Peptic Ulcer and GERD drugs

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Questions and Answers

Drug classes that treat peptic ulcers and GERD?

Proton pump inhibitors, H2 receptor blockers, antacids

What is the time frame for healing ulcers?

6-8 weeks duodenal, 12 weeks gastric

What do antacids do?

Neutralize the acids in the stomach, inactivates pepsin, enhance mucosal protection

Antacids meds?

<p>Aluminum hydroxide, magnesium hydroxide, calcium carbonate</p> Signup and view all the answers

Antacids side effects?

<p>aluminum and calcium: constipation, magnesium: diarrhea</p> Signup and view all the answers

How to offset antacids side effects?

<p>Alternate meds or use a combo</p> Signup and view all the answers

What is the normal stomach pH?

<p>2-5</p> Signup and view all the answers

Antacids administration?

<p>Take on regular schedule, 3 hours after meals and before bed, up to 7x daily, allow two hours before taking other meds</p> Signup and view all the answers

Gastric protectants?

<p>Misoprostol, sucralfate</p> Signup and view all the answers

Misoprostol MOA?

<p>Anti secretory that enhances mucosal defenses, promotes vasodilation, increases bicarbonate and protective mucus</p> Signup and view all the answers

Misoprostol side effect?

<p>Diarrhea, abdominal pain</p> Signup and view all the answers

Sucralfate MOA?

<p>Creates a protective barrier against acid and pepsin</p> Signup and view all the answers

Sucralfate administration?

<p>Take on empty stomach, 1 hour before meals at bedtime</p> Signup and view all the answers

Sucralfate side effects?

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

Sucralfate interactions?

<p>Warfarin, phenytoin, theophylline, digoxin</p> Signup and view all the answers

Normal pH of body?

<p>7.35-7.45</p> Signup and view all the answers

Proton Pump Inhibitors MOA?

<p>Suppresses gastric secretions</p> Signup and view all the answers

Proton Pump Inhibitors administration?

<p>Give before meals</p> Signup and view all the answers

Proton Pump Inhibitors side effects?

<p>Headache, diarrhea, abdominal pain, nausea</p> Signup and view all the answers

Proton Pump Inhibitors complications?

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

Histamine 2 Blockers MOA?

<p>Blocks the histamine receptor on the parietal cells in the stomach</p> Signup and view all the answers

Histamine 2 Blockers administration?

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

Histamine 2 Blockers side effects?

<p>Drowsiness, dizziness, constipation</p> Signup and view all the answers

Cimetidine?

<p>Passes blood brain barrier, causes confusion, food slows absorption, do not give with antacids</p> Signup and view all the answers

H Pylori Treatment?

<p>Eradicate bacteria completely, helps ulcers heal faster and remain in remission longer</p> Signup and view all the answers

H pylori triple therapy?

<p>Esomeprazole, amoxicillin, clarithromycin</p> Signup and view all the answers

H. pylori quadruple therapy?

<p>Esomeprazole or Ranitidine, metronidazole, tetracycline, bismuth subsalicylate</p> Signup and view all the answers

Peptic Ulcer Disease Lifestyle Changes?

<p>Only take low dose aspirin, avoid smoking, reduce stress, avoid coffee, avoid bedtime snacks, avoid alcohol</p> Signup and view all the answers

Prokinetic Agent?

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

Prokinetic Agent administration?

<p>Give 30 minutes before meals &amp; at bedtime</p> Signup and view all the answers

Prokinetic Agent adverse effects?

<p>Parkinsonian reaction, CNS side effects</p> Signup and view all the answers

Prokinetic Agent contraindication?

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

Antiemetics?

<p>Treat nausea and vomiting</p> Signup and view all the answers

Antiemetics medications?

<p>Promethazine, Metoclopramide, Ondansetron, Dronabinol</p> Signup and view all the answers

Zofran adverse effect?

<p>Prolonged QT interval</p> Signup and view all the answers

Cannabinoids use?

<p>Nausea and vomiting from chemotherapy and increases appetite in AIDs patients</p> Signup and view all the answers

Dopamine antagonists?

<p>Prochlorperazine, promethazine</p> Signup and view all the answers

Dopamine antagonists adverse effects?

<p>Extrapyramidal reactions esp in elderly, urinary retention</p> Signup and view all the answers

Extrapyramidal reactions?

<p>Restlessness, anxiety, spasms of face and neck</p> Signup and view all the answers

Anticholinergics?

<p>Treat motion sickness</p> Signup and view all the answers

Scopolamine MOA?

<p>Blocks signals from ear to vomiting center of brain</p> Signup and view all the answers

Antihistamine antiemetics?

<p>Dramamine, antivert</p> Signup and view all the answers

Anticholinergics side effects?

<p>Dry mouth, urinary retention, constipation</p> Signup and view all the answers

Laxatives?

