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56 Cards in this Set
- Front
- Back
Aluminum hydroxide
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Amphojel - not absorbed - may cause constipation - used in pts with renal failure
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Calcium carbonate
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Tums - also used for calcium replacement - may cause constipation, renal calculi
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Calcium carbonate with magnesium hydroxide
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Mylanta, Rolaids - may cause constipation, don't give to renal pt, renal calculi
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magnesium hydroxide
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mom - milk of magnesia - laxative - don't give to renal pt
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magnesium hydroxide and aluminum hydroxide with simethicone
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mylanta, maalox plus, mag al plus - watch for diarrhea
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sodium bicarbonate
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alka seltzer, baking soda - fluid retention (r/t Na+) edema, abdominal distension, used IV form for metabolic acidosis
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antacids nrsg mgmt
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don't take > 2 weeks w/o dr permission
don't exceed maximum dose keep record of stool shake liquid suspension well chew tablets well and follow with 8 oz water |
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calcium carbonate and sodium bicarb may cause ___________
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rebound hyperacidity
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While taking aluminum based antacids increase fluids to ________. Why? _________
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2000 mL/day / help relieve constipation (unless contraindicated)
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do not use antacids in pts taking ____________
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tetracycline
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simethicone
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mylicon - antiflatulent - has defoaming action that disperses and prevents the formation of mucus-surrounded gas pockets in intestine
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charcoal
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absorbent that reduces amount of gas in intestine, can also pull fluid back into GI track in case of poisoning, OD
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Histamine H2 antagonist
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H2 receptor blockers - inhibit action of histamine at histamine H2 receptor cells of stomach, which reduces secretion of gastric acid
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H2 receptor blockers -uses
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GERD, ulcers, hypersecretory dz
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H2 blockers nrsg mgmt
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do not use if pregnant, breast feeding, and in children under 16 years of age
caution in pts with hepatic dz or renal dz I&O ratio monitor gastric pH BUN, CBC, LFTs, creatinine, PT |
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cimetidine
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tagamet - bad drug - dizziness, diarrhea, constipation, gynecomastia, some occasion of impotence, decreased effectiveness with smoking - elderly pts can develop problems with thought processes
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famotidine
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pepcid - best - HA, nausea, dry mouth, if given over period of time can cause neutropenia, if adm IVP too quickly can cause arrythmias
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ranitidine
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zantac - given with bismuth for H. pylori
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carafate
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sucralfate - sucrose + aluminum hydroxide - produces a thick barrier that coats and binds to ulcer. Does not effect secretion of acid. Used short term (8 wks) for active duodenal ulcers and for maintenance therapy.
adverse rxn: constipation |
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carafate nrsg mgmt
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give other meds 1-2 hrs before or after dose
do not adm with antacid, tetracycline, or digoxin (decreased effect) must be taken QID *cannot crush |
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cytotec
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misoprostol - synthetic prostaglandin - stimulates the production of protective mucus and inhibits gastric acid secretion
used to prevent nsaid induced gastric ulcers adverse rxn: diarrhea |
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cytotec nrsg mgmt
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Do not give to pregnant women!
adm 3-4X per day |
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Pepto Bismol
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Bisumth subsalicylate - stimulates mucosal bicarbonate and prostaglandin production
used for dyspepsia, heartburn, and diarrhea **inhibits H. pylori from adhering to ulcerated tissue may be used in combo with bactrim, amoxicillin to treat H. pylori may turn stool black/dark may decrease absorption of tetracycline or any co-administered meds |
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Proton-pump Inhibitors
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act by blocking hydrogen, potassium, and ATPase - this enzyme acts as pump to release gastric acid (also called H+, or protons) on the surface of the GI mucosa.
Short-term tx of GERD - tx should last only 4 weeks *activated by food intake - adm 20-30 min ac with first major meal of the day beneficial effects cont for 3-5 d after d/c. SE uncommon: HA, abd pain, diarrhea, n/v preassess bowel sounds |
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lansoprazole
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prevacid - used for GERD
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omeprazole
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prilosec - used in combo with antibiotics for H. pylori and GERD
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pantoprazole
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protonix - can be given IV - GERD
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anticholinergics/antispasmodics
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scopolamine, ProBanthine, Robinul, Bentyl - dycyclomine
weak inhibitors of gastric acid secretion doesn't heal ulcers increase fiber intake, dry mouth ***contraindicated in galucoma and tachycardia occasionally used for tx of peptic ulcers |
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GI application for atropine
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preoperative drying agent - do not give with glaucoma or tachycardia
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anticholinergics/antispasmodics nrsg mgmt
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adverse effects: constipation, dry mouth, drowsiness, dizziness
Urinary retention or hesitancy: instruct on importance of monitoring for monitor I&O blurred vision may interfere with activities |
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gastrointestinal stimulants
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reglan - metaclopromide
GERD, gastric stasis causes muscles in upper stomach to contract causing faster emptying decreases esophageal relaxation and blocks food from entering esophagus - GERD given parenterally to prevent n/v associated with cancer chemo and to prevent n/v during the immediate postoperative period adverse rxn: drowsiness, fatigue, confusion, insomnia uncommon: pseudoparinsonism |
