Respiratory Drugs Explained - PDF

Here's an explanation for the listed **respiratory drugs** with key points and simplified reasoning for better understanding and retention. **Drugs for Upper Respiratory Tract Conditions** 1. **Antihistamines** (Treat Allergies): - **First-generation (Sedating)**: **Chlorphenamine,...

Here's an explanation for the listed **respiratory drugs** with key points and simplified reasoning for better understanding and retention. **Drugs for Upper Respiratory Tract Conditions** 1. **Antihistamines** (Treat Allergies): - **First-generation (Sedating)**: **Chlorphenamine, Diphenhydramine** - Cross the blood-brain barrier → Cause drowsiness. - Used for runny nose, sneezing, and allergic reactions. - **Second-generation (Non-Sedating)**: **Claritin, Cetirizine** - Do not cross the blood-brain barrier → Less likely to cause drowsiness. - Preferred for daytime allergy relief. **Mnemonic**: - **First-gen**: \"Drowsy Diphenhydramine Dreams.\" - **Second-gen**: \"Clear with Claritin.\" 2. **Drugs for Common Colds** (Nasal Decongestion): - **Phenylephrine**: Constricts blood vessels in nasal passages → Reduces swelling and congestion. - Caution: Prolonged use may cause rebound congestion (rhinitis medicamentosa). **Mnemonic**: **\"Phenylephrine Fights Flared Nostrils.\"** 3. **Cough Drugs**: - **Expectorants (Thin mucus)**: **Guaifenesin** - Loosens mucus, making it easier to cough up. - **Antitussives (Cough Suppressants)**: - **Non-narcotic**: **Dextromethorphan, Butamirate** → Suppress cough reflex without addiction. - **Narcotic**: **Codeine** → Stronger but risk of dependency. - **Mucolytics (Break down mucus)**: **Carbocisteine, Ambroxol, Bromhexine** - Dissolve mucus → Easier to expel. **Mnemonic**: - **Cough relief tools: GEM** → Guaifenesin (expectorant), Expectoration (mucolytics), Mute coughs (antitussives). **Drugs for Lower Respiratory Tract Conditions** 1. **Bronchodilators** (Relieve Airway Constriction): - **Xanthine Derivatives**: **Aminophylline (theophylline derivative)** - **Therapeutic range**: 10--20 mcg/mL. - **Signs of toxicity**: - Nausea (\>20 mcg/mL). - Tremor (\>35 mcg/mL). - **Sympathomimetic Bronchodilators**: - **Short-acting (SABA)**: **Albuterol** → Rapid relief (onset: 20 min, lasts 4-6 hrs). - **Long-acting (LABA)**: **Terbutaline** → Preventative (lasts 12 hrs). - **Anticholinergic Bronchodilators**: **Ipratropium Bromide** - Reduces airway constriction by blocking parasympathetic signals. **Mnemonic**: **\"X, S, A for Airways\"** → Xanthine, Sympathomimetic, Anticholinergic. 2. **Steroids** (Control Inflammation): - **Examples**: Beclomethasone, Hydrocortisone, Prednisone. - **Key Considerations**: - Use **bronchodilators first**, then steroids (to open airways for steroid absorption). - Rinse mouth after inhalation (to prevent oral thrush). - Never abruptly stop steroids → Always taper off. **Mnemonic**: **\"Rinse, Don't Rush with Steroids.\"** **Anti-Asthma Drugs** 1. **Leukotriene Receptor Antagonists**: **Montelukast** - Reduces inflammation and airway constriction caused by leukotrienes. - Used for long-term asthma control. 2. **Mast Cell Stabilizers**: **Cromolyn Sodium** - Prevent histamine release from mast cells. - Used as a preventative measure in asthma. **Mnemonic**: **\"Montelukast & Mast Cell Stabilizers Manage Asthma.\"** **Nursing Considerations for Respiratory Drugs** - Teach **breathing and coughing techniques** to clear secretions. - Encourage **hydration** (8+ glasses/day) to loosen mucus. - **Positioning**: Upright for easier breathing. - Monitor **vital signs** (BP and HR, especially with bronchodilators). - Encourage **smoking cessation** to improve drug effectiveness. **Quick Memory Tips** 1. **ABCD for Bronchodilators**: - **A**: Aminophylline (Xanthine). - **B**: Bronchodilators (SABA/LABA, Anticholinergic). - **C**: Corticosteroids. - **D**: Drugs for cough (Expectorants/Antitussives). 