Flashcards
Miscellaneous Acid-Controlling Drugs
Cards in this deck (44)
- 1Miscellaneous Acid-Controlling DrugsSucralfate
Cytotec
Antacids - 2SucralfateUses: long-term therapy for PUD
Action: acts locally binding directly to the surface of the ulcer.
Note: not used as often due to short-term action and multiple daily dosing - 3Cytotec misoprostolprostaglandin E analogue
incidence of gastric ulcers in patients taking NSAIDs. - 4Traveler’s diarrheaFrequent cause: Escherichia coli
Preventive measures - 5Types of antidiarrhealsAntimotility
Somatostatin analog, octreotide
Adsorbents
Agents modify fluid & electrolyte transport - 6Adsorbents act byAct by coating the walls of the GI tract
Bind with the causative bacteria or toxin for elimination through the stool - 7Kaopectate bismuth subsalicylateSame chemical structure as salicylate
caution in children. May cause Reyes Syndrome
caution in clients who are on anti-coagulation therapy. - 8Imodium A D loperamideOpiate antidiarrheal
- inhibits both peristalsis in the intestine and intestinal secretions,
- decreasing the number of stools and their water content.
Contraindications: ulcerative colitis, acute diarrhea due to E-coli (Escherichia coli) - 9Laxative act by:- Affecting the consistency of the stool
- Increasing fecal movement colon
- Facilitating movement through the colon - 10Constipation:abnormally infrequent and difficult passage of feces.
Constipation is a symptom not a disease. - 11Bulk-forming Laxativeswater-retaining natural and synthetic cellulose derivates
Psylium natural bulk-forming laxative.
Methylcellulose synthetic cellulose derivative - 12Bulk-forming Laxativesincreases water absorption, which results in greater bulk
produce normal, formed stools.
adverse effects are minimal. - 13Classes of LaxativesBoss
- 14systemic effects of high fiber intake occur, include: lowering of serum cholesterol due to binding of cholesterol secreted in the bile- swell in contact with water
- 15 grams of dietary fiber results in softer and bulkier stools within 24-48 hrs.
- No systemic absorption of agent occurs - 15Cellulosecan bind and reduce intestinal absorption of many drugs
Allergic reactions,
Flatulence may be a problem - 16Saline and Osmotic Laxatives clinical settings when prompt evacuation of bowel is needed following the use of activated charcoal or potassium-binding resins used in poisoning and hyperkalemia-Poorly absorbed
- The onset of action is 30 minutes to 3 h
- cause abdominal cramps, electrolyte and acid-base disturbances and volume depletion.
- Up to 20% of salt is absorbed, this may contribute significant Mg++ to cause toxicity in patients with impaired renal function. - 17Lactulose is helpful inmanaging chronic hepatic encephalopathy because it reduces production and reabsorption of ammonia (e.g. by intestinal bacteria, ion trapping, increased fecal excretion).
- 18MAGNETsium is a toilet MAGNETIt pulls you towards the bathroom! (Think magnet also in terms of the osmotic pull, this will make you remember that magnesium is a osmotic agent).
- 19stool softening laxativeEmollient laxative
Mineral Oil - 20Mineral Oil eases the passage of stoolby lubricating the intestines and preventing water from escaping the stool.
- 21Contraindications Mineral oilAbdominal pain
Nausea and vomiting
Intestinal obstruction - 22Hyperosmotic LaxativesGlycerine
promotes bowel movement by increasing the osmotic pressure in the intestine.
Note: given in the form of a suppository - 23Emollient laxative- docusate salts
- work by lowering the surface tension of GI fluids; more water and fat are absorbed into the stool and intestine. - 24Uses: Emollient laxative docusate saltspost partum
postoperative patients
Clients on long-term pain control
Outcomes: soft stool with easier defecation - 25Stimulant Laxatives aleo senna cascara- drugs induces intestinal peristalsis.
- stimulant class is the most likely to cause dependence.
stimulates the GI tract
- Adverse effects: cause abdominal pain.
