nurs 180 pharmacology midterm review west coast universitynurs 180 pharmacology midterm review west coast universitynurs 180 pharmacology midterm review west coast universitynurs 180 pharmacolog
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MEDICATION METHOD OF THERAPEUTIC USES COMPLICATIONS CONTRAINDIC INTERACTION NURSING CLIENT
ACTION ATIONS ADMINISTRATION EDUCATION
CH:28 PEPTIC ULCER DISEASE
Eradication of H. Pylori bacteria -Nausea and
ANTIBIOTICS Administer with diarrhea
food. -take full course
BLOCKING H2 RECEPTORS suppress secretion of gastric acid and -Pregnancy Risk B
HISTAMINE2- lowers the concentration of H+ ions. -Decreases gastric acidity which promotes bacterial
colonization of the stomach and respiratory tract.
RECEPTOR
-use cautiously in pts who have pneumonia, COPD
ANTAGONISTS To prevent or to treat gastric/ duodenal ulcers, GERD,
Hypersecretory conditions, Heartburn, Acid indigestion, Urticaria
Don’t give to patients with pneumonia
**I feel better after I dine!!**
RANATIDINE
Constipation, diarrhea, nausea – REPORT TO DR.
FAMOTIDINE (both can be IV)
(low libido, gynecomastia, and impotence.) -reversed when -increase levels of warfarin, phenytoin, theophylline, and lidocaine
stopped. -monitor bleeding, INR, and PT levels, and toxicity levels.
CIMETIDINE CNS effects -decrease absorption if used with antacids
(lethargy, hallucinations, confusion, restlessness) -do not take an antacid 1 hr before or after taking H2 antagonist.
-Smoking decreases effectiveness.
PROTON PUMP Blocks basal and stimulated “POR HO” -Digoxin, methotrexate, -Take omeprazole once 1 day
INHIBITORS acid production and reduce diazepam, tacrolimus, prior to eating in the
gastric acid secretion by Pneumonia – report antifungal agents and morning
OMEPRAZOLE irreversibly inhibiting the phenytoin levels can
enzyme that produces **Osteoporosis and fractures (decreased acid production can increase when used -active ulcers should be
lead to decreased calcium absorption). Use only until needed
PANTOPRAZOLE gastric acid. then taper. Increase vit D and Ca intake.
with omeprazole. treated 4-6wks.
Pantoprazole can (Monitor digoxin and
be given IV Short-term therapy of gastric phenytoin levels -Notify dr for signs of occult
Rebound acid hypersecretion
and duodenal ulcers, erosive carefully) GI bleeding.
esophagitis, and Gerd.
LANSOPRAZOLE **Hypomagnesemia - increase result reflexes
Treatment should be limited to
(Report tremors, muscle cramps, seizures, tachycardia,
4-8 weeks.
insomnia, confusion.)
1
, CDiff-associated diarrhea.
(Report fever, diarrhea, abdominal cramping, or bloody stools
immediately to the dr.)
-Pregnancy Risk C
-Ripulvirine
-Use cautiously in children and clients who have
dysphagia/liver disease
MUCOSAL -The acidic environment Treatment of acute
of stomach and duodenal ulcers CONSTIPATION Can interfere with the So take before meals!!
PROTECTANT duodenum changes (increase fiber and fluid intake) absorption of phenytoin,
sucralfate into a digoxin, warfarin, and Take four times a day, 1 hr before
SUCRALFATE protective barrier that Neutralize or reduce ciproflaxin (maintain a meals, and at bedtime.
Pregnancy Risk Cat B
sticks to the ulcer the acidity of gastric 2hr interval between
*SUCKS ON THE protecting it from acid; can reduce medications) Complete course of treatment
Use cautiously in clients who have
ULCER** further injury from acid pepsin activity if the chronic kidney disease or DM
and pepsin. Antacids interfere with
pH is raised above 5. the effects of sucralfate
The viscous substance can (take sucralfate 30 mins
stick to the ulcer up to 6 before or after antacids)
hrs.
ANTACIDS Neutralize /reduce the Aluminum and calcium compounds: Decrease absorption of Medication
acidity of gastric acid; can - CONSTIPATION several medications can be
reduce pepsin activity if - ELECTROLYTE IMBALANCES - HYPOPHOSPHATEMIA including ranitidine and administered
ALUMINUM the pH is raised above 5. cimetidine (allow at least seven times a
HYDROXIDE Magnesium compounds: (useful as a laxative) 1 hour between time day:1 hr and 3
Mucosal protection can - DIARRHEA between taking antacids) hr after meals,
MAGNESIUM occur from stimulation of (Alternate use of these compounds to offset intestinal effects and normalize bowel and again at
HYDROXIDE the production of function, adjusting administration as needed to promote a normal bowel pattern.) Aluminum compounds bedtime.
prostaglandins -TOXICITY, HYPERMAGNESEMIA bind to warfarin, digoxin,
CALCIUM (muscle weakness, lethargy, decreased respirations, bradycardia, hypotension) and tetracycline Take all
CARBONATE Treatment of PUD interfering with medications
FLUID RETENTION (antacids containing sodium can retain water). Avoid if you have absorption and reducing at least 1 hr
Prevention of stress- hypertension or heart failure. their effects. (do not take before or
induced ulcers other medications within
after taking
CA COMPOUNDS: HYPERCALCEMIA 1 to 2 hr of taking Al
Relief of signs of GERD compounds without dr antacid.
Report manifestations OF (bone pain, arrythmias, kidney stones, muscle weakness,
excessive urination, constipation, anorexia, N/V, confusion) approval)
Caution in clients who have GI perforation or obstruction
2
, Use cautiously in pts who have abdominal pain.