2. **PEMM for Mucus Management**: - **P**: Phenylephrine (Decongestant). - **E**: Expectorants (Guaifenesin). - **M**: Mucolytics (Carbocisteine). - **M**: Mast cell stabilizers (Cromolyn Sodium). 3. **Steroids Reminder**: - **\"Rinse, Don't Rush, Taper Gradually.\"** Let me know if you'd like any additional clarifications or a detailed explanation of specific drugs! Here's a detailed and structured breakdown of **all the drugs mentioned in the document**, grouped by their classification. Each section includes a **mnemonic** for easier memorization. **Antihypertensive Drugs** **1. ACE Inhibitors (...pril)** - **Drugs**: Captopril, Enalapril, Lisinopril, Perindopril. - **Pharmacodynamics**: Blocks conversion of Angiotensin I to Angiotensin II → ↓ BP, ↓ Aldosterone. - **Indications**: Hypertension, heart failure, diabetic nephropathy, post-MI. - **Nursing Considerations**: Monitor BP, potassium, and kidney function; administer on an empty stomach. **Mnemonic**:\ **\"ACE stops A Conversion Effortlessly.\"** **2. Angiotensin II Receptor Blockers (ARBs) (...sartan)** - **Drugs**: Losartan, Valsartan, Irbesartan, Candesartan. - **Pharmacodynamics**: Blocks Angiotensin II receptors → Prevents vasoconstriction and aldosterone release. - **Indications**: Hypertension, diabetic nephropathy. - **Nursing Considerations**: Monitor BP, ensure contraception (teratogenic). **Mnemonic**:\ **\"ARBs Avoid Receptor Binding for BP control.\"** **3. Calcium Channel Blockers (CCB)** - **Drugs**: Amlodipine, Diltiazem, Nifedipine, Verapamil, Felodipine, Nicardipine. - **Pharmacodynamics**: Blocks calcium ion movement → Vasodilation, ↓ Myocardial oxygen demand. - **Indications**: Hypertension, angina. - **Nursing Considerations**: Avoid grapefruit juice, monitor BP and heart block symptoms. **Mnemonic**:\ **\"Calcium Blocks Contractions for BP control.\"** **4. Beta Blockers (...olol)** - **Drugs**: Metoprolol, Atenolol, Propranolol, Bisoprolol, Acebutolol. - **Pharmacodynamics**: Block beta-adrenergic receptors → ↓ Heart rate, ↓ Cardiac workload, ↓ BP. - **Indications**: Hypertension, angina, heart failure, post-MI, migraine prophylaxis. - **Nursing Considerations**: Monitor HR and BP, avoid in bradycardia, caution in diabetes. **Mnemonic**:\ **\"Beta Breaks Beats.\"** **5. Vasodilators** - **Drugs**: Nitroprusside, Hydralazine, Minoxidil. - **Pharmacodynamics**: Direct action on vascular smooth muscle → Vasodilation, ↓ BP. - **Indications**: Severe hypertension, acute heart failure. - **Nursing Considerations**: Monitor BP, watch for reflex tachycardia, ensure safety from hypotension. **Mnemonic**:\ **\"Vasodilators Vastly Open Vessels.\"** **6. Diuretics** - **Drugs**: Hydrochlorothiazide, Indapamide, Amiloride, Spironolactone. - **Pharmacodynamics**: Increase sodium and water excretion → ↓ Blood volume → ↓ BP. - **Indications**: Hypertension, edema. - **Nursing Considerations**: Monitor electrolytes, dehydration, and BP. **Mnemonic**:\ **\"Diuretics Drain Fluids.\"** **7. Renin Inhibitor** - **Drug**: Aliskiren. - **Pharmacodynamics**: Inhibits renin → ↓ Angiotensin I production → ↓ BP. - **Indications**: Hypertension. - **Nursing Considerations**: Avoid during pregnancy, monitor potassium. **Mnemonic**:\ **\"Renin Reduced = Lowered BP.\"** **Anti-Angina Drugs** **1. Nitrates** - **Drugs**: Nitroglycerin, Isosorbide dinitrate, Isosorbide mononitrate. - **Pharmacodynamics**: Relax vascular smooth muscle → ↓ Myocardial oxygen demand. - **Indications**: Acute angina, angina prophylaxis. - **Nursing Considerations**: Monitor for hypotension, teach sublingual use, protect medication from light. **Mnemonic**:\ **\"Nitrates Need Rapid Relief.\"** **2. Beta-Blockers (see above)** - Reduce myocardial oxygen demand by slowing HR and contractility. **3. Calcium Channel Blockers (see above)** - Relieve vasospasm and improve oxygen supply. **4. Piperazineacetamide** - **Drug**: Ranolazine. - **Pharmacodynamics**: Decreases myocardial workload (exact mechanism unknown). - **Indications**: Chronic angina. - **Nursing Considerations**: Avoid grapefruit, monitor QT interval. **Mnemonic**:\ **\"Ranolazine Relieves with Reduced Workload.