Pharm

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Author:
yagurl_dana
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28466
Filename:
Pharm
Updated:
2010-07-31 23:36:58
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Drugs that Affect Upper Gastrointestinal System
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Upper GI drugs
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  1. What does the upper GI consist of?
    Mouth, esophagus, and stomach.
  2. What is hydrochloric acid (HCI)?
    substance that aids in the initial digestive process.
  3. Antacids do what?
    Neutralizes or reduces acidity of the stomach and duodenal contents by combining with HCI and increasing the pH of the stomach acid.

    • USED IN TX OF HYPERACIDITY cause by?
    • Heartburn
    • Acid indigestion
    • Sour stomach
    • Gastroesophegeal reflux disease
    • Peptic ulcer
  4. What are drugs that reduce the production and release of HCI?
    • Histamine H2 antagonists
    • Proton Pump Inhibitors (important in tx of H.pylori infections)
    • Miscellaneous acid-reducing agents
  5. What is Helicobacter Pylori (H. pylori)?
    Infection in patients with active duodenal ulcers.
  6. What are antiemetics?
    They are used to tx and prevent nausea & vomiting
  7. What are antacids A/R?
    Aluminum-containing antacids= constipation/impaction, intestinal impaction, anorexia, weakness, tremors, bone pain

    Magnesium-containing antacids
    = severe diarrhea, dehydration, hypermagnesemia

    Calcium-containing antacids= REBOUND hyperacidity, metabolic alkslosis, hypercalcemia, vomiting, confusion, headache, renal calculi, neurologic impairment

    Sodium bicarbonate- Systemic alkalosis and REBOUND hyperacidity
  8. Antacids are contrindicated in?
    Peeps with severe ABD pain w/ no known cause and during lactaion.

    Sodium-containing antacids= Cardiovascular problems & sodium-restricted diets.

    Calcium-containing antacids= Renal Calculi or HYPERCALCEMIA=kidney stones.

    • USED CAUTIONSLY IN:
    • Aluminum-containing antacids=w/ gastric outlet obstruction, Upper GI bleeding
    • Magnesium-and aluminum-containing antacids=decreased kidney function
    • Calcium-containing antacids=w/ respiratory insufficiency, renal impairment, cardiac disease.
  9. What is aluninum carbonate (Basaljel)?
    • Antacid.
    • Used: 4-Peptic ulcer, Stomach hyperacidity, hyperphosphatemia (with chronic renal failure)
    • A/R = Constipation, bone softening, neurotoxicity
  10. What is Aluminum hydroxide (Alu-tab, Amphojel, Dialume)?
    • ANTACID
    • Used= same as Aluminum Carbonate
    • A/R= same as Aluminum Carbonate
  11. What is a Calcium carbonate (Tums, Mylanta)?
    • ANTACID
    • Used= Peptic ulcers, Stomach hyperacidity, CA deficiencies, Osteoporosis(menopausal)
    • A/R= Acid rebound
  12. What is Magnesia Hydroxide (Milk of Magnesia, Phillips'MOM)?
    • ANTACID
    • Used= Peptic ulcer, Stomach hyperacidity, CONSTIPATION
    • A/R=diarrhea, bone loss w/pts w/ chronic renal failure
  13. What is Magnesium Oxide?
    • ANTACID
    • Used=Same as magnesium hydroxide, Magnesium deficiencies, malnutrition, alcoholism
    • A/R= sam as magnesium hydroxide DIARRHEA
  14. What is Sodium Bicarbonate (Bellans)?
    • ANTACID
    • Used=Peptic ulcers, Stomach hyperacidity
    • A/R=Electrolyte imbalance, metabolic alkalosis
  15. What are Histamine H2 Antagonists actions and uses?
    Action= Inhibit the action of histamine @ H2 receptor cells of the stomach which then reduces the secretion of gastric acid.

    Used=
    Heartburn, Acid indigestion, sour stomach, GERD, Gastric ulcer, Gastric hypersecretory conditions

    Goal 4 use of ulcers is 2 decrease acid in stomach so ULCER CAN HEAL
  16. What are A/R of Histamine H2 Antagonists?
    Adverse reactions are mild and RARE less than 2% of peeps get any.