Prostaglandin E Acts an endogenous prostaglandin in the GI tract that Diarrhea – when used with Mg antacids. (Notify dr of **Pregnancy Risk Cat X
analog -decreases acid secretion diarrhea/abdominal pain.
-increases secretion of bicarbonate and protective mucus
MISOPROSTOL -promotes vasodilation to maintain submucosal blood flow. Dysmenorrhea, spotting – notify dr.
(Me so
These actions serve to prevent gastric ulcers. Helps will contractions and helps with active labor, so
pregnant)
make sure patient is ready for labor
Pts who take NSAIDs in a long-term basis (like OA and RA pts.) – to
prevent gastric ulcers.
CHAPTER 29: GASTROINTESTINAL DISORDERS
CNS depressants (opioids and alcohol) can intensify CNS depression of antiemetics. (avoid sedatives, opioids, -Prevent or treat N/V from various
and alcohol when taking antiemetics. causes.
Can intensify hypotensive effects of antiemetics with antihypertensives -administer prior to chemotherapy
ANTIEMETIC
S
Serotonin Prevents emesis by blocking the Headache, diarrhea, dizziness. -administer 1 h before chemo
Antagonists: serotonin receptors in the -treat headache with non-opioid analgesics or 1 hr before anesthesia to
chemoreceptor trigger zone and -monitor stool pattern prevent N/V
ONDANSETRON antagonizing the serotonin receptors on the
afferent vagal neurons that travel from the upper **Prolonged QT interval lead to serious dysrhythmia (torsades de
GI tract to the CTZ. pointes)
“I threw up on -Monitor ECG in pts who have cardiac disorders
Dan” Prevents emesis related to chemo, -use with caution in pts w/ electrolyte abnormalities.
radiation, and post-op recovery
Contraindicated in clients who have long QT syndrome
Cannabinoids: unknown To Control CINV and Potential for dissociation, dysphoria For emesis prevention,
to increase appetite Avoid using in pts who have mental health disorders. administer every 4 hrs as
DRONABINOL in pts who have needed.
AIDs. Hypotension, tachycardia
Use cautiously in pts who have cardiovascular disorders
Anticholinergics: Interferes w/ the Prevention and Sedation To prevent motion sickness, apply Client ed:
transmission of treatment of motion transdermal patch behind the ear 4 hrs -increase fluid intake
nerve impulses sickness Anticholinergic effects: before travel or take the tablet 1hr before -Increase physical activity
SCOPOLAMINE traveling from the travel. -suck on hard candy or chew gum to
-dry mouth, urinary
Administer relieve dry mouth.
vestibular retention, constipation. Nursing actions: administer a stimulant
transdermal, PO, IV, -Void every 4 hrs. Monitor 1/O, and
apparatus of the or subq Can intensify laxative (senna) to counteract a decrease in palpate the lower abdomen area
inner ear to the anticholinergic effects of bowel motility. Stool softeners to prevent every 4-6 hrs to check bladder for
3
, vomiting center antiemetics with use of constipation. fullness.
of the brain. anticholinergic meds.
LAXATIVES: Return to regular bowel
function Osmotic laxatives: Mg GI Irritation (do not crush or COMPLICATION: INFLAMMED Chronic laxative use can lead to
hydroxide, lactulose chew EC coated tablets) RECTUM! fluid and electrolyte imbalance.
Evacuation of bowel in Low dose: Prevent painful
preparation for surgery elimination Toxic magnesium levels Contraindicated with patients To promote defecation and
**Do an or diagnostic tests. who have fecal impaction, resumption of normal bowel
abdominal High dose: pt preparation bowel obstruction, and acute function, increase high-fiber
prior to surgery or diagnostic
Dehydration
assessment Osmotic laxatives: Mg surgical abdomen to prevent foods (bran, fresh fruits and
tests. Osmotic diuretics cause
hydroxide, lactulose perforation. vegetables) in the daily diet
first!!** dehydration. (Monitor I/o,
Draw water into the monitor and asses for signs of and to increase amounts of
Rapid evacuation of the Contraindicated in clients who fluids (2-3L/day)
intestine to increase dehydration, patient to increase
bowel after ingestion of have nausea, cramping, and
Osmotic laxatives: the mass of stool, poisons or following water intake to at least 8-10
abdominal pain. Use laxatives occasionally, not
glasses of water per day.
MAGNESIUM stretching anthelmintic therapy to rid routinely.
HYDROXIDE musculature, which the body of dead parasites. Contraindicated in clients who
have UC and diverticulitis
results in peristalsis. Maintain a regular exercise
(except bulk-forming laxatives) regimen to improve bowel
LACTULOSE function.
Use cautiously during pregnancy
and lactation.
Bulk-forming -soften fecal mass and increase -Temporary treatment of constipation Can cause obstruction of the Take with 8oz of water
laxatives: bulk, identical to the action of -decrease diarrhea in clients who have esophagus or intestines. (administer
diverticulosis and IBS. with a full glass of water or juice. Avoid
PSYLLIUM dietary fiber. -control stool for pts who have an use if client has narrowing of the
ileostomy/colostomy intestinal lumen.
-lower surface Treatment of Laxatives with sodium salts Take with 8oz of water
tension of the constipation (sodium phosphate) place clients at risk for sodium absorption and fluid retention.
Surfactant (monitor fluid retention)
laxatives: stool to allow Softening of
DOCUSATE penetration of fecal impaction Dehydration
water. This softens Osmotic diuretics cause dehydration. (Monitor I/o, monitor and asses for signs of
SODIUM the stool so it can be dehydration, patient to increase water intake to at least 8-10 glasses of water per day.
passed more easily. (Same as above) and Pregnancy Risk C
4
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