\"** **Antiarrhythmic Drugs** **1. Class I (Sodium Channel Blockers)** - **Drugs**: Lidocaine, Procainamide, Quinidine, Flecainide. - **Pharmacodynamics**: Block sodium channels → ↓ Depolarization and automaticity. - **Indications**: Ventricular arrhythmias. - **Nursing Considerations**: Monitor ECG, ensure life support is available. **Mnemonic**:\ **\"Class I Slows Sodium Signals.\"** **2. Class II (Beta-Blockers)** - Control arrhythmias by reducing sympathetic stimulation. **3. Class III (Potassium Channel Blockers)** - **Drug**: Amiodarone. - **Pharmacodynamics**: Prolong repolarization → ↓ Arrhythmias. - **Indications**: Life-threatening arrhythmias. - **Nursing Considerations**: Monitor for pulmonary and hepatic toxicity. **Mnemonic**:\ **\"Amiodarone Adds Duration to Repolarization.\"** **4. Class IV (Calcium Channel Blockers)** - **Drugs**: Diltiazem, Verapamil. - **Pharmacodynamics**: Block calcium channels → Slow conduction and prolong repolarization. - **Indications**: Atrial fibrillation, supraventricular tachycardia. **Heart Failure Drugs** **1. Cardiac Glycosides** - **Drug**: Digoxin. - **Pharmacodynamics**: ↑ Intracellular calcium → ↑ Contractility, ↓ HR. - **Indications**: Heart failure, arrhythmias. - **Nursing Considerations**: Monitor apical pulse, therapeutic level (0.5--2 ng/mL). **Mnemonic**:\ **\"Digoxin Digs In for Better Contractions.\"** **2. Phosphodiesterase Inhibitors** - **Drug**: Milrinone. - **Pharmacodynamics**: ↑ cAMP → ↑ Calcium → Stronger contractions. - **Indications**: Short-term heart failure management. - **Nursing Considerations**: Monitor platelets, BP, and IV site. **Mnemonic**:\ **\"Milrinone Makes Muscles Contract.\"** This breakdown can serve as a foundation for detailed flashcards or review sheets. Let me know if you\'d like a specific format or a focus on a particular class! TERMS USED: 1. Gastrin What it is: A hormone secreted by gastric cells. Function: Stimulates the production of gastric juice (stomach acid). Key point to remember: Gastrin = Gastric juice production. 2. Histamine 2 Receptors What it is: Receptors found in parietal cells (cells in the stomach lining). Function: Bind to histamine and stimulate acid production in the stomach. Key point to remember: H2 Receptors = Histamine = Stomach acid. 3. Local Gastric Reflexes What it is: Nervous plexuses in the walls of the GI tract (GIT). Function: Generate impulses that lead to peristalsis (the contraction and movement of food through the digestive tract). Key point to remember: Local gastric reflexes = Peristalsis = GI movement. 4. Nervous Plexus What it is: A network of nerves innervated by the autonomic nervous system. Function: Parasympathetic stimulation promotes activity (e.g., digestion), while sympathetic stimulation inhibits activity (e.g., slows digestion). Key point to remember: Nervous plexus = Parasympathetic = stimulates, Sympathetic = inhibits. 5. Peristalsis What it is: The process of smooth muscle contractions in the gastrointestinal wall. Function: Mixes and propels food through the GI tract. Key point to remember: Peristalsis = Movement of food through the GI tract. 6. Putrefaction What it is: A process where bacteria in the colon break down fecal material. Result: Produces gases (e.g., methane, hydrogen). Key point to remember: Putrefaction = Bacteria break down feces = Gases produced. 7. Vomiting What it is: A complex reflex triggered by various stimuli. Function: Causes regurgitation (expulsion) of ingested food from the stomach. Key point to remember: Vomiting = Reflex = Food regurgitation. Digestive System Breakdown 1. Gastrointestinal Tract (GIT) Upper GIT: ○ Mouth → Small Intestine ○ Function: Digestion of carbohydrates (salivary amylase) and protein (activation by HCl for pepsin). No fat digestion. Lower GIT: ○ Large Intestine → Anus ○ Function: No digestion, but absorbs water, synthesizes Vitamin K, and performs putrefaction (microbial breakdown of fecal material). 