Amphogel) used?
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What is the basic action of the antacid group of GI medications?
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90% of duodenal ulcers are caused by what?
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Which combination drug containing tetracycline/Flagyl/Pepto-Bismol seems to be most effective for duodenal ulcers?
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Which drugs, or classification of drugs, is most likely to cause confusion in the elderly?
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What is a major side effect of the antiulcer synthetic prostaglandin drug Cytotec?
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Belladonna, an anticholinergic drug, may be used as an antiulcer agent.
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What are the major side effects of anticholinergic drugs?
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How do the opioids work as antidiarrheals?
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What nursing action must take place before administering an antidiarrheal drug?
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With which drug is 'Traveler's Diarrhea' treated?
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With the use of a bulk forming laxative such as Metamucil, what nursing action must be followed to avoid complications?
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Osmotic laxatives such as Go-LYTELY may be used for what purpose and what instructions must be followed?
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What is a possible side effect from the use of the stimulant laxative such as the sennosides (Senokot)?
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Besides evacuation of the bowels, what is another use for Lactulose?
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In what situation would the nurse hold (not give) a laxative?
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Which GI stimulant is most commonly given about 30 minutes prior to chemotherapy in order to prevent nausea/vomiting?
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Prilosec and Nexium are gastric pump inhibitors most used for which disorder?
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What does Syrup of Ipecac cause and for what is it useful?
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Anti-emetics commonly cause what side effect?
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Study Notes
GI Disorders
- Common GI disorders include GERD, gastric and duodenal ulcers, nausea/vomiting (N/V), constipation, and diarrhea.
GI Drug Categories
- Main categories of GI drugs: Antacids, anti-ulcer drugs, anti-diarrheals, laxatives, emetics, anti-emetics.
Antacids
- Composed of aluminum, magnesium, calcium, and sodium; they neutralize stomach acid and reduce gastric acidity.
- Indicated for peptic ulcer disease and GERD; aluminum/calcium can cause constipation, while magnesium can lead to diarrhea.
- Antacids may change stool color to whitish; take 2 hours apart from other medications to avoid absorption issues.
- Patients with hypertension or renal issues should avoid magnesium/sodium-based antacids due to fluid retention.
Anti-Ulcer Medications
- H-2 receptor antagonists (e.g., cimetidine, ranitidine, famotidine) reduce gastric acid secretion by blocking histamine action on parietal cells.
- Mucosal barriers, like sucralfate, provide protective paste in the stomach; administered before meals for maximum effect.
- Synthetic prostaglandins (e.g., misoprostol) protect the stomach, particularly in patients using NSAIDs, but can cause spontaneous abortions.
- Antibiotics (e.g., tetracycline, metronidazole, Pepto-Bismol) target Helicobacter pylori, responsible for the majority of ulcers.
- Side effects of antibiotics include allergic reactions and GI disturbances; avoid alcohol with metronidazole.
Anti-Diarrheal Medications
- Opioids, like diphenoxylate and loperamide, decrease GI motility; loperamide is available OTC with low abuse potential.
- Absorbent medications (e.g., Kaopectate, Pepto-Bismol) treat diarrhea by binding toxins and slowing stool passage.
- Caution with anticholinergics for their side effects; often result in dry mouth, urinary retention, and blurred vision.
Laxatives
- Bulk-forming laxatives (e.g., Metamucil) require a full glass of water to prevent choking; otherwise, they can become gelatinous.
- Stool softeners (e.g., Colace) reduce stool hardness; stimulant laxatives (e.g., Dulcolax) can cause reddish urine.
- Laxatives should be avoided in cases of nausea, vomiting, or abdominal pain to prevent complications.
GI Stimulants and Gastric Acid Pump Inhibitors
- Metoclopramide (Reglan) increases GI motility and is effective against nausea; can cause CNS irritability.
- Gastric acid pump inhibitors like omeprazole and esomeprazole are used for long-term ulcer treatment and effective against GERD.
Emetics and Anti-emetics
- Emetics, such as syrup of ipecac, induce vomiting for poison ingestion; never administer to unconscious individuals without guidance.
- Anti-emetics include phenothiazines (e.g., prochlorperazine, promethazine) and antihistamines to treat nausea/vomiting, often causing drowsiness.
- Scopolamine, delivered via a transdermal patch, helps prevent motion sickness and post-operative nausea.
Important Considerations
- Monitor for potential CNS effects; educate patients about side effects associated with antacids, anti-ulcer medications, and anti-emetics.
- Emphasize adherence to medication regimens, discourage self-medication with laxatives, and ensure thorough health assessments for GERD and ulcers.
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Description
This quiz delves into common gastrointestinal disorders such as GERD, ulcers, and nausea. It also covers the various categories of GI drugs, including antacids and their compositions. Test your knowledge on the clinical implications and uses of these medications.
