Pharm GI DRUGS

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Author:
alicia0309
ID:
271421
Filename:
Pharm GI DRUGS
Updated:
2014-04-21 22:33:20
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GI DRUGS
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Pharm
Description:
Exam GI Drugs
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  1. Risk Factors for Peptic Ulcers
    • NSAIDS
    • Infection-H Pylori
    • Alcohol (drink and don't eat and the alcohol eats at the lining of the stomach)
  2. Pharmacotherapy for Peptic Ulcers
    • Proton Pump Inhibitors
    • H2 Receptor Blockers
    • Antacids
    • Antibiotics
  3. Examples of PPI
    • Nexium
    • Prevacid
    • Prilosec
    • Protonix
    • Aciphex
  4. Proton Pump Inhibitors

    Mech of Action
    Reduce acid secretion in the stomach by binding to H+ K+ -ATPase on the surface of the GI mucosa
  5. Proton Pump Inhibitors

    Administration
    PO

    Take 20-30 mins before first meal of the day
  6. Kinetics

    Proton Pump Inhibitors
    Longer duration of action

    Heals more than 90% of duodenal ulcers in 4 weeks and gastric ulcers in 6-8 weeks
  7. Proton Pump Inhibitors

    Adverse Effects
    • N/V/D
    • Abdominal Pain
    • Increased risk for Osteoporosis
  8. Proton Pump Inhibitors

    Contraindications
    Hypersensitivity to the med
  9. Proton Pump Inhibitors

    Interactions
    May increase blood levels of phenytoin, diazepam, and CNS depressants


    Alcohol
  10. Examples of H2 Receptor Blockers
    • Tagamet
    • Pepcid
    • Axid
    • Zantac
  11. H2 Receptor Blockers

    Mech of Action
    Blocks histamine 2 receptors which are responsible for secreting acid in the stomach
  12. H2 Receptor Blockers

    Administration
    • PO
    • IV
    • IM
  13. Kinetics

    H2 Receptor Blockers
    May take 4-8 weeks or more for ulcers to heal
  14. H2 Receptor Blockers

    Adverse Effects
    • Minor GI upset
    • In large doses, Hallucinations, confusion
    • Rarely, Hepatitis, blood dyscrasias
  15. H2 Receptor Blockers

    Contraindications
    Renal or hepatic disease
  16. Interactions

    H2 Receptor Blockers
    • Antacids
    • Smoking
  17. Examples of Antacids
    • Aluminum Hydroxide
    • Calcium Carbonate (TUMS)
    • Milk or Mag
    • Mylanta
    • Alka-Seltzer
  18. Antacids

    Mech of Action
    • Alkaline
    • Provides temporary relief of heartburn symptoms
  19. Antacids

    Administration
    PO
  20. Antacids

    Adverse Effects
    Phosphate depletion
  21. Contraindications

    Antacids
    Bowel Obstruction
  22. Antacids

    Interactions
    should not be taken at the same time as other meds
  23. What is Antibiotic Therapy
    when other GI meds can be combined with Abx to kill H. Pylori infections

    • common combos
    • Omeprazole, clarithromycin and amoxicillin
    • Omeprazole, Pepto Bismol, and tetracycline
  24. Examples of Misc GI Meds
    • Carafate
    • Cytotec
  25. Carafate
    sugar + aluminum hydroxide

    produces gel like substances that coats ulcer and allows it to heal

    Must be given QID
  26. Cyctotec
    Inhibits gastric secretion and stimulates secretion of protection mucus

    Commonly used with patients who are on high dose NSAIDs or corticosteroids

    PREGNANCY CATEGORY X
  27. Nursing Assessment for GI Meds peptic ulcers
    • Health History
    • Labs
    • Vitals
  28. Nursing Dx

    peptic ulcer
    • Acute Pain
    • Altered Nutrition
    • Ineffective health maintenance
  29. Nursing Interventions
    Peptic ulcers
    • Discuss lifestyle
    • Consistent drug therapy
    • monitor for GI Bleeding
    • Discuss timing of medications with meals
  30. Constipation
    • Symptom not Dx
    • Occurs when waste material remains in the body for too long and too much water is reabsorbed
  31. Types of Laxatives
    • Bulk Forming
    • Saline and Osmotic
    • Stimulat
    • Stool Softener/surfactant
    • Herbal Agents
    • Misc
  32. Examples of Bulk Forming Laxatives
    • FiberCon
    • Equalactin
    • Citrucel
    • Metamucil
  33. Bulk Forming Laxatives

    Mech of Action
    Absorb water and increase the size of fecal mass
  34. Bulk Forming Laxatives

    Administration
    • PO
    • must take with plenty of water
  35. Adverse Effects

    Bulk Forming Laxatives
    • Abdominal Fullness
    • Obstruction
  36. Contraindication

    Bulk Forming Laxatives
    Bowel Obstruction
  37. Examples of Saline and Osmotic Laxatives
    • Lactulose (Chronulac)
    • Magnesium hydroxide (Milk of Mag)
    • Polyethylene Glycol (Miralax, GoLYTLEY)
    • Sodium Bisphosphate (Fleet Phospho-Soda)
  38. Saline and Osmotic Laxatives

    Mech of Action
    Pull water into the feces and create a more watery stool
  39. Saline and Osmotic Laxative

    Administration
    • PO
    • Enema
    • SHOULD ONLY BE USED SHORT TERM
  40. Saline and Osmotic

    Adverse Effects
    • Diarrhea
    • Hypermagnesemia
    • Dehydration
  41. Contraindication

    Saline and Osmotic
    Bowel Obstruction
  42. Examples of Stimulant Laxatives
    • Correctol, Dulcolax
    • Emusoil, Neoloid
  43. Stimulant Laxatives

    Mech of Action
    Irritates the bowel mucosa and promote peristalsis
  44. Administration

    Stimulant Laxatives
    PO

    Occasional Use Only
  45. Adverse Effects

    Stimulant Laxatives
    • Diarrhea
    • Abdominal Cramping
    • Dehydration
  46. Examples of Stool softeners/Surfactants
    Colace
  47. Stool Softener/Surfactants

    Mech of Action
    Causes more water and fat to be absorbed into the stools
  48. Administration

    Stool softener/Surfactants
    PO

    Usually used to PREVENT constipation
  49. Stool Softeners/Surfactants

    Adverse Effects
    • Diarrhea
    • Cramping
  50. Contraindications

    Stool Softeners/Surfactants
  51. Bowel Obstruction
  52. Examples of Herbal Agents
    Senna
  53. Herbal Agents

    Mech of Action
    irritates bowel and increases peristalsis
  54. Herbal Agents

    Administration
    PO

    POTENT
  55. Adverse Effects

    Herbal Agents
    • Diarrhea
    • Laxative induced burns in children
  56. Herbal Agents

    Contraindications
    Bowel Obstruction
  57. Miscellaneous Laxatives
    • Mineral Oil
    • Amitiza
    • Relistor
  58. Mineral Oil
    Lubricates the stool and colon mucosa
  59. Why is Mineral Oil Discouraged?
    It interferes with absorption of fat and soluble vitamins
  60. Lubiprostone (Amitiza)
    Used for constipation from IBS
  61. Methylnaltrexone (Relistor)
    For patients on chronic opiate therapy

    Blocks opiate effect in colon without affecting analgesia

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