2. Accessory Organs Liver: Produces bile. Pancreas: Releases digestive enzymes. Salivary Glands: Secrete amylase for carbohydrate digestion. Gall Bladder: Stores and concentrates bile. Digestive Process Carbs: Begin digestion in the mouth with amylase. Proteins: Start digestion in the stomach with pepsin. Fats: Emulsified in the small intestine by bile (from gall bladder) and further digested with pancreatic enzymes. Reflexes Gastroenteric Reflex: Stretching of the stomach → stimulates intestines. Gastrocolic Reflex: Stretching of the stomach → stimulates colon. Duodenal-colic Reflex: Chyme in duodenum → stimulates peristalsis in colon. Nervous Control Parasympathetic: Stimulates GI function (digestion, movement). Sympathetic: Inhibits GI function. Centrally Mediated Reflexes: Swallowing and vomiting. Key Reflexes 1. Swallowing: ○ Voluntary Phase: Bolus pushed to the back of the tongue. ○ Involuntary Phases: Peristalsis in the pharynx and esophagus. 2. Vomiting: ○ Triggered by the CTZ (chemoreceptor trigger zone) in the medulla. ○ Common causes: Overstimulation of the throat, abdominal inflammation, or drugs (like chemotherapy). 1. Digestive System Overview: The digestive system consists of: Gastrointestinal Tract (GIT): A long tube that runs from the mouth to the anus, divided into: ○ Upper GIT: Includes the mouth, esophagus, stomach, and the first part of the small intestine (duodenum). This section is responsible for the initial phases of digestion. ○ Lower GIT: Includes the large intestine and anus. It\'s mainly responsible for water absorption and defecation. Accessory Organs: These include the liver, pancreas, gall bladder, and salivary glands, all of which contribute to the digestion process through secretions like bile and digestive enzymes. 2. Digestion Process: Carbohydrates: Digestion begins in the mouth with the enzyme salivary amylase, which breaks down starch. There's no protein or fat digestion in the mouth. Proteins: Protein digestion starts in the stomach with the enzyme pepsin, activated by hydrochloric acid (HCl). The stomach does not digest carbs or fats. Fats: Digestion of fats starts and finishes in the small intestine, aided by bile (from the gall bladder) and pancreatic enzymes. Large Intestine: While digestion stops in the large intestine, it plays a crucial role in water reabsorption, vitamin K synthesis, and the breakdown of undigested materials by bacteria. 3. Nervous System Regulation: The autonomic nervous system regulates the digestive system. ○ Parasympathetic stimulation promotes GI activity (e.g., peristalsis, secretion). ○ Sympathetic stimulation inhibits GI activity. Local Reflexes: Include gastroenteric, gastrocolic, and duodenal-colic reflexes, which regulate motility and secretions based on the stretch or presence of food. Central Reflexes: Swallowing (voluntary and involuntary phases) and vomiting (triggered by the chemoreceptor trigger zone). 4. Drugs Affecting GIT Function: Drugs for Gastric Acid Secretion Disorders: H2 Receptor Antagonists (e.g., Ranitidine, Cimetidine, Famotidine): These drugs reduce stomach acid production by blocking histamine receptors on parietal cells. ○ Nursing Considerations: Administer before meals or at bedtime, monitor for liver toxicity, and educate patients on side effects like diarrhea or constipation. Proton Pump Inhibitors (PPIs) (e.g., Omeprazole, Pantoprazole): These block the enzyme that produces stomach acid and are the drugs of choice for PUD and GERD. ○ Nursing Considerations: Administer before meals, avoid crushing tablets, and monitor for CNS and GI side effects. Antacids (e.g., Magnesium Aluminum Hydroxide, Calcium Salts): Neutralize stomach acid and relieve heartburn but do not treat the underlying causes of acid-related conditions. ○ Nursing Considerations: Administer 1-2 hours after meals, caution with other medications (e.g., tetracyclines), and monitor for acid-base imbalances. Anti-peptic Drugs (e.g., Sucralfate): Protect the stomach lining to prevent further irritation. ○ Nursing Considerations: Administer 1 hour before meals, avoid concurrent use with antacids. Drugs for Constipation: Laxatives are classified into several types: 1. Chemical laxatives (e.g., Bisacodyl, Senna) that stimulate peristalsis. 