Medication Study Notes

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Questions and Answers

Match the antacid medication with its primary consideration.

Calcium carbonate = May cause rebound hyperacidity Antacids in general = Neutralize stomach acid All antacids = Avoid taking within 1-2 hours of other medications

Match the H-2 receptor antagonist consideration with its appropriate detail.

Cimetidine = Has high drug interaction risk H-2 receptor antagonists = Dosage adjustment for liver/kidney disease may be needed

Match the proton pump inhibitor (PPI) with its consideration.

PPIs = Bind to the H-K+ ATPase enzyme system Long-term PPI use = Increases risk of pneumonia

Match the mucosal protectant with its characteristic.

<p>Mucosal protectants = Can cause constipation Patients with chronic renal failure = Use mucosal protectants with caution</p> Signup and view all the answers

Match the antiflatulent with its consideration.

<p>Antiflatulents = Can cause nausea, constipation, diarrhea, or headaches Simethicone = Safe for infants</p> Signup and view all the answers

Match the antidiarrheal type with its mechanism of action.

<p>Adsorbents = Coat the walls of the GI tract Antimotility agents = Slow peristalsis Probiotics = Restore normal bacteria in the lower intestine</p> Signup and view all the answers

Match the characteristic with its antidiarrheal.

<p>Bismuth subsalicylate = Assess for Reye's syndrome Antimotility agents = Decrease flow of fluid and electrolytes into the bowel Opioid-like antidiarrheals = Slow down movement of intestines Anticholinergics = Block action of acetylcholine in the nervous system</p> Signup and view all the answers

Match the laxative type with its mechanism of action.

<p>Fiber = Adds bulk to stool to facilitate passage Stool softeners = Facilitate movement of water and fats into stool Osmotic agents = Cause water to be retained with the stool Stimulant laxatives = Cause contraction of intestines and stimulate stool to move</p> Signup and view all the answers

Match the laxative type with the considerations for its use.

<p>Fiber = May affect GI absorption of other medications Stool softeners = Monitor electrolyte imbalances Osmotic Agents = Can cause diarrhea and dehydration Lubricants = Coat stool to help seal in water</p> Signup and view all the answers

Match the antiemetic type with its mechanism of action.

<p>Anticholinergics = Block acetylcholine receptors Antihistamines = Block H1 receptors Dopamine antagonists = Block dopamine in CTZ Prokinetics = Block dopamine and acetylcholine, promote motility</p> Signup and view all the answers

Match the antiemetic with its consideration.

<p>Scopolamine = Comes in a transdermal patch Meclizine = Drowsiness, dry mouth, blurred vision Dopamine Antagonists = Can cause drowsiness, restlessness, and dry mouth Serotonin antagonists = May cause headache and constipation</p> Signup and view all the answers

Match the medication with its indication.

<p>Phenazopyridine = Local anesthetic for lining of the urinary tract Desmopressin = Diabetes insipidus &amp; bedwetting Tamsulosin = Benign prostatic hyperplasia</p> Signup and view all the answers

Match the medication with its nursing consideration.

<p>Phenazopyridine = Is excreted in urine and may cause it to turn orange/red Desmopressin = Many drug interactions Tamsulosin = Monitor I &amp; O, daily weight and BP</p> Signup and view all the answers

Match the laxative with its consideration.

<p>Stimulant laxatives = Avoid long-term use Fiber = May affect GI absorption; take 2 hours before other medications. Stool softeners = Monitor electrolyte imbalances Osmotic agents = Can cause diarrhea and abdominal cramping</p> Signup and view all the answers

Match the term regarding anti-diarrheal medications to its definition.

<p>Adsorption = Adhesion of molecules to a surface Antimotility anti-diarrheals = Slow peristalsis Probiotics = Restore normal bacteria in the lower intestine Opioid-like anti-diarrheals = Reduce frequency and volume of bowel movements</p> Signup and view all the answers

Match the term regarding antiemetic medications to its definition.

<p>Anticholinergics = Prevent nausea-inducing stimuli Antihistamines = Vertigo and motion sickness Prokinetics = Promote motility Antiemetics = Target specific neuroreceptors</p> Signup and view all the answers

Match the term regarding medications for the urinary tract to its definition.

<p>Phenazopyridine = Local anesthetic for lining of urinary tract Desmopressin = Increase H20 re-absorption Tamsulosin = Relaxes muscles in prostate &amp; bladder</p> Signup and view all the answers

Match the condition to its characteristic.