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

Cathartic?

<p>Stronger and more complete bowel emptying</p> Signup and view all the answers

Laxatives patient education?

<p>Increase fluid intake</p> Signup and view all the answers

Laxatives contraindications?

<p>Fecal impaction, obstruction, ulcerative colitis</p> Signup and view all the answers

Bulk-forming agents MOA?

<p>Absorb water into feces and increase bulk to produce large soft stool</p> Signup and view all the answers

Bulk-forming agents side effects?

<p>Dehydration, electrolyte imbalances</p> Signup and view all the answers

Bulk-forming agents education?

<p>Effective for long-term therapy, may take a few days to see the effects, increase fluids</p> Signup and view all the answers

Bulk-forming agents bonus quality?

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

Can stimulants be used long term?

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

Stimulants MOA?

<p>Increases motility of large intestine</p> Signup and view all the answers

Surfactants MOA?

<p>Inhibit absorption of water so fecal mass remains large and soft, reduces stool surface tension so it absorbs more water and fats</p> Signup and view all the answers

Osmotics MOA?

<p>Attract water into large intestine to produce bulk and stimulate peristalsis</p> Signup and view all the answers

Lubricants meds?

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

Lubricants interactions?

<p>Interferes with the absorption of fat-soluble vitamins</p> Signup and view all the answers

Antidiarrheal opioids?

<p>Lomotil, imodium, morofen</p> Signup and view all the answers

Lomotil adverse effects?

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

Why is imodium better than lomotil?

<p>No euphoria</p> Signup and view all the answers

Bismuth subsalicylate?

<p>Antidiarrheal, traps bacteria to remove it, reduces ability of bacteria to adhere to mucosa</p> Signup and view all the answers

Anti-diarrheal nursing actions?

<p>Encourage small amounts of clear liquid and electrolyte solutions, avoid caffeine and plain water</p> Signup and view all the answers

Inflammatory bowel treatments first line of treatment?

<p>5-aminosalicylates- decrease GI inflammation</p> Signup and view all the answers

Inflammatory bowel treatments second line of treatment?

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

Antimicrobials?

<p>Ciprofloxacin, metronidazole, clarithromycin</p> Signup and view all the answers

Immunosuppressants?

<p>Azathioprine, cyclosporine</p> Signup and view all the answers

Immunomodulators?

<p>Adalimumab, infliximab</p> Signup and view all the answers

Constipation related anticholinergics?

<p>Linaclotide, lubiprostone</p> Signup and view all the answers

Alosetron adverse effects?

<p>Constipation, ischemic colitis</p> Signup and view all the answers

Lubiprostone MOA?

<p>Increase intestinal mobility, increases passage of stool</p> Signup and view all the answers

Lubiprostone side effects?

<p>UTI, flatulence, diarrhea</p> Signup and view all the answers

Hepatic encephalopathy medication?

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

Lactulose MOA?

<p>Lowers blood ammonia levels, allows for tolerance of protein intake with liver cirrhosis</p> Signup and view all the answers

How to tell if iron preparations are effective?

<p>Increase reticulocyte within 4-7 days, increase hemoglobin of 2g/dl within 1 months</p> Signup and view all the answers

Iron intercations?

<p>Vitamin c increases absorption, calcium and antacids decrease absorption</p> Signup and view all the answers

B12 deficiency?

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

What do you monitor for when giving B12?

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

Signs of B12 deficiency?

<p>Beefy red tongue, pallor, neuropathy</p> Signup and view all the answers

What drug classes are used to treat peptic ulcers and GERD?

<p>Proton pump inhibitors, H2 receptor blockers, antacids</p> Signup and view all the answers

What is the typical timeframe for healing ulcers?

<p>6-8 weeks for duodenal ulcers, 12 weeks for gastric ulcers</p> Signup and view all the answers

What is the mechanism of action of antacids?

<p>Neutralize the acids in the stomach, inactivate pepsin, enhance mucosal protection</p> Signup and view all the answers

Name some common antacid medications.

<p>Aluminum hydroxide, magnesium hydroxide, calcium carbonate</p> Signup and view all the answers

What are the common side effects of antacids?

<p>Aluminum and calcium can cause constipation; magnesium can cause diarrhea</p> Signup and view all the answers

How can the side effects of antacids be offset?

<p>Alternate medications or use a combination</p> Signup and view all the answers

What is the normal pH of the stomach?

<p>2-5</p> Signup and view all the answers

When and how should antacids be administered?

<p>Take on a regular schedule, 3 hours after meals and before bed, up to 7 times daily. Allow two hours before taking other medications</p> Signup and view all the answers

Name two gastric protectant medications.

<p>Misoprostol, sucralfate</p> Signup and view all the answers

What is the mechanism of action of misoprostol?

