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Questions and Answers
Which of the following conditions should be assessed in individuals before administering antacids?
Which of the following conditions should be assessed in individuals before administering antacids?
Antacids should be administered immediately before or after other medications.
Antacids should be administered immediately before or after other medications.
False
Name two examples of H2 antagonists.
Name two examples of H2 antagonists.
Ranitidine and famotidine
H2 antagonists reduce acid secretion from stimuli such as food, histamine, and _________.
H2 antagonists reduce acid secretion from stimuli such as food, histamine, and _________.
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Which of the following side effects may be caused by H2 antagonists?
Which of the following side effects may be caused by H2 antagonists?
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Match the following H2 antagonist medications with their characteristics:
Match the following H2 antagonist medications with their characteristics:
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Individuals using H2 antagonists can safely consume alcohol and spicy foods.
Individuals using H2 antagonists can safely consume alcohol and spicy foods.
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What is the recommended administration method for dispersible tablets of H2 antagonists?
What is the recommended administration method for dispersible tablets of H2 antagonists?
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What is the primary action of proton pump inhibitors (PPIs)?
What is the primary action of proton pump inhibitors (PPIs)?
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Proton pump inhibitors are used to treat both duodenal ulcers and gastroesophageal reflux disease.
Proton pump inhibitors are used to treat both duodenal ulcers and gastroesophageal reflux disease.
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Name one side effect of proton pump inhibitors.
Name one side effect of proton pump inhibitors.
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Proton pump inhibitors should be swallowed whole with _____ and should not be chewed or crushed.
Proton pump inhibitors should be swallowed whole with _____ and should not be chewed or crushed.
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Which medication is NOT an example of a proton pump inhibitor?
Which medication is NOT an example of a proton pump inhibitor?
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Match the following uses of antiemetics with their causes:
Match the following uses of antiemetics with their causes:
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Antiemetics primarily stimulate gastric emptying to alleviate nausea.
Antiemetics primarily stimulate gastric emptying to alleviate nausea.
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What should individuals be advised against doing if they experience dizziness while taking PPIs?
What should individuals be advised against doing if they experience dizziness while taking PPIs?
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What is the primary indication for the use of antiemetics?
What is the primary indication for the use of antiemetics?
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Antiemetics can be administered via oral, intramuscular, or intravenous routes only.
Antiemetics can be administered via oral, intramuscular, or intravenous routes only.
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Name one common side effect of antiemetics.
Name one common side effect of antiemetics.
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One of the medications used as an antiemetic is __________.
One of the medications used as an antiemetic is __________.
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Match the antiemetic with its potential side effect:
Match the antiemetic with its potential side effect:
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Which of the following statements is true regarding the use of antiemetics?
Which of the following statements is true regarding the use of antiemetics?
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Individuals are advised to drive or operate machinery after using antiemetics due to the risk of dizziness.
Individuals are advised to drive or operate machinery after using antiemetics due to the risk of dizziness.
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What must be monitored when administering antiemetics?
What must be monitored when administering antiemetics?
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Which of the following is NOT a common side effect of emollient laxatives?
Which of the following is NOT a common side effect of emollient laxatives?
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Individuals should take laxatives if they are experiencing nausea.
Individuals should take laxatives if they are experiencing nausea.
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What should be encouraged as an alternative to laxative use?
What should be encouraged as an alternative to laxative use?
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Long-term use of laxatives may lead to decreased bowel ________.
Long-term use of laxatives may lead to decreased bowel ________.
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Match the following emollient laxatives with their examples:
Match the following emollient laxatives with their examples:
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Which of the following is an example of an adsorbent used as an antidiarrheal agent?
Which of the following is an example of an adsorbent used as an antidiarrheal agent?
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Antidiarrheal agents are used primarily to treat chronic diarrhea.
Antidiarrheal agents are used primarily to treat chronic diarrhea.
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What is one common side effect of adsorbents used for treating diarrhea?
What is one common side effect of adsorbents used for treating diarrhea?
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Antidiarrheal adsorbents work by coating the intestinal mucosa and _____ the causative bacteria or toxins.
Antidiarrheal adsorbents work by coating the intestinal mucosa and _____ the causative bacteria or toxins.
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Match the following antidiarrheal agents with their respective categories:
Match the following antidiarrheal agents with their respective categories:
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What is the primary action of anticholinergics in the treatment of diarrhea?
What is the primary action of anticholinergics in the treatment of diarrhea?
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Adsorbents can cause increased absorption of anticoagulants.
Adsorbents can cause increased absorption of anticoagulants.