<p>Constipation = Take a stool softener Dysuria = Phenazopyridine Upset stomach = Calcium Carbonate Diarrhea = Loperamide</p> Signup and view all the answers

Match consideration with H-2 Receptor Antagonists

<p>Cimetidine = High drug interaction risk Take 15-60 minutes before meal = Take before heartburn causing foods Histamines receptors = Block histamines action at Hâ‚‚ receptor of the stomach's parietal cells Liver/Kidney = Dosage adjustment may be needed for liver/kidney disease</p> Signup and view all the answers

Match consideration with PPIs

<p>Long-term risks = Zinc/magnesium/B12 deficiency Liver Drug Metabolism = Can interfere with liver drug metabolism H-K+ ATPase Enzyme = Bind to H-k+ ATPase Enzyme system (proton pump) Hydrochloric acid secretion = Inhibit hydrochloric acid secretion</p> Signup and view all the answers

Flashcards

Antacids: Action

Neutralizes stomach acid, raising pH.

H-2 Receptor Antagonists: Action

Block histamine action at H2 receptors in parietal cells.

Proton Pump Inhibitors (PPIs): Action

Binds to H+-K+ ATPase, inhibiting hydrochloric acid secretion.

Mucosal Protectants: Action

Covers and protects GI ulcers from acid, pepsin, and bile salts.

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Antiflatulents: Action

Alters gas bubble elasticity, breaking them into smaller bubbles.

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Adsorbents (Antidiarrheals): Action

Helps eliminate toxins/bacteria from the GI tract.

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Antimotility Agents: Action

Slows down peristalsis, reducing bowel movement speed.

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Probiotics: Action

Restores normal bacteria in the lower intestine.

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Fiber: Action

Adds bulk to stool to ease passage.

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Stool Softeners: Action

Facilitates water and fat movement into stool.

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Osmotic Agents: Action

Causes water retention in stool, softening it for easier passage.

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Lubricants: Action

Coats stool with mineral oil to seal in water.

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Stimulant Laxatives: Action

Causes contraction of intestines, stimulating stool movement.

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Anticholinergics (Antiemetics): Action

Blocks acetylcholine receptors to prevent nausea.

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Antihistamines (Antiemetics): Action

Blocks H1 receptors to prevent motion sickness.

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Dopamine Antagonists (Antiemetics): Action

Blocks dopamine in CTZ to reduce nausea; may cause drowsiness.

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Prokinetics (Antiemetics): Action

Blocks dopamine and stimulates acetylcholine to boost motility.

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Serotonin Antagonists (Antiemetics): Action

Blocks serotonin receptors to reduce nausea; may cause prolonged QTI.

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Phenazopyridine (Pyridium): Action

Local anesthetic for urinary tract lining; causes orange/red urine.

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Desmopressin: Action

Synthetic ADH that increases water reabsorption, reducing urine production.

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Study Notes

  • Study notes on medications

Antacids

  • Neutralize stomach acid, increasing pH
  • Taken 3-4 times a day Interactions occur, avoid taking with other medications for 1-2 hours.
  • Calcium carbonate might be contraindicated in clients who have kidney disease due to risk of hypercalcemia
  • May cause rebound hyperacidity
  • Encourage patients to stop smoking and to avoid alcohol, high-fat foods, spicy foods, and caffeine

H-2 Receptor Antagonists

  • Blocks histamine's action at H2 receptors of stomach's parietal cells
  • Take 15-60 minutes before foods that cause heartburn
  • Possible dosage adjustments needed for liver or kidney disease
  • Cimetidine poses a high risk of drug interactions

Proton Pump Inhibitors

  • Binds to H+-K+ ATPase enzyme system, also known as proton pump
  • Inhibits hydrochloric acid secretion
  • May interfere with liver drug metabolism
  • Long-term risks include zinc/magnesium/B12 deficiency, increased pneumonia risk, renal dysfunction, osteoporosis, and lupus erythematosus.

Mucosal Protectants

  • These cover and protect GI ulcers from further attack by acid, pepsin, and bile salts
  • Take on an empty stomach 2 hours after or 1 hour before meals
  • Use cautiously in patients who have chronic renal failure to avoid excretion of small amounts of absorbed aluminum
  • Side effect is constipation

Antiflatulents

  • Alters elasticity of gas bubbles, breaking them into smaller bubbles
  • Simethicone should be taken four times a day, after meals and at bedtime
  • Safe for infants
  • Common side effects include nausea, constipation, diarrhea, and headache
  • Encourage position change, movement and avoidance of straws

Antidiarrheals

  • Three types exist: adsorbents, anti-motility, and probiotics

Adsorbents

  • Adsorption involves the adhesion of molecules to a surface
  • Coats walls of GI tract
  • Binds to causative bacteria or toxins
  • Eliminates bacteria or toxins from the GI tract
  • Examples include bismuth
  • Reduce inflammation in intestine and the flow of fluids and electrolytes into bowel
  • Salicylate is contained in Bismuth, avoid when taking aspirin
  • Assess for Reye's Syndrome
  • Contradictions exist with ulcer or bleeding problems
  • Side effects include black or dark tongue and ringing in the ears

Antimotility Agents

  • Decreases flow of fluids and electrolytes into the bowel
  • Slows bowel movement
  • Two examples are opioid-like and anticholinergics