<p>Anti-secretory that enhances mucosal defenses, promotes vasodilation, increases bicarbonate and protective mucus</p> Signup and view all the answers

What is misoprostol used for?

<p>Prevention of NSAID-induced ulcers</p> Signup and view all the answers

What are the common side effects of misoprostol?

<p>Diarrhea, abdominal pain</p> Signup and view all the answers

What is the mechanism of action of sucralfate?

<p>Creates a protective barrier against acid and pepsin</p> Signup and view all the answers

How should sucralfate be administered?

<p>Take on an empty stomach, 1 hour before meals at bedtime</p> Signup and view all the answers

What is a common side effect of sucralfate?

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

What are some medications that interact with sucralfate?

<p>Warfarin, phenytoin, theophylline, digoxin</p> Signup and view all the answers

What is the normal pH of the body?

<p>7.35-7.45</p> Signup and view all the answers

What is the mechanism of action of Proton Pump Inhibitors (PPIs)?

<p>Suppresses gastric secretions</p> Signup and view all the answers

What are PPIs used for?

<p>Ulcer, erosive esophagitis, hypersensitivity secretory conditions</p> Signup and view all the answers

What is the common suffix for PPI medications?

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

How should PPIs be administered?

<p>Give before meals</p> Signup and view all the answers

What are the common side effects of PPIs?

<p>Headache, diarrhea, abdominal pain, nausea</p> Signup and view all the answers

What are some potential complications of PPIs?

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

What is the mechanism of action of Histamine 2 Blockers?

<p>Blocks the histamine receptor on the parietal cells in the stomach</p> Signup and view all the answers

What are Histamine 2 Blockers used for?

<p>Heartburn, ulcers, GERD</p> Signup and view all the answers

How should Histamine 2 Blockers be administered?

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

What are the common side effects of Histamine 2 Blockers?

<p>Drowsiness, dizziness, constipation</p> Signup and view all the answers

Name two common Histamine 2 Blocker medications.

<p>Cimetidine, Ranitidine</p> Signup and view all the answers

What are some unique characteristics of Cimetidine?

<p>Passes blood brain barrier, causes confusion, food slows absorption, do not give with antacids</p> Signup and view all the answers

Why is H. pylori treatment important?

<p>Eradicate bacteria completely, helps ulcers heal faster and remain in remission longer</p> Signup and view all the answers

What medications are included in H. pylori triple therapy?

<p>Esomeprazole, amoxicillin, clarithromycin</p> Signup and view all the answers

What are some Peptic Ulcer Disease Lifestyle Changes?

<p>Only take low dose aspirin, avoid smoking, reduce stress, avoid coffee, avoid bedtime snacks, avoid alcohol</p> Signup and view all the answers

Name a common Prokinetic Agent medication.

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

What is the mechanism of action of Prokinetic Agents?

<p>Stimulates mobility of upper GI tract, increases gastric emptying, does stimulate secretions</p> Signup and view all the answers

What are Prokinetic Agents used for?

<p>Treats GERD &amp; Paralytic ileus, nausea and vomiting after surgery or chemo</p> Signup and view all the answers

How should Prokinetic Agents be administered?

<p>Give 30 minutes before meals &amp; at bedtime</p> Signup and view all the answers

What are the adverse effects of Prokinetic Agents?

<p>Parkinsonian reaction, CNS side effects</p> Signup and view all the answers

What are the contraindications for Prokinetic Agents?

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

What are antiemetics used for?

<p>Treat nausea and vomiting</p> Signup and view all the answers

Name some common antiemetic medications.

<p>Promethazine, Metoclopramide, Ondansetron, Dronabinol</p> Signup and view all the answers

What is an adverse effect of Zofran?

<p>Prolonged QT interval</p> Signup and view all the answers

What are cannabinoids used for?

<p>Nausea and vomiting from chemotherapy and increases appetite in AIDs patients</p> Signup and view all the answers

Name two dopamine antagonist medications.

<p>Prochlorperazine, promethazine</p> Signup and view all the answers

What are the adverse effects of dopamine antagonists?

<p>Extrapyramidal reactions especially in elderly, urinary retention</p> Signup and view all the answers

What are extrapyramidal reactions?

<p>Restlessness, anxiety, spasms of face and neck</p> Signup and view all the answers

What are anticholinergics used for?

<p>Treat motion sickness</p> Signup and view all the answers

Name three common anticholinergic medications.

<p>Scopolamine, Dramamine, Meclizine</p> Signup and view all the answers

What is the mechanism of action of scopolamine?

<p>Blocks signals from ear to vomiting center of brain</p> Signup and view all the answers

Name two antihistamine antiemetic medications.

<p>Dramamine, Antivert</p> Signup and view all the answers

What are the common side effects of anticholinergics?

<p>Dry mouth, urinary retention, constipation</p> Signup and view all the answers

What are laxatives used for?

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

What is a cathartic?