- complete bowel evacuation in 6 to 12 hours - 26Chloride channel activator Lubiprostone, Linaclotide treatment of women with IBS with predominant constipation.activates the type 2 chloride channels in the small intestine,
indirectly by activates guanylyl cyclase-C on the luminal intestinal epithelial surface, resulting in increased intracellular and extracellular cGMP, which in turn leads to activation of the type 2 chloride channels - 27Mylicon simethicone- alters the elasticity of mucus-coated gas bubbles, break them down into smaller ones
- reduce the discomfort of gastric or intestinal gas (flatulence)
Used post-operatively and in post-partum patients to relieve gas pain.
used in combination with activated charcoal in oral poisoning (overdose). - 28Probioticsalters the elasticity of mucus-coated gas bubbles, causing them to break down into smaller ones
Used to reduce the discomfort of gastric or intestinal gas (flatulence)
Used post-operatively and in post-partum patients to relieve gas pain.
Often used in combination with activated charcoal in oral poisoning (overdose). - 29Uses of probioticChronic Diarrhea
Irritable Bowel Syndrome
Digestive disorders
Clients on oral or IV antibiotic therapy
Status post abdominal surgery - 30Cerebral Centers Affecting VomitingVomiting Center (VT)
Chemoreceptor Trigger Zone (CTZ) - 31Origin of vomiting Vomiting center,located in medulla oblongata
Stimuli are relayed to the vomiting center from the periphery (gastric mucosa, peritoneum, intestines, joints) and centrally (cerebral cortex, vestibular apparatus in the ear and from the chemoreceptor trigger zone in the 4th ventricle - 32Motion sicknesstriggers receptors in inner ear>>CTZ and the vomiting center
- 33Vomiting center, chemoreceptor trigger zone and the GI tractcontain benzodiazepine, cholinergic, dopaminic, histaminic, opiate and serotonin receptors that are stimulated by emetogenic drugs and toxins
- 34Causes of nausea and vomiting GI disorders Cardiovascular, infectious, neurologic or metabolic disorders as wellPain
Emotional disturbances
Radiation therapy
Motion sickness
Drug therapy: especially w/alcohol, ASA, digoxin, anticancer drugs, antimicrobials, estrogen preparations and Opioids - 35Antiemetic Drugs- anticholinergic, antidopaminergic, antihistaminic or antiserotonergic effects
- more effective in prophylaxis than treatment
- act on the vomiting center, the chemoreceptor trigger zone, the cerebral cortex, the vestibular apparatus or a combination of. - 36Antiemetic Drugs
- 37Mnemonics on Anti-emetics: Awesome People Had Antiemetic Drugs SuccesfullyA- anticholinergics
P- prokonetic
H- H1-antihistamines
A- adjuvents
D- D2 blockers
S- serotonin antagonist - 38Adjuvent antiemetics@ABCD
A-adjuvent
B-benzodiazepines
C-cannabinoides
D-dexamethasone - 39D2 BLOCKER @ 2nd gen HP Computer Act on the CTZ and the vomiting center (EPS)2- D2
H-haloperidol
P-prochlorperazine
C-chlorpromazine - 40serotonin antagonist: @Old Granny took serotonis antagonistO-ondansetron
G-granisetron - 41for h1-antihistamines @CDP(community development Programme)C-cyclizine, cinnarizine
D-doxylamine, dimenhydrinate
P-promethazine - 42for prokinetics: MeDicineM D
Metoclopramide & domperidone
D2 dopamine receptor antagonists
that increases GI motility and the rate of gastric emptying by increasing the release of acetylcholine from nerve endings in the GI tract - 43(metoclopramide& domperidone)central antiemetic effects, antagonizes the action of dopamine
Can be given IV, PO or IM
extrapyramidal reactions, increase the effects of cyclosporine and decrease the effects of cimetidine and digoxin - 44Aprepitant, NK-1 receptor antagonistuse in combination with other antiemetics for prevention of the nausea and vomiting associated with highly emetogenic chemotherapeutic regimens
can cause fatigue, dizziness, and diarrhea
inhibitor of CYP3A4,
in many drug interactions