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Ilopan
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increases the rate at which stomach and intestines move during digestion. Increases rate at which your stomach empties into your intestines
may be given immediately after major abd surgery to reduce risk of paralytic ileus |
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oioids (antidiarrheals)
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diphenoxylate with atropine (lomotil)
loperamide (imodium) slows peristalsis *atropine -ACHN! BS HR glaucoma SE: drowsiness, nausea, dizziness, dry mouth, paralytic ileus, constipation |
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bismuth subsalicylate
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kaopectate, pepto bismol)
binds and absorbs toxins SE: constipation, nausea, tinnitus |
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octreotide
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sandostatin - prevents release of serotonin and other active peptides that promote diarrhea. Also inhibits intestinal secretions and enhances absorption
SE: nausea diarrhea, abd pain |
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pro-biotics
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lactobacillus, live cultures foods
replaces normal flora in intestinal tract used in tx of diarrhea associated with antibiotic and antineoplastic tx. |
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antidiarrheals local-acting
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charcoal, pectin, psyllium - used for tx of bacterial diarrhea
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antidiarrheals systemic-acting
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lomotil, imodium
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metamucil
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tx for constipation
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Bulk forming laxatives
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calcium polycarbophil (fibercon)
methylcellulose (citracel) psyllium mucilloid (metamucil) absorbs water and adds to fecal mass onset - 24-48 hrs should be given at HS with at least 8 oz water *don't give with other meds SE: abd fullness or cramping, esophageal or GI obstruction if not taken with enough fluid, gas |
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Saline cathartics/osmotics
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*strong
magnesium hydroxide (MOM) polyethylene glycol (miralax) sodium biphosphate (fleet phospho-soda) lactulose magnesium citrate go-LYTELY increase water content of stoll and softens stool, poorly absorbed in intestine, pull water into fecal mass, produce BM quickly 1-6 hrs onset *do not give miralax at the same time as other meds *risk for fluid & lyte imbalance SE: abdominal cramping, diarrhea lactulose may also be given for high levels of ammonia. *never serve warm: causes severe abd cramping (mag citrate) |
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stimulant laxatives
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bisacodyl (correctol, dulcolax)
castor oil (vit deficiencies) phenolphthalein (ex-lax) promote peristalsis by irritating bowel onset 6-12 hrs Do not use routinely r/t dependency, used for bowel preps se: abd cramping, nausea, diarrhea |
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stool softeners/surfactant
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docusate sodium (colace)
docusate calcium (surfak) cause more water and fat to be absorbed into stool. rx: for pts at risk of constipation onset 24-48 hrs abd cramping, diarrhea *check Na+ and Ca+ |
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herbal agent laxatives
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senna - sennacot
stimulate bowel and increases peristalsis *abd cramping |
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mineral oil
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lubricates intestinal wall and softens stool
onset 24-48 hours SE: diarrhea, nausea, nutritional deficiencies |
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Never admin laxative to pt experiencing ___ ___, ____, ____, without consulting MD
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abd pain, nausea, vomiting
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antiemetics: anticholinergics, antihistamines
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dramamine, benadryl, vistaril, antivert, transderm scop
use: motion sickness SE: drowsiness, dry mouth *Z-track when giving vistaril IM - can cause tissue sloughing *never admin >25 mg phenergan IV *phenergan given pre-op for peds |
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marinol
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cannabinoid - inhibit pathway to vomiting center
use: chemo, increase appetite SE: dizziness, drowsiness, confusion, decrease sensory awareness |
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glucocorticoids
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dexamethasone (decadron)
methylprednisolone (solu-medrol) used to prevent chemo and post-op nausea SE: wt gain, nausea, fld retention, insomnia, neutropenia, mask s/s infection, hyperglycemia |
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phenothiazines
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prochlorperazine (compazine)
promethazine (phenergan) chemo, general illness se: drowsiness, dry mouth, photosensitivity |
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serotonin antagonist
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ondansetron (zofran)
general illness, hyperemesis gravidarum, chemo SE: HA, drowsiness, fatigue |
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Emetics
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ipecac syrup
causes vomiting by irritating effect on stomach as well as by stimulation of the vomiting center of medulla can be used as expectorant adverse effect: hypovolemic shock *must know what pt took before admin can be used as expectorant at 1/10 recommended dose for emetic |
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digestive enzymes
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lipase and protease are two that are manufactured and secreted by the pancreas and are responsible for the breakdown of fats, starches, and proteins.
available in oral form used as replacement therapy for cystic fibrosis, chronic pancreatitis, ca of pancreas, malabsorption syndrome, surgical removal of all or part of the stomach, surgical removal of all or part of pancrease |
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gallstone solubizing agents
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suppress the manufacture of cholesterol and colic acid by liver which decreases size of gallstones
nonsurgical tx of gallstones asacol, dipentum, azulfindine asacol - tx of ulcerative colitis azulfidine - chron's dz and ulcerative colitis - a sulfonamide |
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vermox
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antihelmintic - Gi irritation, HA, dizziness, numbness (rare)
may chew, crush, or swallow whole for best results take with high fat meal f/u exam important identify close contact for possible infestation and tx good hand washing and hygiene change linen dly clean fingernails, cut short, mitten socks to prevent scratching do not allow dogs to play in sandbox |
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pediculicide/scabicide
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lindane (kwell)
permethrin (nix) may cause neruotoxicity follow directions for use prior to application of lotions or creams wash area, allow to dry apply enough to cover entire body surface with thin layer, leave on 6-8 hrs cut long hair, come with fine-toothed comb dipped in vinegar to remove nit discard comb after use educate on use of others hygiene items launder bed linens, towels, clothes wear gloves |