    A/R=
    Dizziness, somnolence, headache, confusion, hallucinations, diarrhea, reversible impotence

    Contrinidicated=w/known hypersensitvity 2 drug

    Precautions= Renal or Hepatic impairment, severely ill elderly, debilitated pts, pregnancy, lactation

    Cimetidine used cautiously in peeps w/ DIABETES
  17. Cimetidine (Tagamet)
    • HISTAMINE H2 ANTAGONIST
    • Used=Gastic/duodenal ulcers, GERD, Gastric hyperSECRETORY conditions, GI bleeding, heartburn
    • A/R= Headache, somnolence, diarrhea

    Caution in peeps w/ DIABETES
  18. Famotidine (pepcid)
    • HISTAMINE H2 ANTAGONISTS
    • Used=Cimetidine
    • A/R=Cimetidine
  19. Nizatidine(Axid)
    • HISTAMINE H2 ANTAGONISTS
    • Used=Cimetidine
    • A/R=Cimetidine
  20. Ranitidine(Zantac)
    • HISTAMINE H2 ANTAGONISTS
    • Used= same as Cimetidine, EROSIVE ESPOPHAGITIS
    • A/R=Same as Cimetidine
  21. What are actions and uses for Proton Pump Inhibitors?
    Actions=Suppressess GASTRIC ACID SECRETIONS by inhibition of hydrogen=potassium adenosine triphosphate enzyme system of the gastric parietal cells. Blocks final step in production of acid.

    Used=Gastric & Duodenal ulcers, GERD, Erosive esophagitis, pathologic Hypersecretory conditions(Cystic Fibrosis) tx of H.pylori infections

    A/R=
    Headache, nausea, diarrhea, ABD pain
  22. What are Contraindication & Precautions in Proton Pump Inhibitors?
    • Contraindicated= Hypersensitivity 2 any of the drugs
    • Omeprazole, lansoprazole, Rabeprazole, Pantoprazole Contrainicated in pregos & lactation

    Cautionsly= Older peeps, Hepatic impairment

    PROLONGED USE OF MAY DECREASE THE BODY'S ABILITY 2 ABSORB VIT B12(INTRINSIC FACTOR)=ANEMIA
  23. Esomeprazole magnesium(Nexium)
    • PROTON PUMP INHIBITORS
    • Used=Erosive esophagitis, GERD, H.pylori eradication, NSAID-associated gastric ulcers
    • A/R=Headache, nausea, diarrhea
  24. Lansoprazole(Prevacid)
    • PROTON PUMP INHIBITORS
    • Used=Esomeprazole, hypersecretory conditions, cystic fibrosis, intestinal malabsorption
    • A/R=same as esomeprazole
  25. Omeprazole(Prilosec, Zegerid)
    • PROTON PUMP INHIBITORS
    • Used=same as esomeprazole, heartburn, reduce risk of upper GI bleeding
    • A/R=Same as esomeprazole
  26. Pantoprazole sodium(Protonix)
    • PROTON PUMP INHIBITORS
    • Used=GERD, erosive esophagitis, hypersecretory conditions
    • A/R=same as esomeprazole
  27. Rabepraxole sodium (Aciphex)
    • PROTON PUMP INHIBITORS
    • Used=same as esomeprazole
    • A/R=same as esomeprazole
  28. Miscellaneous Acid Reducers
    Cholinergic Blocking drugs= Reduce gastric motality & decrease amt of acid secreted by stomach

    Pepsin Inhibitor= Binds w/ Protein molecules 2 form a viscous substance which buffers acid and protects the mucosal lining

    Prostaglandin drug= Reduces the risk of nonsteroidal anti-inflammatory drug(NSAID)-induced gastric ulcers in high risk pts.

    USED LESS FREQUENTLY CUZ HISTAMINE H2 ANTAGONISTS BETTER
  29. Sucralfate(Carafate)
    • MISCELLANEOUS ACID REDUCER known as pepsin inhibitor or mucosal protective drug
    • Used=short-term duodenal ulcers tx
    • A/R=Constipation
  30. Misoprostal(Cytotec)
    • MISCELLANEOUS ACID REDUCER Prostaglandin drug
    • Used=Prevention of Gastric ulcers in peeps taking NSAIDs
    • A/R=Headache, nausea, diarrhea, ABD pain,