Opioid-like

  • Slows down the movement of intestines, thus reducing frequency and volume of bowel movements
  • The structure is opioid-like, but causes fewer CNS effects
  • Loperamide is an example
  • Taking >rx abnormal heart rhythm
  • Side effects include abdominal discomfort, N/V, dizziness, and drowsiness

Anticholinergics (Antispasmodics)

  • Blocks action of acetylcholine (ACh) in nervous system
  • Works on smooth muscle of GI tract to inhibit propulsive motility
  • Decreases gastric acid secretion and cramping
  • Examples include dicyclomine (Bentyl) and hyoscyamine (Levsin)
  • Assess for intestinal obstruction
  • Should not be taken in the presence of glaucoma, myasthenia gravis, or paralytic ileus
  • Side effects include dry mouth, constipation, blurred vision, and confusion

Probiotics

  • Microorganisms that help replenish normal bacteria flora in GI tract
  • Lacta bacillus is an example
  • Various strains exist with differing health benefits
  • Side effects include gas, bloating, and diarrhea

Laxatives

  • Different types of laxatives listed include Fiber, Stool Softeners, Osmotic agents, Lubricants, and Stimulant Laxatives

Fiber

  • Adds bulk to stool to facilitate passage
  • May affect GI absorption; take two hours before other meds
  • Produces a BM in 12-72 hours
  • Start on one dose per day, increase to 3 doses per day if needed to maintain soft stools

Stool Softeners (Emollient Laxatives)

  • Facilitates movement of water and fats into stool
  • Produces a BM in 1-72 hours
  • Monitor electrolyte imbalances
  • May interact with blood thinners and antibiotics

Osmotic Agents (Lubricant Laxatives)

  • Causes water to be retained with the stool, increasing the number of bowel movements and softening the stool for easier passage
  • Usually produces a BM in 1-3 days
  • May cause diarrhea, abdominal cramping, and electrolyte imbalances

Lubricants

  • Mineral oil coats stool to help seal in H2O
  • Ex: Mineral Oil enema (fleet enema)
  • Produce BM in 2-15 minutes (rapid BM)
  • Side effects include: stomach cramps, bloating, diarrhea, dehydration, and electrolyte imbalances

Stimulant Laxatives

  • BM happens in 15 minutes
  • Causes contraction of intestines and stimulates stool to move
  • PO or Rectal Supply
  • Avoid long term use
  • Can cause dehydration, electrolyte imbalances, chronic constipation & laxative dependency
  • Side effects include abdominal cramps, nausea, vomiting, and diarrhea

Antiemetics

  • Stop the process of vomiting
  • Target specific neuroreceptors and interact with vomiting center (VC) and chemoreceptor trigger zone (CTZ)
  • Types of antiemetics are anticholinergics, antihistamines, dopamine antagonists, prokinetics, and serotonin antagonists

Anticholinergics

  • Block acetylcholine receptors, preventing nausea-inducing stimuli
  • Example: Scopolamine = Transdermal patch!
  • Side effects include Seizures!, Psychosis, and drowsiness!

Antihistamines

  • Anti-Vertigo
  • Block H1 receptors, thus preventing motion sickness
  • Ex. Meclizine
  • Side effects include drowsiness, dry mouth, and blurred vision

Dopamine Antagonists

  • Blocks dopamine in the CTZ
  • Side effects are drowsiness, Restlessness, dry mouth, and constipation

Prokinetics

  • Increase GI movement and reduce nausea
  • Blocks dopamine and acetylcholine, helping to promote motility
  • Contradicted with GI hemorrhage, obstruction or perforation
  • *Used post-opp
  • Side effects = hypertensive Crisis or Seizure, suicidal thoughts

Serotonin Antagonists

  • Block serotonin receptors
  • May cause HA, Constipation, prolonged QTI Range

Nursing Considerations for Antiemetics

  • Varied side effects depending on type
  • Monitor for potential interactions

Phenazopyridine (Pyridium)

  • Local anesthetic for lining of urinary tract
  • Indication is dysuria
  • Available OTC, but higher doses require prescription
  • Excreted in urine and may cause it to turn orange/red

Desmopressin

  • Synthetic version of ADH (vasopressin), a selective agonist of V2 receptors in renal collecting duct
  • Increases H2O re-absorption & reduces urine production
  • Indications include antidiuretic in diabetes insipidus and bedwetting
  • Available as a nasal spray and tablet
  • Take at night for bedwetting
  • Many drug interactions occur
  • Monitor BP
  • Can cause hyponatremia, HA, dizziness, restlessness edema, N/V

Tamsulosin (Flomax)

  • Blocks alpha receptors, relaxing muscles in prostate & bladder
  • Indications include benign prostatic hyperplasia and kidney stone
  • Monitor I & O, daily weight & BP
  • Not enough data regarding pregnancy

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