<p>Stronger and more complete bowel emptying</p> Signup and view all the answers

What patient education is important when administering laxatives?

<p>Increase fluid intake</p> Signup and view all the answers

What are the contraindications for laxative use?

<p>Fecal impaction, obstruction, ulcerative colitis</p> Signup and view all the answers

What is the mechanism of action of bulk-forming agents?

<p>Absorb water into feces and increase bulk to produce large soft stool</p> Signup and view all the answers

What are the side effects of bulk-forming agents?

<p>Dehydration, electrolyte imbalances</p> Signup and view all the answers

What patient education is important when administering bulk-forming agents?

<p>Effective for long-term therapy, may take a few days to see the effects, increase fluids</p> Signup and view all the answers

What is a bonus quality of bulk-forming agents?

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

Name three bulk-forming agent medications.

<p>Methylcellulose, polycarbophil, psyllium</p> Signup and view all the answers

What is the mechanism of action of stimulants?

<p>Increases motility of large intestine</p> Signup and view all the answers

What are stimulants used for?

<p>Bowel prep, or opioid constipation</p> Signup and view all the answers

Name two stimulant medications.

<p>Bisacodyl, senna</p> Signup and view all the answers

What is the mechanism of action of surfactants?

<p>Inhibit absorption of water so fecal mass remains large and soft, reduces stool surface tension so it absorbs more water and fats</p> Signup and view all the answers

What are surfactants used for?

<p>To avoid straining, good for hemorrhoids, post MI, or cerebral aneurysm</p> Signup and view all the answers

Name a surfactant medication.

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

What is the mechanism of action of Osmotics?

<p>Attract water into large intestine to produce bulk and stimulate peristalsis</p> Signup and view all the answers

Name four Osmotic medications.

<p>Magnesium hydroxide, magnesium citrate, sodium phosphate, polyethylene glycol</p> Signup and view all the answers

What are the interactions of lubricants?

<p>Interferes with the absorption of fat-soluble vitamins</p> Signup and view all the answers

Name three antidiarrheal opioids.

<p>Lomotil, Imodium, Morofen</p> Signup and view all the answers

What is an adverse effect of Lomotil?

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

What are the actions of bismuth subsalicylate?

<p>Antidiarrheal, traps bacteria to remove it, reduces ability of bacteria to adhere to mucosa</p> Signup and view all the answers

What are the nursing actions for patients with diarrhea?

<p>Encourage small amounts of clear liquid and electrolyte solutions, avoid caffeine and plain water</p> Signup and view all the answers

What is the first line of treatment for inflammatory bowel disease?

<p>5-aminosalicylates- decrease GI inflammation</p> Signup and view all the answers

What is the second line of treatment for inflammatory bowel disease?

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

Name three antimicrobials.

<p>Ciprofloxacin, metronidazole, clarithromycin</p> Signup and view all the answers

Name two immunosuppressant medications.

<p>Azathioprine, cyclosporine</p> Signup and view all the answers

Name two immunomodulator medications.

<p>Adalimumab, infliximab</p> Signup and view all the answers

Name three anticholinergic medications.

<p>Dicyclomine, alosetron, eluxadoline</p> Signup and view all the answers

Name two constipation related anticholinergics.

<p>Linaclotide, lubiprostone</p> Signup and view all the answers

What are the adverse effects of alosetron?

<p>Constipation, ischemic colitis</p> Signup and view all the answers

What is the mechanism of action of Lubiprostone?

<p>Increase intestinal mobility, increases passage of stool</p> Signup and view all the answers

What are the side effects of Lubiprostone?

<p>UTI, flatulence, diarrhea</p> Signup and view all the answers

What does simethicone do?

<p>Reduces gas and bloating</p> Signup and view all the answers

What medication is used to treat hepatic encephalopathy?

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

What is the mechanism of action of lactulose?

<p>Lowers blood ammonia levels, allows for tolerance of protein intake with liver cirrhosis</p> Signup and view all the answers

What are iron's interactions?

<p>Vitamin C increases absorption, calcium and antacids decrease absorption</p> Signup and view all the answers

What does B12 deficiency cause?

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

What are signs of B12 deficiency?

<p>Beefy red tongue, pallor, neuropathy</p> Signup and view all the answers

What drug classes treat peptic ulcers and GERD?

<p>Proton pump inhibitors, H2 receptor blockers, antacids</p> Signup and view all the answers

What is the action of antacids?

<p>Neutralize the acids in the stomach, inactivates pepsin, and enhance mucosal protection</p> Signup and view all the answers

What are some antacid medications?

<p>Aluminum hydroxide, magnesium hydroxide, calcium carbonate</p> Signup and view all the answers

What are the side effects of antacids?

<p>Aluminum and calcium: constipation; magnesium: diarrhea</p> Signup and view all the answers

How should antacids be administered?

