Pharmacology Chapter on Enemas and Side Effects

Questions and Answers

What is the recommended maximum dosage of loperamide within a 24-hour period for treating diarrhea?

10mg

8mg (correct)

6mg

12mg

Which statement accurately describes a potential side effect of loperamide?

It may cause drowsiness. (correct)

It may lead to increased heart rate.

It may cause excessive salivation.

It may induce severe hallucinations.

What should a client be advised against consuming while taking loperamide?

High-fiber foods

Tonic water (correct)

Decaffeinated beverages

Protein supplements

Which class of medication is used to prevent nausea and vomiting by blocking receptors in the chemoreceptor trigger zone?

Anti-emetics Signup and view all the answers

Which of the following medications is an example of a glucocorticoid that may be used in anti-emetic treatment?

Beclomethasone Signup and view all the answers

What is a common misconception regarding the use of benzodiazepines for nausea?

They have no sedative effects. Signup and view all the answers

Which medication mentioned is commonly used to treat motion sickness?

Scopolamine Signup and view all the answers

What is an essential aspect of patient education regarding the administration of gastrointestinal medications?

Patients should report any unexpected side effects immediately. Signup and view all the answers

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

They inhibit the gastric H+/K+ ATPase pump. Signup and view all the answers

What is a common initial treatment choice for symptomatic relief of heartburn?

Antacids like calcium carbonate Signup and view all the answers

Which H2 receptor antagonist is known for being reintroduced to the market in 2021 after issues with its predecessor?

Ranitidine Signup and view all the answers

What should a patient do to avoid interference with medication absorption when taking antacids?

Avoid antacids 30-60 minutes before or after other medications. Signup and view all the answers

Which side effect is particularly concerning with H2 receptor antagonists in older adults?

Confusion Signup and view all the answers

Which factor can decrease the effectiveness of H2 receptor antagonists?

Smoking Signup and view all the answers

When is it recommended for patients to take H2 blockers for optimal effect?

30-60 minutes before meals Signup and view all the answers

What potential long-term effect should patients be monitored for when using gastrointestinal medications like PPIs and H2 blockers?

Decreased intestinal absorption of calcium Signup and view all the answers

What is a potential side effect of magnesium-based laxatives seen in renal patients?

Anal leakage Signup and view all the answers

Why is it important to separate the administration of antacids from stimulant laxatives?

Antacids can dissolve enteric coating too fast. Signup and view all the answers

What class of drug does loperamide belong to?

Anti-diarrheal Signup and view all the answers

What common side effect can result from using loperamide?

Drowsiness Signup and view all the answers

What should a patient do if they have not had a bowel movement after 12 hours of laxative use?

Seek medical attention if abdominal pain worsens. Signup and view all the answers

How do proton pump inhibitors (PPIs) generally function in the body?

They inhibit acid production in the stomach. Signup and view all the answers

Which of the following symptoms is commonly associated with GI side effects of medication?

Bloating Signup and view all the answers

Which of the following statements about stool softeners is incorrect?

They should be taken only when experiencing abdominal pain. Signup and view all the answers

What is the recommended timing for a client to take famotidine if they have GERD?

30-60 minutes before meals Signup and view all the answers

Which of the following statements about Proton Pump Inhibitors (PPIs) is correct?

PPIs have a delayed-release mechanism and should not be crushed. Signup and view all the answers

What symptom reported by the client may indicate liver impairment?

Dark urine Signup and view all the answers

What advice should a nurse give regarding alcohol consumption while taking famotidine?

Alcohol may worsen symptoms associated with the drug. Signup and view all the answers

What is the primary mechanism of action for Proton Pump Inhibitors?

They block the proton pump to reduce gastric acid production. Signup and view all the answers

Which PPI is commonly referred to as the 'purple pill'?

Esomeprazole Signup and view all the answers

What is a common side effect of gastrointestinal medications like PPIs?

Diarrhea Signup and view all the answers

What should patients be educated about regarding the administration of medications like famotidine?

It's important to take it consistently at scheduled times. Signup and view all the answers

What is the main use of Tums?

To neutralize hydrochloric acid Signup and view all the answers

Which reaction represents the chemical interaction of calcium carbonate with hydrochloric acid?