2. Bulk-forming laxatives (e.g., Psyllium) that absorb water to increase stool bulk. 3. Lubricant laxatives (e.g., Docusate) that soften the stool. ○ Nursing Considerations: Monitor for diarrhea, dehydration, and electrolyte imbalances. Teach patients to increase fluid intake to prevent constipation. Drugs for Diarrhea: Anti-diarrheal Drugs (e.g., Loperamide, Bismuth subsalicylate): ○ Loperamide reduces peristalsis, slowing down bowel movements. ○ Bismuth subsalicylate coats and protects the gastrointestinal lining. ○ Opium derivatives (e.g., Diphenoxylate with atropine) block nerve impulses, but carry the risk of addiction. ○ Nursing Considerations: Monitor for constipation, abdominal discomfort, and fluid replacement to prevent dehydration. Drugs for Vomiting (Anti-emetics): Phenothiazines (e.g., Prochlorperazine, Promethazine) suppress the vomiting center. Non-phenothiazine (e.g., Metoclopramide) reduce sensitivity in the CTZ. 5-HT3 Receptor Blockers (e.g., Ondansetron) block serotonin receptors to reduce nausea and vomiting. ○ Nursing Considerations: Monitor for CNS effects like dizziness or drowsiness, and provide comfort measures. Ensure fluid and electrolyte balance. 5. General Nursing Considerations for GI Drugs: For most GI drugs, nursing considerations include: ○ Administering medications at the right time (e.g., before meals, at bedtime). ○ Monitoring for adverse effects like GI disturbances (nausea, diarrhea, constipation), CNS effects (drowsiness, dizziness), and electrolyte imbalances. ○ Providing education on proper medication usage and possible side effects to improve patient compliance and understanding. Key Points: Digestion involves a complex interplay of enzymes, bile, and muscle movements across different sections of the GIT. Drugs for GI conditions typically aim to either neutralize stomach acid, protect the stomach lining, or alter motility (e.g., with laxatives or anti-diarrheals). Nursing interventions for GI disorders include administering drugs properly, monitoring for side effects, ensuring hydration, and providing education for better patient compliance. Drugs Affecting the GIT 1. Drugs for Gastrointestinal Secretions Histamine 2 Receptor Antagonists (e.g., Ranitidine, Cimetidine) § Action: Block histamine receptors → reduce HCl secretion. § Side effects: Diarrhea/constipation, dizziness, insomnia. ○ Proton Pump Inhibitors (PPI) (e.g., Omeprazole, Esomeprazole) □ Action: Block H+/K+ ATPase → decrease acid production. □ Side effects: Dizziness, GI effects, respiratory symptoms. ○ Antacids (e.g., Magnesium hydroxide, Calcium salts) □ Action: Neutralize stomach acid. □ Side effects: Electrolyte imbalances, constipation or diarrhea. ○ Anti-peptic drugs (e.g., Sucralfate) □ Action: Coat stomach lining to protect from acid. □ Side effects: Constipation, dizziness. 2. Laxatives and Anti-diarrheal Drugs ○ Laxatives: □ Chemical (e.g., Bisacodyl) - Stimulate peristalsis. □ Bulk-forming (e.g., Psyllium) - Increase stool bulk. □ Lubricant (e.g., Docusate) - Soften stool. ○ Anti-diarrheals: □ Bismuth subsalicylate: Coats mucosa to reduce irritation. □ Loperamide: Decreases peristalsis in the colon. □ Opium derivatives: Block nerve impulses, reduce peristalsis. 