<p>Take on a regular schedule, 3 hours after meals and before bed, up to 7x daily, allow two hours before taking other meds</p> Signup and view all the answers

What are some gastric protectants?

<p>Misoprostol, sucralfate</p> Signup and view all the answers

What is the MOA of misoprostol?

<p>Anti secretory that enhances mucosal defenses, promotes vasodilation, increases bicarbonate and protective mucus</p> Signup and view all the answers

What are the side effects of misoprostol?

<p>Diarrhea, abdominal pain</p> Signup and view all the answers

What is the MOA of sucralfate?

<p>Creates a protective barrier against acid and pepsin</p> Signup and view all the answers

What are the side effects of sucralfate?

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

What medications interact with sucralfate?

<p>Warfarin, phenytoin, theophylline, digoxin</p> Signup and view all the answers

What is the MOA of Proton Pump Inhibitors?

<p>Suppresses gastric secretions</p> Signup and view all the answers

What are the uses of Proton Pump Inhibitors?

<p>Ulcer, erosive esophagitis, hypersensitivity secretory conditions</p> Signup and view all the answers

Proton Pump Inhibitors typically end in the suffix: _____

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

How should Proton Pump Inhibitors be administered?

<p>Give before meals</p> Signup and view all the answers

What are the side effects of Proton Pump Inhibitors?

<p>Headache, diarrhea, abdominal pain, nausea</p> Signup and view all the answers

What are the complications of Proton Pump Inhibitors?

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

What is the MOA of Histamine 2 Blockers?

<p>Blocks the histamine receptor on the parietal cells in the stomach</p> Signup and view all the answers

What are the uses of Histamine 2 Blockers?

<p>Heartburn, ulcers, GERD</p> Signup and view all the answers

What are the side effects of Histamine 2 Blockers?

<p>Drowsiness, dizziness, constipation</p> Signup and view all the answers

What are some Histamine 2 Blocker medications?

<p>Cimetidine, ranitidine</p> Signup and view all the answers

Describe Cimetidine

<p>Passes blood brain barrier, causes confusion, food slows absorption, do not give with antacids</p> Signup and view all the answers

What is the goal of H Pylori Treatment?

<p>Eradicate bacteria completely, helps ulcers heal faster and remain in remission longer</p> Signup and view all the answers

What drugs are used in H pylori triple therapy?

<p>Esomeprazole, amoxicillin, clarithromycin</p> Signup and view all the answers

What drugs are used in H. pylori quadruple therapy?

<p>Esomeprazole or Ranitidine, metronidazole, tetracycline, bismuth subsalicylate</p> Signup and view all the answers

What is an example of a Prokinetic Agent?

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

What is the MOA of Prokinetic Agents?

<p>Stimulates mobility of upper GI tract, increases gastric emptying, and does stimulate secretions</p> Signup and view all the answers

What are Prokinetic Agents used to treat?

<p>Treats GERD &amp; Paralytic ileus, nausea and vomiting after surgery or chemo</p> Signup and view all the answers

What do antiemetics treat?

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

What are some antiemetic medications?

<p>Promethazine, Metoclopramide, Ondansetron, dronabinol</p> Signup and view all the answers

What are some examples of dopamine antagonists?

<p>Prochlorperazine, promethazine</p> Signup and view all the answers

What are some signs of extrapyramidal reactions?

<p>Restlessness, anxiety, spasms of face and neck</p> Signup and view all the answers

What do anticholinergics treat?

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

What are some anticholinergic medications?

<p>Scopolamine, dramamine, meclizine</p> Signup and view all the answers

What is the MOA of scopolamine?

<p>Blocks signals from ear to vomiting center of brain</p> Signup and view all the answers

What are some antihistamine antiemetics?

<p>Dramamine, antivert</p> Signup and view all the answers

What are the side effects of anticholinergics?

<p>Dry mouth, urinary retention, constipation</p> Signup and view all the answers

What do laxatives treat?

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

What patient education should be provided when prescribing laxatives?

<p>Increase fluid intake</p> Signup and view all the answers

What is the MOA of bulk-forming agents?

<p>Absorb water into feces and increase bulk to produce large soft stool</p> Signup and view all the answers

What education should be provided when prescribing bulk-forming agents?

<p>Effective for long-term therapy, may take a few days to see the effects, increase fluids</p> Signup and view all the answers

What are some bulk-forming agent medications?

<p>Methylcellulose, polycarbophil, psyllium</p> Signup and view all the answers

What is the MOA of stimulants?

<p>Increases motility of large intestine</p> Signup and view all the answers

What are stimulants used to treat?

<p>Bowel prep, or opioid constipation</p> Signup and view all the answers

What are some stimulant medications?

<p>Bisacodyl, senna</p> Signup and view all the answers

What is the MOA of surfactants?