CaCO3 + 2HCl → CaCl2 + CO2 + H2O Signup and view all the answers

What should be monitored when using antacids, especially in heart failure patients?

Sodium levels Signup and view all the answers

Which of the following is a side effect of milk of magnesia?

Diarrhea Signup and view all the answers

What type of laxatives are effective for preventing constipation rather than treating existing constipation?

Bulk forming laxatives Signup and view all the answers

When should sucralfate or Pepto-Bismol be taken for optimum effect?

On an empty stomach Signup and view all the answers

What is a common combination used for balancing the effects of milk of magnesia?

Aluminum hydroxide and magnesium hydroxide Signup and view all the answers

What dose of Tums is considered the maximum to avoid potential cardiac issues?

7500 mg Signup and view all the answers

Study Notes

Mineral Oil Enema and Laxatives

Mineral oil enema is used to lubricate the pathway for stool passage.
Magnesium may accumulate, leading to anal leakage as a side effect, especially in renal patients.
Use caution when administering anything with excess sodium to heart failure patients.

Side Effects and Drug Interactions

Expected gastrointestinal side effects include bloating, gas, nausea, and stomach cramping.
A lack of bowel movement after 12 hours and increased abdominal pain may indicate an intestinal blockage, requiring immediate medical attention.
Antacids, H2 blockers, and PPIs can interact with stimulant laxatives.
Dairy and antacids can accelerate the dissolution of enteric coatings, so they should be taken separately.
Dulcolax has an enteric coating to prevent gastric irritation.

Anti-diarrheal Medication

Loperamide works by binding to mu-opioid receptors in the gut to slow peristalsis, allowing more time for water reabsorption, resulting in more formed stools.
Side effects of loperamide include dizziness and dry mouth. Diarrhea can worsen dehydration.
It can cause drowsiness; avoid combining with other CNS depressants like antihistamines.
Loperamide can cross the blood-brain barrier at higher doses, potentially causing opioid-like responses.

Gastroesophageal Reflux Disease (GERD) Treatment

Heartburn is a primary symptom; people often start with antacids like calcium carbonate (Tums).
For persistent symptoms, they may progress to aluminum hydroxide/magnesium hydroxide (Mylanta), H2 blockers, and finally PPIs, minimizing long-term PPI use.
H. pylori testing is not indicated for GERD treatment.

H2 Receptor Antagonists (H2RAs)

Common H2RAs include famotidine (Pepcid), ranitidine (Zantac), and cimetidine (Tagamet).
Famotidine is used OTC for heartburn; prescription doses treat ulcers.
Ranitidine was removed from the U.S. market due to carcinogenic concerns but returned as generic famotidine.
Cimetidine can also treat heartburn and should be used cautiously in the elderly due to confusing side effects.
Potential side effects include liver and kidney monitoring, as drugs can cross the blood-brain barrier.

Proton Pump Inhibitors (PPIs)

DPIs include omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), and lansoprazole (Prevacid).
Most preferably taken in delayed-release gel capsules, should not be crushed or split.
PPIs are more effective than H2RAs in blocking stomach acid but have a higher toxicity potential.

Constipation and Antacid Medications

Milk of magnesia (magnesium hydroxide) acts as both an antacid and laxative, effective against constipation but may also cause diarrhea.
Combination of magnesium hydroxide with aluminum hydroxide stabilizes effects between constipation and diarrhea.
Mylanta (aluminum hydroxide + magnesium hydroxide) needs monitoring for sodium levels, particularly in heart failure patients on sodium-restricted diets.

Other Information

Sucralfate and bismuth subsalicylate (Pepto-Bismol) coat the stomach and should be taken on an empty stomach for optimal effectiveness in treating ulcers or diarrhea.
Note the component in Pepto, a salicylate related to aspirin.
Laxatives should begin with basic fiber or stool softeners for prevention versus treatment of existing constipation.

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Description

This quiz explores the use of mineral oil enemas, their effectiveness, and potential side effects such as anal leakage and gastrointestinal issues. It also addresses caution in administering certain substances to renal and heart failure patients, highlighting important drug interactions. Test your knowledge on this crucial aspect of pharmacology.