GI Drugs

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GI Drugs
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2010-05-07 04:59:55
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GI Drugs
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Term 2 Exam 3 Review
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  1. PRIORITY SETTING: who do you see 1st?
    [give med] for pt. on call for surgery.
    pt. c/o indigestion.
    pt. who needs routine med for GERD.
    pt. who needs pepto for ulcer.
    [give med] for pt. on call for sugery.
  2. MATH: physician orders: cimetidine (Tagamet)--[H2-blocker]--for pt. w/ ulcers. med comes in 400 mg/tablet. how many tablets do you give?
    4 tablets.
  3. what type of med is diphenoxylate/atropine (Lomotil)?
    anti-diarrheal med.
  4. lactulose (Cephulac, Chronulac) [hepatobiliary; constipation] is given for what?
    • to relieve constipation.
    • as tx for hepatic encephalopathy to decrease ammonia levels.
  5. whom would you not give diphenoxylate/atropine (Lomotil)--[Diarrhea]--to & why?
    78 yr. old w/ diarrhea
    68 yr. old w/ glaucoma
    50 yr. old w/ CAD
    pt. recieving aminoglycoside antibiotics
    pt. w/ glaucoma b/c anti-diarrheals causes retention of fluid causing increased pressure.
  6. which physician's orders would you question?
    *omeprazole (Prilosec)--[PPIs; H. pylori]--for duodenal ulcer
    *metronidazole (Flagyl)--[Antiparasitics; other antibacterials]--for h. pylori.
    *psyllium (Metamucil)--[Constipation/(Vitamins/Nutritionals)]--for chronic constipation
    *misoprostol (Cytotec)--[Constipation; other GI/gynecologics]--for pt. w/ NSIAD induced ulcer
    ?
  7. what type of drug is simethicone (Mylicon)?
    anti-flatulence med.
  8. pt. teaching for taking calcium carbonate (Tums):
    chew thoroughly then drink full 8 oz. glass of water.
  9. pt. is taking omeprazole (Prilosec)--[PPIs; H. pylori]--for GERD. how do you med is effective?
    if pt. doesn't have heartburn (decreased production of acid).
  10. if pt. has hypertension. what don't you want to increase?
    • BP (don't give docusate sodium (Colace)--[Constipation]--b/c it has sodium in it).
    • **can't give any med that contains sodium.
  11. almost all antacids (if chewable) should be?
    chewed thoroughly followed by drinking an 8 oz. glass of water.
  12. dr. ordered pancrelipase (Cotazym)--[Digestive Enzyme]. why would drug be prescribed?
    • to supplement pancreatic enzymes.
    • breakdown fats, starches, & proteins.
    • necessary for breakdown & digestion of food.
    • replacement therapy for those w/ pancreatic enzyme insufficiency.
  13. what type of drug is ranitidine (Zantac)?
    H2 [antagonist] blocker med.
  14. where does antacid mainly work?
    stomach.
  15. suppository procedure:
    • place pt. in left-lateral position w/ knees slightly flexed.
    • get suppository out of fridge.
    • get gloves.
    • lubricate med w/ KY-jelly.
    • squeeze cheeks to hold in place for 2-3 min.
  16. aluminum carbonate (Basaljel)--[Antacid]--is given for what?
    • to treat hyperacidity caused by:
    • heartburn.
    • acid indigestion [dyspepsia].
    • sour stomach.
    • GERD.
    • peptic ulcer.
    • to prevent formation of phosphate based urinary stones.
  17. aluminum containing antacids may cause?
    • constipation.
    • intestinal impaction.
    • anorexia.
    • weakness.
    • tremors.
    • bone pain.
  18. pt. who has cirrhosis has high serum ammonial level. what med would be prescribed?
    lactulose (Cephula, Chronulac).
  19. how do you know if lactulose (Cephulac, Chronulac)--[Laxative]--is effective?
    level of consciousness has increased.
  20. what type of drug is loperamide (Imodium)?
    anti-diarrheal med.
  21. pt. has CHF & dr. prescribed sodium bicarbonate (Baking Soda)--[Antacid]--for GI upset. would you question order?
    • yes b/c of sodium--given to pt. w/ metabolic acidosis.
    • **may cause systemic alkalosis & rebound hyperacidity.
    • **contraindicated w/ cardiovascular probs. & those on sodium restricted diets.
  22. what type of drug is loperamide (Imodium)?
    anti-diarrheal med.
  23. how does loperamide (Imodium)--[Antidiarrheal]--work?
    • acts directly on muscle of bowel to slow motility.
    • take after ea. loose stool.
  24. what type of med is magnesium hydroxide (MOM) & can cause what?
    • antacid.
    • severe diarrhea, dehydration, & hypermagnesemia.
  25. nursing/teaching interventions for pt. who has hiatal hernia [defect in diaphragm permits portion of stomach to pass through diaphragmatic opening into the chest] to decrease heartburn?
    • provide sm. frequent meals.
    • do not recline for 1 hr. after eating.
    • elevate HOB on 4-8 in. blocks.
  26. pt. who has inflammatory bowel disease was prescribed sulfasalazine (Azulfidine)--[Aminosalicylate]. what are the instructions for taking med?
    • 3-4 g/day PO in divided doses.
    • then 2 g PO QID.
    • push fluids to prevent crystalluria from sulfa.
    • **monitor BUN & serum creatinine for kidney damage.
  27. where should suppositories be stored?
    in fridge.
  28. MATH: pt. prescribed 100 mL to be given over 20 min.
    • 60 gtts per min.