<p>Inhibit absorption of water so fecal mass remains large and soft, reduces stool surface tension so it absorbs more water and fats</p> Signup and view all the answers

What is a surfactant medication?

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

What is the MOA of Osmotics?

<p>Attract water into large intestine to produce bulk and stimulate peristalsis</p> Signup and view all the answers

What are some Osmotic medications?

<p>Magnesium hydroxide, magnesium citrate, sodium phosphate, polyethylene glycol</p> Signup and view all the answers

What are lubricants used to treat?

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

What are some antidiarrheal opioids?

<p>Lomotil, imodium, morofen</p> Signup and view all the answers

What are the adverse effects of lomotil?

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

Describe bismuth subsalicylate

<p>Antidiarrheal, traps bacteria to remove it, reduces ability of bacteria to adhere to mucosa</p> Signup and view all the answers

What are some anti-diarrheal nursing actions?

<p>Encourage small amounts of clear liquid and electrolyte solutions, avoid caffeine and plain water</p> Signup and view all the answers

What are some antimicrobials that may be used to treat IBD?

<p>Ciprofloxacin, metronidazole, clarithromycin</p> Signup and view all the answers

What are some immunosuppressant medications?

<p>Azathioprine, cyclosporine</p> Signup and view all the answers

What are some examples of immunomodulators?

<p>Adalimumab, infliximab</p> Signup and view all the answers

What are some anticholinergic meds?

<p>Dicyclomine, alosetron, eluxadoline</p> Signup and view all the answers

What are some constipation related anticholinergics?

<p>Linaclotide, lubiprostone</p> Signup and view all the answers

What adverse effects are associated with alosetron?

<p>Constipation, ischemic colitis</p> Signup and view all the answers

What is the MOA of Lubiprostone?

<p>Increase intestinal mobility, increases passage of stool</p> Signup and view all the answers

What is simethicone?

<p>Reduces gas and bloating</p> Signup and view all the answers

What medication is commonly used to treat hepatic encephalopathy?

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

What is the MOA of lactulose?

<p>Lowers blood ammonia levels, allows for tolerance of protein intake with liver cirrhosis</p> Signup and view all the answers

How can you tell if iron preparations are effective?

<p>Increase reticulocyte within 4-7 days, increase hemoglobin of 2g/dl within 1 months</p> Signup and view all the answers

What are some iron intercations?

<p>Vitamin c increases absorption, calcium and antacids decrease absorption</p> Signup and view all the answers

Flashcards

Drugs for peptic ulcers/GERD

Proton pump inhibitors, H2 receptor blockers, antacids.

Ulcer healing time

6-8 weeks for duodenal ulcers, 12 weeks for gastric ulcers.

Antacids

Neutralize stomach acid, inactivate pepsin, enhance mucosal protection.

Antacid medications

Aluminum hydroxide, magnesium hydroxide, calcium carbonate.

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Antacid side effects

Aluminum and calcium: constipation; magnesium: diarrhea.

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Offset antacid side effects

Rotate medications or use a combination of antacids.

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Stomach pH

2-5

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Antacid administration

Administer on a regular schedule, 3 hours after meals and before bed, up to 7x daily; allow two hours before/after other meds.

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Gastric protectants

Misoprostol, sucralfate.

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Misoprostol MOA

Antisecretory, enhances mucosal defenses, promotes vasodilation, increases bicarbonate and protective mucus.

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Misoprostol use

Prevention of NSAID-induced ulcers.

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Misoprostol side effects

Diarrhea, abdominal pain.

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Sucralfate MOA

Creates a protective barrier against acid and pepsin.

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Sucralfate administration

Take on an empty stomach, 1 hour before meals and at bedtime.

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Sucralfate side effect

Constipation

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Sucralfate interactions

Warfarin, phenytoin, theophylline, digoxin.

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Normal body pH

7.35-7.45

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Proton Pump Inhibitors MOA

Suppresses gastric secretions, blocks acid production.

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Proton Pump Inhibitors use

Ulcers, erosive esophagitis, hypersecretory conditions.

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Proton Pump Inhibitors

-prazole

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PPI administration

Give before meals.

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PPI side effects

Headache, diarrhea, abdominal pain, nausea.

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PPI complications

Pneumonia and osteoporosis.

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Histamine 2 Blockers MOA

Blocks the histamine receptor on parietal cells in the stomach.

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Histamine 2 Blockers use

Heartburn, ulcers, GERD.

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Histamine 2 Blockers administration

After meals

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Histamine 2 Blockers side effects

Drowsiness, dizziness, constipation.

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Histamine 2 Blockers

Cimetidine, Ranitidine.

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Cimetidine

Passes blood-brain barrier, causes confusion; food slows absorption, don't give with antacids.

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Ranitidine

Does not pass blood-brain barrier and is not affected by food.

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H. pylori Treatment

Eradicate bacteria completely to help ulcers heal faster and stay in remission longer.

