GI Medications: Antacids and PPIs

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Questions and Answers

Which class of medication is primarily used to reduce stomach acid production by inhibiting the proton pump in parietal cells?

  • H2 Receptor Antagonists
  • Antiemetics
  • Proton Pump Inhibitors (PPIs) (correct)
  • Antacids

Which of the following medications is commonly used to provide a protective layer on the stomach lining, thus relieving symptoms of heartburn?

  • Loperamide
  • Omeprazole
  • Ranitidine
  • Gaviscon (correct)

A patient taking omeprazole daily for several years is advised by their healthcare provider to monitor for potential:

  • Bone fractures (correct)
  • Increased bone density
  • Improved kidney function
  • Reduced risk of pneumonia

Which of the following side effects is most associated with overuse of stimulant laxatives?

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

A patient reports taking loperamide (Imodium) for chronic diarrhea. Which nursing intervention is most important?

<p>Assessing for underlying causes of the diarrhea. (D)</p> Signup and view all the answers

Which medication is contraindicated for patients with a known bowel obstruction?

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

What instruction should the nurse provide to a patient who is newly prescribed an antacid?

<p>Take the antacid 1 hour before or 2 hours after other medications. (C)</p> Signup and view all the answers

A patient with GERD is prescribed pantoprazole. What is the optimal timing for this medication?

<p>30 minutes before breakfast (B)</p> Signup and view all the answers

Which of the following H2 receptor antagonists has a higher risk of drug interactions due to its inhibition of the cytochrome P450 enzyme system?

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

A patient is prescribed senna for constipation. What education should the nurse provide regarding its use?

<p>Increase fluid intake and fiber in the diet. (B)</p> Signup and view all the answers

Which of the following is a common side effect of antiemetic medications like metoclopramide?

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

Which medication is an antidiarrheal that works by decreasing intestinal motility?

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

A patient with peptic ulcer disease is prescribed famotidine. What is an important aspect of patient education regarding this medication?

<p>Take famotidine on an empty stomach 30 minutes before meals. (B)</p> Signup and view all the answers

Which of the following medications is an osmotic laxative?

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

A patient receiving chemotherapy is experiencing nausea and vomiting. Which medication would be most appropriate?

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

Which of the following is a common side effect of bismuth subsalicylate?

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

A patient with a history of heart failure should use caution when taking which type of antacid?

<p>Sodium-based antacids (A)</p> Signup and view all the answers

What potential interaction should a nurse monitor for in a patient taking both an H2 receptor antagonist and warfarin?

<p>Increased risk of bleeding (B)</p> Signup and view all the answers

For which condition would a nurse administer polyethylene glycol?

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

Which of these medications used to treat gastrointestinal issues requires monitoring for potential extrapyramidal symptoms (EPS)?

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

What is the primary indication for prescribing alginic acid?

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

Which of the following is a common side effect of taking antiemetics?

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

What is the most important consideration when administering a Fleet enema?

<p>Monitor for hyperphosphatemia. (B)</p> Signup and view all the answers

A patient with Clostridium difficile-associated diarrhea should avoid which anti-diarrheal medication?

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

What is the mechanism of action of H2 receptor antagonists in treating gastrointestinal conditions?

<p>Inhibiting the histamine-stimulated release of gastric acid. (B)</p> Signup and view all the answers

What is the primary reason for administering antacids between meals and at bedtime?

<p>To prevent nocturnal acid breakthrough. (A)</p> Signup and view all the answers

Which of the following is a potential adverse effect associated with long-term use of proton pump inhibitors (PPIs)?

<p>Vitamin B12 deficiency (A)</p> Signup and view all the answers

A patient is prescribed both loperamide and an antibiotic for infectious diarrhea. Why should this combination be approached with caution?

<p>It may prolong exposure to the infectious agent. (A)</p> Signup and view all the answers

Which type of laxative is most appropriate for a patient who needs to avoid straining during bowel movements due to recent surgery?

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

A patient on long-term antacid therapy that contains aluminum is at risk for which condition?

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

Which of the following is the most appropriate initial intervention for a patient experiencing mild nausea and vomiting?

<p>Encouraging small, frequent sips of clear fluids (A)</p> Signup and view all the answers

A patient with GERD is prescribed esomeprazole. Which of the following statements indicates that the patient understands the proper administration of this medication?

<p>&quot;I should take this medication on an empty stomach, 30-60 minutes before breakfast.&quot; (C)</p> Signup and view all the answers

Which of the following interventions should be prioritized when caring for a patient receiving antiemetic medications?

<p>Assessing for signs of dehydration (C)</p> Signup and view all the answers

A patient is taking loperamide for diarrhea. What findings should the nurse instruct the patient to report immediately?

<p>Abdominal distension. (B)</p> Signup and view all the answers

Which of the following stool types is most likely after prep with magnesium sulfate?

<p>Watery stool. (D)</p> Signup and view all the answers

What is the most significant risk to educate the patient about before administering senna?

<p>Medication will likely cause dependency with long-term use. (A)</p> Signup and view all the answers

Which medication is LEAST likely to have an effect on laboratory values?

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

A patient with pre-existing renal disease should consult their provider prior to taking which of the following medications?

<p>Antacids with magnesium (C)</p> Signup and view all the answers

Which of the following is a potential adverse effect that is unique to the long-term use of cimetidine compared to other H2 receptor antagonists?

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

A patient who recently had bariatric surgery is complaining of chronic nausea. Which of these medications should be avoided?

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

Flashcards

Antacids

Neutralize stomach acid; examples include Gaviscon, Pepto-Bismol, Tums, Mylanta, and Rolaids.