    • **re-check IV every hr.
  29. what does an H. pylori infection cause?
    peptic/duodenal ulcers--H. pylori produces toxin that destroys mucus.
  30. nursing considerations for H. pylori infections?
    • all ulcers at risk for hemorrhage & hypovolemic shock from perforation & obstruction--assess for melena & hematemesis.
    • s/s of bleeding include increase in pulse & drop in BP.
    • **monitor CBC & FOBT.
  31. what type of drug is sennosides (Senokot)?
    [irritant/stimulant laxative] constipation.
  32. pt. taking sennosides (Senokot)--[Irritant/Stimulant Laxative]--is c/o brown urine & yellow-green stool. what should you tell pt.?
    normal side effect of drug.
  33. dronabinol (Marinol)--[Antiemetic]--is used for what?
    • for chemotherapy induced nausea & vomiting.
    • appetite stimulant for pt. w/ HIV.
  34. what type of med is dronabinol (Marinol)?
    • antiemetic.
    • **may cause drowsiness, somnolence, euphoria, dizziness, & vomiting.
  35. prolonged us of loperamide (Imodium)--[Antidiarrheal]--may cause?
    • dry skin & mucous membranes.
    • nausea.
    • constipation.
    • lightheadedness.
  36. prolonged use of laxatives may cause?
    • diarrhea & loss of water/electrolytes.
    • abd pain/discomfort.
    • nausea.
    • vomiting.
    • perianal irritation.
    • fainting.
    • bloating.
    • flatulence.
    • cramps.
    • weakness.
  37. which meds are used to treat ulcerative colitis?
    • corticotropin & adrenal corticosteroids.
    • sulfasalazine (Azulfidine).
    • olsalazine (Dipentum).
    • mesalamine (Asacol).
    • anti-diarrheals.
    • iron/liquid (IV) supplements.
  38. best time to administer mineral oil--[Emollient]--for constipation?
    take at HS [at night] on empty stomach.
  39. what is 1 advantage of giving an H2 [antagonist] blocker rather than an antacid?
    • dosing is less frequent.
    • **antacids may be taken hourly for 1st 2 wks.
    • **H2-blockers usually given BID/at HS for maintenance.
  40. H2 [antagonist] blockers are used cautiously?
    • in pts. w/ renal/hepatic impairment.
    • in severely ill, elderly/debilitated pts.
    • during pregnancy & lactation.
  41. other meds taken w/ an antacid should be take when?
    2 hrs before/after.
  42. metoclopramide (Reglan)--[Gastrointestinal Stimulant]--is used to treat? how?
    • used to treat GERD & gastric distress.
    • increases motility of upper GI tract w/o increasing production of secretions.
  43. laxatives are also used for what besides constipation?
    • for pt. w/ [IBS] irritable bowel syndrome & severe watery diarrhea.
    • for pt. going for sigmoidoscopy/colonoscopy.
  44. what type of med is cimetidine (Tagamet)?
    H2 [antagonist] blocker med.
  45. cimetidine (Tagamet)--[H2 [antagonist] blocker]--can cause what for men?
    reversible impotency.
  46. if pt. has trouble taking laxative [tablet], can they chew it?
    • no--can be split in half, but not crushed.
    • **suggest liquid form/suppository.
  47. before administering sulfasalazine (Azulfidine)--[Aminosalicylate]--what should you ask pt. & what is it given for?
    • any allergies to sulfa.
    • used to treat inflammatory bowel disease: Chron's disease & ulcerative colitis.
  48. if pt. is given combination drugs for H. pylori, how long do they have to take them?
    2 wks (14 days).
  49. what consistency & color of stool be for pt. taking Colace?
    soft & brown (means Colace is working).
  50. pt. prescribed bulk laxative [methylcellulose (Citrucel)psyllium (Metamucil), polycarbophil (FiberCon)] how do those meds work?
    provides fiber.
  51. pt. scheduled for colonoscopy. what drug is prescribed for stool evacuation?
    • laxatives [MOM] (turns stool clear-yellow).
    • **assess skin turgor before administering med.
  52. what is the generic name for Colace?
    docusate sodium.
  53. docusate sodium (Colace)--[Laxative]--is contraindicated for pts. who have?
    HTN (hypertension).
  54. lactulose (Cephulac) can be given for?
    • cerebralencephalopathy.
    • **check neurological status (level of consciousness).
  55. prochlorperazine (Compazine) is an antidopaminergic antiemetic drug that prevents?
    nausea/vomiting.
  56. pt. is being prescribed promethazine (Phenergan), what type of drug is it & how does it work?
    • antidopaminergic antiemetic.
    • inhibits [CTZ--chemoreceptor trigger zone] & brain's primary neurotransmitters dopamine & acetylcholine.
  57. what should be avoided when taking promethazine (Phenergan)--[Antidopaminergic Antiemetic]?
    alcohol.
  58. dicyclomine (Bentyl) is an anticholinergic [reduces gastric motility & decreases amt. of hydrochloric acid produced by stomach], how do you know if drug is effective?
    pt. will have decrease in pain & # of stool (formed-soft stool).
  59. propantheline (Probanthine)--[Anticholinergic]--may cause?
    • drowsiness.
    • dizziness & photophobia.
    • confusion in elderly.
    • diarrhea.
  60. dicyclomine (Bentyl)--[Anticholinergic]--is contraindicated in?
    • clients w/ [BPH--benign prostatic hypertrophy] (enlarged prostate).
    • anyone w/ urinary retention.

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