upper GI disorders drugs

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adrienne
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10257
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upper GI disorders drugs
Updated:
2010-03-13 13:17:22
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upper GI
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  1. What is peptic ulcer disease
    • when the patient has a gastric or duodenal ulcer or
    • GERD
  2. risk factors for PUD
    • family history
    • tobacco use and caffeine
    • glucocorticoids and NSAIDS
    • psychological stress
    • type O blood
  3. other causes of PUD
    • Helicobactor pylori- primary cause, its a gram negative bacteria
    • -secretion of gastric acid
    • -hyposcretion of adequate mucus
    • -NSAIDS- 2nd most common
  4. GERD caused by
    • loosening of sphincter between esophagus and stomach
    • symptoms- heartburn
    • could lead to strictures, esophageal ulcers, esophagitis
  5. duodenal ulcer
    • more common than gastric
    • common in 30-50
    • s/s gnawing or burning
    • occurs 1-3 hours after meal
    • pain is worse on empty stomach
    • nocturnal pain
    • nausea
    • vomiting
    • bleeding in vomit or stool
  6. gastric ulcer
    • less common
    • more common over 60
    • s/s pain may be relieved after food or may continue
    • anorexia, weight loss, vomiting
    • remissions infrequent or absent
    • more commonly associated with cancer
  7. Treatment of GERD, PUD
    • H2 receptor blockers
    • antacids
    • proton pump inhibitors
  8. antiacid
    prototype
    mech of action
    use
    adverse effects
    • aluminum hydroxide
    • mech of action - neutralizes stomach acid by raising pH of stomach
    • use- in combo other antiulcer agents, for heartburn related to PUD, GERD
    • adverse effects - minor constipation
    • other antiacids
    • amphojel
    • tums
    • mylanta
    • milk of mag
    • maalox
    • mylanta plus
    • riopan
    • alka sletzer
    • baking soda
  9. proton pump inhibitors
    prototype
    mech of action
    primary use
    adverse effects
    • Prilosec
    • mech- reduces acid secretion
    • use- short term 4-8 weeks for peptic ulcers and GERD
    • adverse effects- headache, nausea, diarrhea, rash, abd pain, long term increases the risk of cancer
  10. other common proton pump inhibitors
    • nexium
    • prevacid
    • prilosec
    • protonix
    • aciphex
    • ----headache, diarrhea, nausea, rash, dizziness
  11. H2 receptor blockers
    prototype
    mech of action
    use
    adverse effects
    • zantac
    • mech - decrease acid production
    • use PUD
    • adverse effects- reduction in RBC, WBC, platelets, impotence or loss of libido
    • common H2 meds
    • tagament- confusion in elderly
    • pepcid
    • mylanta
    • axid
    • zantac
  12. when to take proton pump inhibitors- prilosec, prevacid, nexium, protonix, aciphex
    • 30 min before breakfast
    • -you can take with antiacids
    • -often given with biaxin for H-Pylori
  13. assessment for Antacid for PUD
    amphojel
    tums
    milk of mag
    mylanta
    maalox alkaseltzer etc
    • med history
    • all meds including OTC
    • renal insufficiency- can cause hypermagnesmia when unable to excrete magnesium
  14. fyi antiacids
    calcium causes constipation
    magnesium and aluminum cause diarrhea
  15. fyi interactions
    no antiacids with H2 so no amphojel and zantac
  16. what to monitor for in PUD GERD
    • old carts
    • s/s gi bleeding
    • rigid belly
    • increased temp
    • loc
    • cbc
    • liver and renal function
    • emesis
  17. constipation and pt teaching
    • how to prevent
    • drink fluids
    • eat fiber
    • exercise
  18. how do bulk forming laxatives work (psyllium)
    adverse effects
    • absorbs water adding to size of fecal mass
    • adverse effects abd fullness, cramping, fainting, esophageal or GI obstruction if not taken with enough fluids
  19. how do stool softener work
    adverse reactions
    • cause more water and fat to be absorbed into stool
    • abd cramping, diarrhea
  20. stimulants work by....
    adverse reactions
    • causing irritation to the bowel to increase peristalsis
    • adverse reactions abd cramping, nausea, fainting, diarrhea, fluid and electrolyte loss
  21. saline or osmotic laxatives work by....
    adverse reactions...
    • pulls water into fecal mass to create a watery stool
    • adverse reactions are diarrhea, abd cramping, diarrhea, heypermagnesmia with magnesium hydoxide, dysrhythmias, resp failure
  22. mineral oil works by....
    adverse reaction.....
    • lubrication of stool and colon mucosa
    • adverse reaction diarrhea, nausea, nutritional deficiencies
  23. laxatives
    prototype
    mech of action
    use
    advese effects
    other common names
    • psyllim mucilloid (metamucil
    • mech of action- swells and increases size of fecal mass
    • use-promote passsage of stool
    • adverse effects- rare, less cramping that with other lax types.
    • nuring alert- instrut patient to drink enough water due to obstrutions in esophagus or intestine
    • other common names fibercon, fiberall, citrucel, metamucil (then the saline and osmotics, and stimulants, softners, herbal agents senna, mineral oil.
  24. saline and osmotic laxative.....
    adverse reactions....
    • milk of mag
    • miralax
    • fleets phospho soda
    • adverse reactions... diarrhea, cramping, diarrhea, hypermagnesemia with magnesium hydroxide, dysrhythmias, resp failure.
  25. stimulant laxatives....
    adverse reactions......
    • dulcolax
    • castor oil
    • ex lax feen a mint
    • correctol
    • adverse reaction.... abd cramping, nausea, fainting , diarrhea, fluid and electrolyte loss
  26. stool softner
    colace
  27. misc laxative
    • mineral oil
    • amitizia
  28. reglan
    • is an anti emetic and gastric stimulant
    • for prevention of emesis related to chemo
    • reduction of GERD
    • prevention of aspiration in enteral feedings

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