    Causes spontaneous abortion tell chicks use reliable contraceptives & report severe menstraul pain bleeding or spotting
  31. Gastrointestinal Stimulants
    • Actions=increases the motility of uupper GI tract w/out increasing the production of secretions
    • Used=4 tx of GERD, Gastric stasis, Post surgery
    • Higher doses of prolonged administration= produce CNS symptoms (restlessness, dizziness, drowsiness, extrapyramidal symptoms
    • Contraindicated=GI obstruction, Gastric perforation, Hemorrhage, pheochromocytoma
    • Precaution=Diabetes, Cardiovascular disease
  32. Dexpanthenol(Ilopan)
    • GI STIMULANTS
    • Used=Immediate postoperative medication for prevention of paralytic ileus
    • A/R=Itching, tingling, difficulty breathing and urticaria

    Don't use in peeps w/ hemophilia (lack of B12)
  33. Metoclopramide(Reglan)
    • GI STIMULANT
    • Used=Diabetic gastroparesis, GERD, prevention of nausea&vomiting
    • A/R=Restlessness, dizziness, fatigue, extrapyramidal effects
  34. Antiemetics
    • Prevents vomiting caused by drugs radiation, and metabolic disorders
    • Reduces the non-GI adverse effects
    • Tested for use in Irritable Bowel Syndrome (IBS)

    • Common A/R= varying degrees of drowsiness
    • Contraindications=severe CNS depression

    • Precautions:
    • Cholinergic blocking antiemetics=glaucoma, Obstructive disease of GI or genitourinary system
  35. Prochlorperazine(Compazine)
    • ANTIEMETIC
    • Used=control of nausea&vomiting
    • A/R=same as chlorpromazine
    • Contraindicated=bone marrow depression, blood dyscrasia, parkinson's disease, servere liver, cardiovascular disease
  36. Thiethylperazine(Torecan)
    • ANTIEMETICS
    • Used=Control nausea&vomiting
    • A/R=same as chlorpromoazine
    • Contraindicated=PREGNANCY
    • Precaution= Children w/ viral illness REYES SYNDROME(persistant vomiting, signs of brain dysfunction, listlessness, drowsiness
  37. 5-HT3 Receptor Antagonists
    • ANTIEMETICS
    • Used cautiously in pts w/ cardiac conduction problems, electrolyte imbalances

    SHOULD NOT BE USED BY PATIENTS W/ HEART BLOCK OR PROLONGED QT INTERVALS
  38. What are the PREadministration assessments?
    • Question Type & intensity of symptoms
    • Document # of times vomited and apprx amt of fluid loss
    • V/S & assess s/s fluid & electrolyte imbalances
    • Ask about any situations of N&V
    • Get NG tube suction @ bedside
  39. What ONGOING assessment does the nurse need 2 do w/ these drugs?
    • Monitor 4 continued complaints of pain, sour taste, spitting of blood or coffee ground colored emesis
    • Montitor 4 s/s of electrolye imbalance
    • Measure I&O
    • Weigh pt daily 2 weekly w/ repeated episodes of vomiting
  40. Educating Pt & Family
    • Tell them 2 avoid driving or performing other hazardous tasks due 2 drowsiness
    • Explain correct method 2 take the drugs
    • Explain the necessity of contacting DR immediately if A/R occur
  41. Emetics
    Drug that induces vomiting rapidly when an individual accidentally or intentionally ingested poison or drug overdose.

    • Because more harm can occur from vomiting of many substances guidelines were established for the use of syrup of ipecac:
    • Don't use on a person who is not fully conscious
    • Don't use unless DR. orders
    • Don't use if turpentine, corrosives(lyle) strong acids, petroleum distillates, kerosene, paint thinner, cleaning fluid, furniture polish have been ingested
    • Don't use in comatose or altered mental status peeps
    • Don't use in peeps having convulsions
    • Don't use if substance ingested is capable of causing altered mental mental status or convulsions
    • Dont use if caustic or corrosive agent
    • Don't use if ingested low-viscosity petroleum distillate w/ potential 4 pulmonary aspiration and the developement of chemica pneumonitis
    • Don't use if medical condition may be exacerbated by vomiting (severe hypertension, bradycardia, hemorrhagic diathesis)
  42. Dronabinol(Mrinol)
    • Miscellaneous Antiemetic (WEED) :)
    • Used=Prevention of chemotherapy induced nausea&vomiting, appetite stimulant 4 pts w. HIV
    • A/R=Drowsiness, somnolence, euphoria, dizziness, vomiting, Paranoia, Coughing, sweating

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