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45 Cards in this Set

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What are H2-Blockers used for? And give examples of two that are commonly used.
They decrease acid production for patients with Gastric and duodenal ulcers, heartburn, acid ingestion, and gastroesophageal reflux disease, and upper gastrointestinal bleeding.

Ranitidine (Zantac)
Cimetidine (Tagamet)
What is the mechanism of action of Ranitidien (Zantac) and Dimetidine (Tagamet)?
Ranitidine and Cimetidine are Histamine H2-antagonists that inhibit histamine action on H2-receptors, which are found on the gastric parietal cells and prevent gastrin secretion, thus decreasing acid production.
What are the common side effects of Ranitidine (Zantac) and Cimetidine (Tagamet)?
Confusion, dysrhythmias.

-There is a decrease in stomach acid which may increase growth of Candida and bacteria in the stomach.
What are important patient teachign for clients taking Ranitidine (Zantac) and Cimetidien (Tagamet)?
-Teach to avoid alcohol
-Smoking may decrease effectiveness
What type of drug is Psyllium (Metamucil)? And what are its uses?
-Bulk Forming laxative
-Used for constipation, also prevents constipation and straining after myocardial infarction or rectal surgery
-Can be used to form and thicken diarrhea, but watch for N/V
What is the mechanism of action of Psyllium (Metamucil)?
Acts similar to dietary fiber. THis medication is not digested or absorbed. After ingestion, it will swell to form a viscous solution or gel, softening the fecal mass and increasing the bulk. A fecal mass stretches the intestinal wall to stimulate peristalsis and passage of soft-formed stool in 1 to 3 days.
What are some side effects of Psyllium (Metamucil)?
Abdominal discomfort.
Impaction and obstruction if not given with adequate liquids.
What are important nursing implications when caring for a patient taking Psyllium (Metamucil)?
-If powder is mixed with water, mix at bedside immediately before administration
-Instruct client to drink a full glass of water after administration.
What type of drug is Metoclopramide Hydrochloride (Reglan) and what is it used for?
-Peristaltic stimulant, antiemetic