3. Anti-emetics (used to prevent vomiting) ○ Phenothiazines (e.g., Prochlorperazine): Suppress vomiting center in the brain. ○ Nonphenothiazines (e.g., Metoclopramide): Block CTZ response. ○ Anticholinergics/Antihistamines (e.g., Meclizine): Block signals to the CTZ (good for vertigo-induced vomiting). ○ 5-HT3 Receptor Blockers (e.g., Ondansetron): Block nausea signals from the gut and brain. ○ Substance P/Neurokinin 1 Receptor Antagonists (e.g., Aprepitant): Block nausea and vomiting receptors in the CNS. General Nursing Considerations for GIT Drugs ○ Monitor for side effects like GI discomfort, CNS effects (dizziness, drowsiness), and fluid/electrolyte imbalances. ○ Administer on time: Some drugs should be taken before meals or at bedtime for maximum effectiveness. ○ Patient education: Teach patients about drug actions, side effects, and interactions to enhance compliance. Quick Recap of Key Points 1. Upper GIT: Mouth → Small Intestine (digestion). 2. Lower GIT: Large Intestine → Anus (no digestion, water absorption). 3. Key Enzymes: Amylase (mouth), Pepsin/Trypsin (stomach), Bile/Pancreatic enzymes (small intestine). 4. Reflexes: Gastroenteric, Gastrocolic, Duodenal-colic (coordinate movement). 5. Autonomic control: Parasympathetic = stimulate, Sympathetic = inhibit. 6. Vomiting trigger: CTZ in the brain responds to irritants. 7. Drugs: Antacids, PPIs, H2 blockers, laxatives, anti-diarrheals, and anti-emetics, all have distinct mechanisms and side effects. 1. Drugs for Gastrointestinal Secretions Antacids (e.g., Magnesium hydroxide, Calcium salts): ○ Action: Neutralize stomach acid. ○ Indications: GERD, heartburn, gastritis. ○ Side Effects: Electrolyte imbalances, constipation or diarrhea. ○ Nursing Considerations: Avoid in renal failure, monitor for electrolyte imbalances. ○ Histamine 2 Receptor Antagonists (H2 Blockers) (e.g., Ranitidine, Cimetidine): § Action: Block histamine receptors → reduce HCl secretion. § Indications: GERD, peptic ulcers, Zollinger-Ellison syndrome. § Side Effects: Diarrhea/constipation, dizziness, insomnia. § Nursing Considerations: Monitor for confusion in elderly, drug interactions (e.g., with warfarin or theophylline). ○ Proton Pump Inhibitors (PPIs) (e.g., Omeprazole, Pantoprazole, Esomeprazole): § Action: Block H+/K+ ATPase → reduce acid production. § Indications: Peptic ulcers, GERD, Zollinger-Ellison syndrome. § Side Effects: Dizziness, GI effects (nausea, diarrhea), respiratory symptoms (cough, sinusitis). § Nursing Considerations: Take before meals for optimal effect; long-term use may increase risk of fractures and infections (e.g., C. difficile). ○ Anti-peptic Drugs (e.g., Sucralfate, Bismuth subsalicylate): § Action: Coats the stomach lining, protects from acid and irritation. § Indications: Peptic ulcers, gastritis. § Side Effects: Constipation, dizziness. § Nursing Considerations: Administer on an empty stomach for maximum effectiveness; take with caution in renal impairment (sucralfate). 2. Laxatives and Anti-diarrheal Drugs Laxatives: ○ Chemical Laxatives (e.g., Bisacodyl): □ Action: Stimulate peristalsis in the bowel. □ Indications: Acute constipation. □ Side Effects: Cramping, dehydration. □ Nursing Considerations: Avoid long-term use to prevent dependence. ○ Bulk-forming Laxatives (e.g., Psyllium): § Action: Increase stool bulk, absorb water to soften stool. § Indications: Chronic constipation, IBS. § Side Effects: Bloating, gas. § Nursing Considerations: Must be taken with plenty of fluids to avoid impaction. ○ Osmotic Laxatives (e.g., Lactulose, Polyethylene glycol): § Action: Draws water into the colon to soften stool. § Indications: Chronic constipation, hepatic encephalopathy (lactulose). § Side Effects: Dehydration, abdominal cramps, bloating. § Nursing Considerations: Monitor electrolytes and hydration status. ○ Stool Softeners (e.g., Docusate sodium): § Action: Softens stool by drawing water into the stool mass. § Indications: Prevent constipation, particularly after surgery. § Side Effects: Mild cramping, diarrhea. § Nursing Considerations: Ensure