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H. pylori triple therapy

Esomeprazole, amoxicillin, clarithromycin.

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H. pylori quadruple therapy

Esomeprazole or Ranitidine, metronidazole, tetracycline, bismuth subsalicylate.

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PUD Lifestyle Changes

Only take low-dose aspirin, avoid smoking, reduce stress, avoid coffee, avoid bedtime snacks, avoid alcohol.

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Prokinetic Agent

Metoclopramide

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Prokinetic Agent MOA

Stimulates mobility of upper GI tract, increases gastric emptying; does not stimulate secretions.

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Prokinetic Agent use

Treats GERD & paralytic ileus, nausea and vomiting after surgery or chemo.

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Prokinetic Agent administration

Give 30 minutes before meals & at bedtime.

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Prokinetic Agent adverse effects

Parkinsonian reaction, CNS side effects.

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Prokinetic Agent contraindication

Mechanical obstruction, perforation, hemorrhage.

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Antiemetics

Treat nausea and vomiting.

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Antiemetics medications

Promethazine, metoclopramide, ondansetron, dronabinol.

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Zofran adverse effect

Prolonged QT interval.

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Cannabinoids use

Nausea and vomiting from chemotherapy, increases appetite in AIDS patients.

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Dopamine antagonists

Prochlorperazine, promethazine.

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Dopamine antagonists adverse effects

Extrapyramidal reactions (especially in elderly), urinary retention.

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Extrapyramidal reactions

Restlessness, anxiety, spasms of face and neck.

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Anticholinergics

Treat motion sickness.

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Anticholinergics meds

Scopolamine, dramamine, meclizine.

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Scopolamine MOA

Blocks signals from ear to vomiting center of brain.

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Study Notes

Drugs for Peptic Ulcers and GERD

  • Proton pump inhibitors (PPIs), H2 receptor blockers, and antacids are drug classes used.

Ulcer Healing Timeframes

  • Duodenal ulcers typically heal in 6-8 weeks.
  • Gastric ulcers usually require about 12 weeks to heal.

Antacids

  • They work by neutralizing stomach acids.
  • They inactivate pepsin and enhance mucosal protection.

Antacid Medications

  • Common antacids include aluminum hydroxide, magnesium hydroxide, and calcium carbonate.

Antacid Side Effects

  • Aluminum and calcium-based antacids may cause constipation.
  • Magnesium-based antacids can lead to diarrhea.

Managing Antacid Side Effects

  • Alternating medications or using a combination of antacids can offset side effects.

Stomach pH

  • The normal pH range of the stomach is 2-5.

Antacid Administration

  • Take antacids on a regular schedule.
  • It is best to take 3 hours after meals and before bedtime, up to 7 times daily.
  • Allow two hours before taking other medications.

Gastric Protectants

  • Misoprostol and sucralfate are examples of gastric protectants.

Misoprostol

  • It's an antisecretory medication that enhances mucosal defenses.
  • It promotes vasodilation and increases bicarbonate and protective mucus production.
  • It is used for the prevention of NSAID-induced ulcers.
  • Side effects include diarrhea and abdominal pain.

Sucralfate

  • It creates a protective barrier against acid and pepsin in the stomach.
  • Take on an empty stomach, 1 hour before meals and at bedtime.
  • Constipation is a common side effect.
  • It interacts with warfarin, phenytoin, theophylline, and digoxin.

Normal Body pH

  • The normal pH of the body is 7.35-7.45.

Proton Pump Inhibitors (PPIs)

  • PPIs work by suppressing gastric secretions.
  • They are used for ulcers, erosive esophagitis, and hypersecretory conditions.
  • Medications in this class typically end in "-prazole".
  • Administer before meals.
  • Common side effects: include headache, diarrhea, abdominal pain, and nausea.
  • Complications: pneumonia and osteoporosis.

Histamine 2 Blockers (H2 Blockers)

  • H2 Blockers work by blocking the histamine receptor on the parietal cells in the stomach.
  • They are used for heartburn, ulcers, and GERD.
  • Administer after meals.
  • Common side effects include drowsiness, dizziness, and constipation.
  • Examples of H2 Blockers: cimetidine and ranitidine.
  • Cimetidine passes the blood-brain barrier, potentially causing confusion.
  • Food slows its absorption, and it should not be given with antacids.
  • Ranitidine does not pass the blood-brain barrier and is not affected by food.

H. Pylori Treatment

  • The goal is to eradicate the bacteria completely.
  • This helps ulcers heal faster and remain in remission longer.
  • Triple therapy: includes esomeprazole, amoxicillin, and clarithromycin.
  • Quadruple therapy: includes esomeprazole or ranitidine, metronidazole, tetracycline, and bismuth subsalicylate.