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Name one condition that can cause chronic diarrhea.
Name one condition that can cause chronic diarrhea.
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What is the primary action of Lactobacillus bacterial cultures in antidiarrheals?
What is the primary action of Lactobacillus bacterial cultures in antidiarrheals?
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Antidiarrheals can improve hydration by decreasing the transit time through the bowel.
Antidiarrheals can improve hydration by decreasing the transit time through the bowel.
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Name one example of an opiate used in antidiarrheals.
Name one example of an opiate used in antidiarrheals.
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Lactobacillus acidophilus is an example of a __________ used in antidiarrheal treatment.
Lactobacillus acidophilus is an example of a __________ used in antidiarrheal treatment.
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Match the types of antidiarrheals with their actions:
Match the types of antidiarrheals with their actions:
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What is a known side effect of using opiates as antidiarrheals?
What is a known side effect of using opiates as antidiarrheals?
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Antidiarrheals should not be administered if symptoms persist longer than 72 hours.
Antidiarrheals should not be administered if symptoms persist longer than 72 hours.
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What are laxatives commonly used for?
What are laxatives commonly used for?
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Study Notes
Pharmacology: Drugs Affecting the Gastrointestinal System
- The presentation covers medications affecting the gastrointestinal system (GIT), specifically focusing on common GIT medications, including antacids, H2 antagonists, proton pump inhibitors (PPIs), and antiemetics.
- The GIT is divided into upper and lower sections.
- Understanding drug action, indications, side effects, precautions, and nursing considerations is a focus.
- Common medical/surgical problems related to the GIT are reviewed.
Upper Gastrointestinal Medications
- Antacids are the most common upper GIT medications. They neutralize stomach acid.
- Other upper GIT medications include anticholinergics, antihistamines, and antidepressants. These sometimes treat gastric dysfunction.
Antacids
- Acid-related diseases result from imbalances in gastric glands.
- Hyperacidity is the most common imbalance.
- Peptic ulcer disease is a severe acid-related condition.
- Antacids contain aluminum hydroxide, calcium carbonate, magnesium salts, and sodium bicarbonate.
- Actions: promote gastric mucosal defense (buffer); increase gastric pH, thus increasing emptying rate; promote secretion of mucus for protection against hydrochloric acid; promote bicarbonate and prostaglandins to buffer acid and prevent proton-pump activation.
- Indications: acid-related disorders (e.g., hyperacidity, peptic ulcer, gastroesophageal reflux disease); heartburn, indigestion, nervous dyspepsia; relieving pain from non-steroidal anti-inflammatory drugs (NSAIDs)
- Examples include aluminum salts (AlternaGEL), calcium salts (Oystercal, Tums), magaldrate (Losopan, Riopan), magnesium salts (Milk of Magnesia), and sodium bicarbonate (Bell-ans).
- Side effects: constipation, phosphate depletion, fecal impaction, chalky taste/intestinal obstruction, belching, flatulence; hypercalcemia, alkalosis, gastrointestinal irritation, renal calculi; diarrhea, chalky taste, belching, elevated magnesium levels; belching, abdominal distension, systemic alkalosis, hyperventilation, hypokalemia.
- Precautions: reduce absorption of other medications, especially tetracyclines; use with caution due to potential interactions with other medications; can cause early dissolving of enteric-coated medications, causing stomach upset.
- Nursing considerations: assess allergies and pre-existing conditions (renal disease, fluid imbalance); administer 2 hours before or after other medications; ensure tablets are chewed thoroughly; administer with sufficient water (240mL or more) for optimal absorption; monitor for side effects (nausea, vomiting, abdominal pain, diarrhea, constipation); monitor for therapeutic effect; protect liquid forms from light.
H2 Antagonists
- Actions: reduce acid secretion from stimuli such as food, histamine, and caffeine; block histamine receptors in acid-producing parietal cells; decrease hydrochloric acid production.
- Indications: maintenance treatment of gastric/duodenal ulcers, dyspepsia, gastroesophageal reflux disease, upper GIT bleeding.
- Examples: ranitidine, famotidine, cimetidine.
- Side effects: headache, constipation, nausea, diarrhea, rash, dizziness, flatulence, musculoskeletal pain, depending on medication chosen.
- Precautions: avoid alcohol, spicy foods, smoking; avoid taking with antacids (separate by at least two hours); dispersible tablets should be dissolved in water before swallowing; ensure IV solutions are administered slowly ;protect tablets from light.
- Nursing considerations: assess allergies; monitor for medication interactions, especially taking with antacids (separate time by 2 hours at least); administer with water; ensure proper administration; protect tablets from light.