Used for:
-Stimulates gastric emptying, intestinal transit
-Treatment of heartburn, delayed gastric emptying secondary to reflux esophagitis
-Suppresses vomiting in cancer therapy.
What is the mechanism of action of Metoclopramide Hydrochloride (Reglan)?
Increases tone and accelerates intestinal transit and gastric emptying; suppresses emesis.
What are the common or dangerous side effects of Metoclopramide Hydrochloride (Reglan)?
-Sedation and diarrhea
-Extrapyramidal symtoms (toxic)
What are the important nursing implications for a patient taking Metoclopramide Hydrochloride (Reglan)?
-Monitor for anxiety, restlessness, extrapyramidal symptoms
-Give 30 minutes before meals and at bedtime.
What type of drug is Omeprazole (Prilosec)?
Proton Pump Inhibitor
What type of medication is Magnesium Hydroxide (Milk of Magnesia) and what is it used for?
-Osmotic Laxative, magnesium compound
Used for: Constipation, to cleanse the GI tract, and/or flush ingested toxins out the gastrointestinal tract.
What is the mechanism of action of Magnesium Hydroxide (Milk of Magnesia)?
Draws water into the intestine by osmotic action on the surrounding tissue. the increase in fluid in the intestine will dilute the stool, stretch the bowel and increase peristalsis.
What are side effects of Magnesium Hydroxide (Milk of Magnesia)?
-Abdominal cramping, diarrhea, dehydration, hypermagnesemia.
What are the important nursing implications when administering Magnesium hydroxide (Milk of Magnesia)?
-Give with at least 8 ounces of water
-Will generally act within 6 to 12 hours, so if given in the PM, there will be a BM in the AM.
What patient teaching is important for a patient taking Magnesium Hydroxide (Milk of Magnesia)?
-Laxative abuse (laxative taken every day) decreases the defecatory reflex, leading to laxative dependence.
-Teach client to eat foods high in fiber (brans, fruits), increase fluid intake.
What type of drug is Esomeprazole (Nexium)?
Proton Pump Inhibitor
What type of Drug is Lansoprazole (Prevacid)?
Proton Pump Inhibitor
What type of drug is Pantoprazole (Protonix)?
Proton Pump Inhibitor
What is the mechanism of action of Proton Pump Inhibitors?
Produces an irreversible block of the enzymes that generates gastric acids. Blocks the final common path for gastric acid production. The effect will last until gastric enzymes are resynthesized.
What are proton pump inhibitors used for?
-Short term (4 to 8 wks): duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease (GERD)
-Long Term: hypersecretory conditions.
What are the most common side effects of Proton Pump Inhibitors?
Headaches
What are important patient teaching points for a client taking Proton Pump Inhibitors?
-Instruct client to avoid opening, chewing, or crushing capsules
-Instruct client to return for follow-up if symptoms are unresolved after 4 to 8 weeks of therapy.
-Should be taken before meals.
How can a nurse recognize that a drug is a proton pump inhibitor from its name?
The generic names end in ZOLE
What is the use of Aluminum Hydroxide (Amphojel)?
-It is a phosphate-binding antacid, aluminum compound
-It is used for:
>Relief of hyperacidity related to gastritis and reflux
-Gastric and duodenal ulcers
-May be used to treat hyperphosphatemia in renal insufficiency (Kidney stones due to high phosphate levels).
What is the mechanism of action of Aluminum Hydroxide (Amphojel)?
Reduces acid concentration and pepsin activity by raising the pH of gastric secretions. Dinds with phosphate and helps prevent hyperphosphatemia. Decrease in serum phospherous may precipitate in an increase in serum calcium.
What are important contraindications and precautions for patients who may be prescribed Aluminum Hydroxide (Amphojel)?
-May reduce effects of tetracyclines, warfarin, and digoxin
-Clients on sodium restriction should take caution if taking this.
What are the side effects of Aluminum Hydroxide (Amphojel)?
Constipation
What are the important nursing implications for a patient taking Aluminum Hydroxide (Amphojel)?
-Monitor serum calcium, phosphate, magnesium and sodium levles.
-Monitor for bone disease and neurologic impairment associated with magnesium toxicity.
-Do not administer antacids to cardiac clients complaining of dyspepsia, discomfort may be referred anginal pain.
What type of medication is Loperamide (Imodium)?
Antidiarrheal
What type of drug is Diphenoxylate Hydrochloride (Lomotil)?
Antidiarrheal
What is the mechanism of action and uses for Loperamide (Imodium) and Diphenoxylate Hydrochloride (Lomotil)?
Action: DIrect effect on intestinal wall muscles, slowing intestinal motility
Uses: Symptomatic relief of acute nonspecific diarrhea
-Chronic diarrhea associated with inflammatory bowel disease.
What are the common side effects of Loperamide (Imodium) and Diphenoxylate Hydrochloride (Lomotil)?
Drowsiness, dizziness, nausea, sedation, flushing, tachycardia, fatigue, depression, GI discomfort and constipation.
What are important nursing implications for a patient taking Loperamide (Imodium) and Diphenoxylate (Lomotil)?
-Encourage adequate fluid intake, monitor hydration status
-Check bowel sounds for peristalsis; discontinue and report abdominal pain and distention.
What is Lactulose used for?
-If you have portal hypertension (hepatic encephalopathy), your liver is not working right and so lactulose is used to help flush out the ammonia in your intestinal tract.
-Also used to treat constipation.
What type of drug is Lactulose and what is its mechanism of action?
-Retains ammonia in the colon by producing osmotic effects. Promotes increased peristalsis, bowel evaculation (expelling ammonia from colon).
What are important side effects to be aware of with a patient taking lactulose?
Abdominal discomfort, belching, abdominal distention (flatulence), n/v and diarrhea.
What is important nursing implications for a nurse caring for a patient on Lactulose?
-Check ammonia labs
-Anticipate need for a low-protein diet
-May be given PO or by enema
>>PO: mix with fruit juice, water, or milk to improve flavor.
>>Rectally: Use rectal balloon catheter; need to retain enema for 30 to 60 minutes.
What is Sodium Polystyrene Sulfonate (Kayexalate) used for?
-Used for the treatment of hyperkalemia. It is a cation exchange resin.
What is the mechanism of action of Sodium Polystyrene Sulfonate (Kayexalate)?
Ion exchange releases sodium for potassium. Removes potassium from the intestine before the resin is excreted.
What are the side effects of Sodium Polystyrene Sulfonate (Kayexelate)
Constipation, fecal impaction, gastric irritation, diarrhea, sodium retention and hypokalemia.
What is the most important patient teaching for a client being administered Sodium Polystyrene Sulfonate (Kayexalate)?
Discontinue any foods that are high in potassium.
What are important nursing implications when administering Sodium Polystyrene Sulfonate (Kayexalate)?
-If given orally, it usually is given with 20 to 100 ml of sorbital to facilitate passage of resin through the intestinal tract, which helps prevent constipation.
-If given by enema, a cleansing enema may be given before and after the administration of the enema with medication. Sorbitol 100 ml may be added to the enema solution. After the medicaiton is given, flush with 50 to 100 ml of fluid and clamp. Retain for several hours if possible.
-Draw POTASSIUM levels every 24 hours
-Monitor daily bowel activity and stool consistence (Fecal impaction may occur, especially in older adult clients).
-Monitor client's electrolyte level and electrocardiogram.