Indications for antacids

Heartburn, acid indigestion, upset stomach and mild peptic ulcers.

Side effects of antacids

Constipation, diarrhea, gas, and electrolyte imbalances with long-term use.

Nursing considerations for antacids

Monitor bowel habits, assess for electrolyte imbalances, and educate patients about the difference between OTC vs prescription.

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Proton Pump Inhibitors (PPIs)

Reduce stomach acid production; examples include omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole.

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Indications for PPIs

Heartburn, GERD, peptic ulcers and Zollinger-Ellison syndrome.

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Side effects of PPIs

Headache, diarrhea, nausea, fatigue, and bone fractures with long-term use.

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Nursing considerations for PPIs

Monitor for side effects, educate patients about taking with water and not crushing tablets, and advise about potential interactions with other medications.

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H2 Receptor Antagonists

Reduce stomach acid production; examples include famotidine, cimetidine, nizatidine and ranitidine.

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Indications for H2 receptor antagonists

Heartburn, GERD, and peptic ulcers.

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Side effects of H2 receptor antagonists

Headache, diarrhea, constipation and drowsiness.

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Nursing considerations for H2 receptor antagonists

Monitor for side effects, educate patients about proper medication administration and advise about potential interactions.

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Laxatives

Promote bowel movements; examples include Senokot, Prepokit, Sutab, and Fleet enema.

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Indications for Laxatives

Constipation, fecal impaction, and bowel preparation for procedures.

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Side effects of laxatives

Abdominal cramps, diarrhea, dehydration, and electrolyte imbalances with overuse.

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Nursing considerations for laxatives

Assess bowel habits, educate about types of laxatives, and emphasize non-pharmacological methods.

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Antidiarrheals

Reduce or stop diarrhea; examples include Loperamide (Imodium), Pepto-Bismol, and Kaopectate

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Indications for Antidiarrheals

Acute diarrhea, traveler's diarrhea, and chronic diarrhea in specific cases.

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Side effects of antidiarrheals

Constipation, bloating, and abdominal pain.

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Nursing considerations for antidiarrheals

Assess the cause of diarrhea, identify dehydration risks, and educate patients about appropriate use and importance of hydration.

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Antiemetics

Reduce nausea and vomiting; examples include Reglan, Motilium, and Thorazine.

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Indications for Antiemetics

Nausea and vomiting due to various causes, including motion sickness, chemotherapy, and surgical procedures.

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Side effects of antiemetics

Drowsiness, dry mouth, and dizziness.

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Nursing consideration for antiemetics

Monitor for side effects, assess hydration status, and educate patients about potential interactions.

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Study Notes

  • Medications commonly used to manage gastrointestinal (GI) problems

Antacids

  • Common brands include Gaviscon (alginic acid), Pepto-Bismol (bismuth), Tums, Mylanta, and Rolaids
  • Dosage varies; typically taken between meals and at bedtime as chewable, liquid, or tablet
  • Treats heartburn, acid indigestion, upset stomach, and mild peptic ulcers
  • Side effects include constipation, diarrhea, gas, and electrolyte imbalances (high calcium or magnesium) with long-term use
  • Nurses should monitor bowel habits and electrolyte imbalances
  • Important to educate patients about differences between over-the-counter and prescription options

Proton Pump Inhibitors (PPIs)

  • Common PPIs: omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole
  • Dosage varies depending on brand and condition
  • Usually taken once daily before breakfast
  • Used for heartburn, GERD, peptic ulcers, and Zollinger-Ellison syndrome
  • Side effects: headache, diarrhea, nausea, fatigue, and bone fractures with long-term use
  • Nurses should monitor for side effects and educate patients to take with water and not crush tablets, as well as advise about interactions with other medications

H2 Receptor Antagonists

  • Common types: famotidine, cimetidine, nizatidine and ranitidine
  • Dosage varies depending on brand and condition and often taken twice daily before meals and at bedtime
  • Treats heartburn, GERD, and peptic ulcers
  • Side effects include headache, diarrhea, constipation, and drowsiness
  • Nursing considerations include monitoring for side effects, educating patients about proper medication administration, check for potential interactions with other medications.

Laxatives

  • Common types: Senokot (senna), Prepokit (citric acid/magnesium), Sutab (mag sulfate), Fleet enema (sodium biphosphate)
  • Dosage varies and use can be occasional or daily
  • Treats constipation, fecal impaction, and bowel preparation for procedures
  • Side effects: abdominal cramps, diarrhea, dehydration, and electrolyte imbalances with overuse
  • Nurses should assess causes of constipation, educate about different types and appropriate use, and emphasize non-pharmacological methods

Antidiarrheals

  • Common types: loperamide (Imodium), Pepto-Bismol, Kaopectate (bismuth subsalicylate)
  • Dosage varies and typically taken after loose stools
  • Treats acute diarrhea, traveler's diarrhea, and chronic diarrhea
  • Side effects: constipation, bloating, and abdominal pain
  • Nurses should assess the cause, identify dehydration risks, educate patients about appropriate use, and stress addressing underlying causes

Antiemetics (anti-nausea medications)

  • Common types: Reglan (metoclopramide), Motilium (domperidone), Thorazine (chlorpromazine)
  • Dosage varies and may be given orally, intravenously, or rectally
  • Treats nausea and vomiting from motion sickness, chemotherapy, and surgical procedures
  • Side effects: drowsiness, dry mouth, and dizziness
  • Nurses should monitor for side effects, assess hydration, and educate patients about potential interactions with other medications

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