Proton Pump Inhibitors (PPIs)
- Actions: reduce gastric acid production by blocking the proton pump in parietal cells; inhibit basal and stimulated gastric acid secretion.
- Indications: treatment of duodenal ulcer, benign gastric acid reflux, esophagitis, gastrinoma, Helicobacter pylori-induced ulcers; maintenance therapy for gastroesophageal reflux disease.
- Examples: omeprazole, pantoprazole, esomeprazole.
- Side effects: rash, urticaria, alopecia, arthralgia, muscle weakness, headache, dizziness, insomnia, abdominal pain, diarrhea, depending on chosen medication.
- Precautions: advise patient not to drive or operate machinery if dizziness occurs.
- Nursing considerations: capsules, tablets, and pellets should be swallowed whole with water; powder should be protected from light; monitor for side effects.
Anti-Emetics
- Nausea and vomiting are often responses to remove harmful substances from the body (before absorption).
- Actions: act on various body systems (GIT, semi-circular canals, vomiting centre in the brain); often prokinetic agents; stimulate peristalsis to increase gastric emptying; reduce impulses to vomiting centre.
- Indications: relieve nausea/vomiting caused by cytotoxic chemotherapy, gastroesophageal reflux, vertigo, post-operative period.
- Examples: dolasetron, ondansetron, domperidone, prochlorperazine, metoclopramide.
- Side effects: depends on medication; can include oculogyric crisis, headache, dizziness, drowsiness, diarrhoea, constipation, pain, pruritis, insomnia, gastroesophageal reflux, hyperkalemia, extrapyramidal reactions.
- Precautions: avoid alcohol, spicy foods, smoking, caffeine; hypotension may occur, especially with the elderly; patient should be warned not to drive/operate machinery due to possible drowsiness.
- Nursing considerations: do not administer until underlying cause determined; monitor vitals; metoclopramide is compatible with morphine/pethidine; protect medication from light; slow administration of IV; avoid co-administering with antacids (separate by 2 hours).
Lower Gastrointestinal Medications
- Medications used to treat the lower GIT are focused on conditions such as diarrhea, constipation, and impaired digestion.
- These medications include antidiarrheals (adsorbents, anticholinergics, intestinal flora modifiers, opiates), and laxatives (bulk-forming, stimulants, saline or osmotic, emollients).
Antidiarrheals
- Actions vary depending on the type (e.g., adsorbents coat the intestinal mucosa, anticholinergics decrease peristalsis).
- Indications: diarrhea relief, prevention of fluid/electrolyte loss, chronic diarrhea due to conditions such as tumors or irritable bowel syndrome.
- Examples: loperamide (adsorbent), hyoscine N-butylbromide (anticholinergic), Lactobacillus acidophilus (flora modifier), codeine phosphate (opiate).
- Precautions: avoid if pregnant or breastfeeding.
- Nursing considerations: assess individual history (bowel habits, dietary changes, allergies); use adsorbents cautiously with patients with bleeding disorders; avoid administering anticholinergics to patients with glaucoma, urinary retention, or cardiac problems; monitor fluid balance/hydration status; monitor symptoms.
Laxatives
- Types include bulk forming, stimulants, saline/osmotic, emollients.
- Bulk forming actions/indications: increase volume of feces by absorbing water; used in constipation, hemorrhoids, bowel preparation, and acute diarrhea
- Stimulants actions/indications: increase peristalsis; used in acute/chronic constipation, bowel preparation
- Saline/osmotic actions/indications: increase osmotic pressure in bowels, induce diarrhea; used in constipation, diagnostic bowel prep, parasite removal
- Emollients actions/indications: act as stool softeners, increase water/fat in stools, lubricate stool; used for acute/chronic constipation, painful anorectal disorders.
- Examples: psyllium, sterculia, ispaghula (bulk-forming); bisacodyl, glycerol (stimulants); lactulose, sodium phosphate (saline/osmotic); docusate sodium, poloxamer (emollients).
- Side effects can vary based on the type of laxative and the amount taken (e.g., nausea, flatulence, abdominal cramps, constipation).
- Nursing considerations of laxatives include thorough history taking from patient, assessing fluid/electrolyte balance before initiating therapy; patients taking laxatives should be encouraged to consume plenty of water, especially with bulk forming.
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Description
This quiz focuses on pharmacological agents that impact the gastrointestinal system, including antacids, H2 antagonists, and proton pump inhibitors. It covers their actions, indications, side effects, and relevant nursing considerations. Deepen your understanding of upper gastrointestinal medications and their applications in clinical practice.