Peptic Ulcer Disease Lifestyle Changes

  • Only take low-dose aspirin if necessary.
  • Avoid smoking, reduce stress, and avoid coffee, bedtime snacks, and alcohol.

Prokinetic Agents

  • Metoclopramide is an example.
  • They stimulate the mobility of the upper GI tract, increasing gastric emptying, but does not stimulate secretions.
  • It treats GERD and paralytic ileus and also helps with nausea and vomiting after surgery or chemo.
  • Administer 30 minutes before meals and at bedtime.
  • Adverse effects: Parkinsonian reaction and CNS side effects.
  • Contraindications: mechanical obstruction, perforation, or hemorrhage.

Antiemetics

  • These treat nausea and vomiting.
  • Examples are promethazine, metoclopramide, ondansetron, and dronabinol.
  • Ondansetron may cause prolonged QT interval.
  • Cannabinoids, such as dronabinol, help with nausea and vomiting from chemotherapy and increase appetite in AIDS patients.
  • Dopamine antagonists like prochlorperazine and promethazine may cause extrapyramidal reactions, especially in the elderly, and urinary retention.
  • Extrapyramidal reactions include restlessness, anxiety, and spasms of the face and neck.

Anticholinergics

  • Treat motion sickness by blocking signals from the ear to the vomiting center of the brain (scopolamine).
  • Medications include scopolamine, dramamine, and meclizine.
  • Dramamine and antivert are antihistamine antiemetics.
  • Side effects: dry mouth, urinary retention, and constipation.

Laxatives

  • Treat constipation.
  • Cathartics are stronger and cause more complete bowel emptying.
  • Patients should increase fluid intake while taking laxatives.
  • Contraindications: fecal impaction, obstruction, and ulcerative colitis.

Bulk-Forming Agents

  • Absorb water into feces and increase bulk to produce a large soft stool.
  • Side effects: dehydration and electrolyte imbalances.
  • Effective for long-term therapy, but may take a few days to see effects which reduce cholesterol.
  • It is important to increase fluid intake.
  • Medications include methylcellulose, polycarbophil, and psyllium.

Stimulants

  • Should not be used long term due to the risk of dependence.
  • They increase the motility of the large intestine.
  • Used for bowel prep or opioid-induced constipation.
  • Medications: bisacodyl and senna.

Surfactants

  • Inhibit absorption of water, keeping the fecal mass large and soft.
  • Reduce stool surface tension, allowing it to absorb more water and fats.
  • Use: to avoid straining, helpful for hemorrhoids, post MI, or cerebral aneurysm.
  • Medication: docusate sodium.

Osmotics

  • Attract water into the large intestine to produce bulk and stimulate peristalsis.
  • Medications: magnesium hydroxide, magnesium citrate, sodium phosphate, and polyethylene glycol.

Lubricants

  • Soften feces, easing the strain of passing stool.
  • Medication: mineral oil.
  • Use: for hemorrhoids.
  • They may interfere with the absorption of fat-soluble vitamins.

Antidiarrheal Opioids

  • Examples include lomotil, imodium, and morofen.
  • Lomotil: may cause euphoria.
  • Imodium: is preferred due to the lack of euphoric effects.
  • Bismuth subsalicylate traps bacteria to remove it and reduces their ability to adhere to mucosa.
  • Nursing actions: encourage small amounts of clear liquids and electrolyte solutions, and avoid caffeine and plain water.

Inflammatory Bowel Disease Treatments

  • First-line: 5-aminosalicylates to decrease GI inflammation.
  • Second-line: corticosteroids.
  • Third-line: immunosuppressants.
  • Fourth-line: immunomodulators (monoclonal antibodies) modulate immune response to induce and maintain remission.
  • Antimicrobials: ciprofloxacin, metronidazole, and clarithromycin.
  • Immunosuppressants: azathioprine and cyclosporine.
  • Immunomodulators: adalimumab and infliximab.
  • Anticholinergics reduce bowel spasms.
  • Medications: dicyclomine, alosetron, and eluxadoline.
  • Anticholinergics for constipation: linaclotide and lubiprostone.
  • Alosetron adverse effects: constipation, ischemic colitis.
  • Lubiprostone increases intestinal motility, increasing the passage of stool.
  • Side effects: UTI, flatulence, and diarrhea.

Simethicone

  • Reduces gas and bloating.

Hepatic Encephalopathy Medication

  • Lactulose lowers blood ammonia levels, allowing for tolerance of protein intake with liver cirrhosis.

Iron Preparations Effectiveness

  • Increase in reticulocytes within 4-7 days.
  • Increase in hemoglobin of 2g/dL within 1 month.
  • Vitamin C increases iron absorption, while calcium and antacids decrease absorption.

B12 Deficiency

  • Leads to megaloblastic anemias.
  • Monitor for hypokalemia when administering B12.
  • Signs of deficiency: beefy red tongue, pallor, and neuropathy.

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