adequate fluid intake to enhance efficacy. ○ Anti-Diarrheals: § Loperamide: □ Action: Reduces bowel motility and fluid secretion. □ Indications: Acute diarrhea, chronic diarrhea (e.g., IBS). □ Side Effects: Constipation, abdominal distention. □ Nursing Considerations: Avoid use in infectious diarrhea (e.g., C. difficile), monitor for signs of dehydration. § Bismuth subsalicylate (e.g., Pepto-Bismol): □ Action: Coats the stomach and intestines, reduces irritation and inflammation. □ Indications: Traveler's diarrhea, indigestion. □ Side Effects: Black stools, tinnitus (with high doses). □ Nursing Considerations: Avoid in children with viral infections due to risk of Reye's syndrome. § Diphenoxylate with Atropine: □ Action: Slows peristalsis by inhibiting bowel motility; atropine is added to discourage misuse. □ Indications: Severe diarrhea. □ Side Effects: Drowsiness, constipation, dry mouth. □ Nursing Considerations: Monitor for signs of anticholinergic toxicity (dry mouth, blurred vision). 3. Anti-emetics (For Nausea and Vomiting) Phenothiazines (e.g., Prochlorperazine, Promethazine): ○ Action: Block the vomiting center in the brain. ○ Indications: Nausea and vomiting (due to chemotherapy, surgery, or other causes). ○ Side Effects: Sedation, dry mouth, dizziness, hypotension. ○ Nursing Considerations: Monitor for sedation, avoid alcohol and CNS depressants. Non-Phenothiazines (e.g., Metoclopramide): ○ Action: Blocks dopamine receptors in the CTZ (chemoreceptor trigger zone). ○ Indications: Nausea/vomiting, GERD (due to delayed gastric emptying). ○ Side Effects: Drowsiness, extrapyramidal symptoms (e.g., tardive dyskinesia, restlessness). ○ Nursing Considerations: Monitor for movement disorders; use cautiously in elderly. Anticholinergics/Antihistamines (e.g., Meclizine, Cyclizine): ○ Action: Block cholinergic and histamine receptors, preventing signals to the CTZ. ○ Indications: Nausea and vomiting from motion sickness or vertigo. ○ Side Effects: Drowsiness, dry mouth, constipation. ○ Nursing Considerations: Avoid in patients with glaucoma or urinary retention. 5-HT3 Receptor Blockers (e.g., Ondansetron, Dolasetron): ○ Action: Block serotonin receptors in the gut and brain to prevent nausea. ○ Indications: Chemotherapy-induced nausea, postoperative nausea. ○ Side Effects: Headache, constipation, dizziness. ○ Nursing Considerations: Can be used with corticosteroids for better efficacy in chemotherapy-induced nausea. Substance P/Neurokinin 1 Receptor Antagonists (e.g., Aprepitant): ○ Action: Block substance P receptors in the CNS, reducing nausea and vomiting. ○ Indications: Nausea and vomiting from chemotherapy. ○ Side Effects: Fatigue, dizziness, liver enzyme elevation. ○ Nursing Considerations: Monitor liver function, often used in combination with other anti-emetics. General Nursing Considerations for GIT Drugs Monitor for side effects: GI discomfort, CNS effects (e.g., dizziness, drowsiness), and fluid/electrolyte imbalances. Administration timing: ○ PPIs: Best taken before meals for optimal acid suppression. ○ Antacids: Take between meals and at bedtime. ○ Laxatives: Ensure adequate hydration; avoid overuse to prevent dependence. ○ Anti-emetics: Assess for sedation, dizziness, and other CNS effects. Patient Education: ○ Teach patients about the drug's actions, side effects, and appropriate administration times. ○ For laxatives and anti-diarrheals, advise on fluid intake to prevent dehydration. ○ For anti-emetics, warn about potential drowsiness, and the need to avoid alcohol or driving while on treatment. Quick Recap of GIT Drugs Antacids, H2 blockers, PPIs: Manage gastric acid-related disorders (GERD, ulcers). Laxatives (bulk-forming, chemical, osmotic, stool softeners): Treat constipation. Anti-diarrheals: Control diarrhea (loperamide, bismuth subsalicylate). Anti-emetics: Prevent or treat nausea and vomiting (phenothiazines, serotonin blockers, substance P antagonists).