Meds for GI part 2

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Prittyrick
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275582
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Meds for GI part 2
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2014-05-29 18:59:59
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  1. Antiflatulents
    • Decrease gas production
    • breakdown gas bubbles
    • facilitate the passage

    breakdown the gas bubbles into tiny little bubbles so it could be expel
  2. Antiflatulents (example and CI)
    ex- Simethicone

    • CI to reduce the symptoms associated with excess gas in the GI system. 
    • relieves pain and discomfort by promoting belching and the passing of flatus.
  3. Antiflatulents MOA
    • MOA
    • change the surface tension.
    • cause the gas bubbles to join and form larger gas bubbles that can be easily expelled 

    can be used with an antacid to decrease flatulence (creates a film to collapse the gas bubbles
  4. Antiflatulents SE NI
    SE few belching and flatulence

    • NI: local effect (not aborbed)
    • immediate onset, last up to three hours
    • best given after meals
    • no known drug interaction
    • teach pt methods to decrease flatulence
  5. H. Pylori Infection
    • H. pylori
    • it is spiral shape gram negative bacteria found in stomach
    • discovered in 1982
    • can cause peptic ulcer disease and leading cause of gastritis.
  6. H. Pylori more
    • spiral shape rod can penetrate the protecting lining of stomach
    • gets under the mucous. releases an enzyme which then causes cell breakdown produces urease
    • weakens the stomach lining which can then form an ulcer 
    • attaches to stomach cells- local inflammation
  7. How do we treat h. pylori (Dx S/s, Tr)
    Dx: Blood test, stool culture, breath test and endoscopy

    s/s gastritis, dull gnawning pain, weight loss, loss of appetite, bloating, PUD

    TR: usually two weeks, triple drug therapy PPI and two antibiotics (over 90% effective)
  8. Drug Therapy for treatment of H. pylori
    • Two antibiotics and a PPI
    • - Prevacid, amoxicillan, ciarithromycin
    • -pepto bismol
    • treatment of this reduces the reoccurence of ulcer disease
    • for uncomplicated cases no furher tx
  9. miscellaneous agent constipation
    • ex: lactalose
    • if u see a pt on this around the clock (q 4hr) it is because they have liver disease. It causes loose stools (elders this might be there bowel regimen). use this to reduce ammonia levels. ammonia (breakdown protein) likes acid enviroment. lactalose creates this enviroment. high ammonia cross in the brain (changes in mentation slow to respond, confusion). loose stools are great so u can get rid of ammonia 
    • normal se are loose stools
    • MOA- degraded by bacteria and acts as an osmotic agent causes fluid accumulation in the colon
  10. Bismuth Subslicylate
    • Pepto Bismol (solves all)
    •  locally active antidiarrheal agent, can be used to treat travellers diarrhea 
    • binds to toxins and excretes.
    • can be used to treat h pylori
    • MOA form protective coating around the ulcer (increases bicarb (ph), promotes prostagladins, supress growth of h pylori


    SE stool black, constipation

    • NI: careful with adminstration of salicylates
    • assess for allergy to aspirin
    • can be used for the treatment of h pylori
    • not to be given to children
  11. Lactobacillus acidophilus supplments
    • Probiotic (friendly) bacteria
    • pt on long management of antibiotics would usually be given this

    • CI replaces the good bacteria in the intestines that could be destroyed by antibiotics. reestablish balance Aids in reestablishing the normal flora in the bowel
    • treatment of overgrowth bacteria that can cause disease
    • improves lactose aborption digestion in peeps who are lactose intolerant

    • SE: mild GI upset
    • NI research is showing multiple other uses for this drug
  12. Laxatives and Cathartics
    drugs used to treat constipation

    Laxative: produces a soft formed stool over one or more days

    Cathartic- immediate evacuation like an enema
  13. Hyperosmotic/ hypertonic
    ex is Milk of Mg

    MOA- draws water into the stool causes the volume to be bigger stimulants the intestinal walls and u have a bowel movement. 

    works within an hour

    SE Fluid and eletrolyte disturbance

    • NI: assess FVD (I&O)
    • drug interactions
    • followed by a full glass of water (increase perstalsis)
    • becareful with pt with cardiac can cause arrythmias (bc of MOM)
  14. Bulk Forming Laxative
    ex. Metamucil 

    • increase the bulk of the stool. non digestable agent it keeps water in the stool to form a vicous gel
    • softens stool and stimulant perilstalsis
    • onset action 12-24 hours
    • mimics normal bowel function- not immediate

    SE flatulence, abdominal fullness

    • NI give with a full glass of water 
    • mix at the bedside- if not it will get solid and could cause esopheal obstruction
  15. Stool Softner
    Ex docusate (colace)

    MOA- detergent action, decreases the surface tension which facilitate the penetration of fat and H2O into the stool

    Onset 12-72 hours (a day late take up to three days for an effect)

    SE rare

    NIL safe agent
  16. Stimulant Agent
    Stimulant the bowel

    ex. bisacodyl (dulcolax)

    • MOA: direct effect
    • stimulants peristalsis by irritating the mucosa and nerve endigns

    onset 6-12

    SE abdominal cramping

    • NI: most abused
    • drug interactions 
    • assess for FVD
  17. Lubricant Agents (rarely used)
    ex mineral oil

    • MOA: lubricate the bowel and intestinal mucosa, prevents the reabsorption of water from the lumen
    • Onset 6-8

    • risk of aspiration
    • SE: GI effects, decrease absorption of fat soluble vitamins (A,D, E, K)

    NI; safety risk for aspiration (do not give to pt with change in mental status)
  18. Antidiarrheal agents
    ex: diphenoxylate (lomotil)

    CI: treats diarrhea

    MOA: acts on the smooth muscle of the intestine to slow intestinal motility, prolongs intestinal transit time

    usually works in 1 hour
  19. antidiarrheal SE NI
    SE: dry mouth, drowiness, dizziness

    • NI: drug interaction be careful b/c is slows down motility, 
    • know why the pt is having diarrhea (bacteria caused) because it may be a good thing
    • should not be used more than 10 days
  20. Other Antidiarrheal meds
    Imodium

    bulk forming laxative

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