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Gastrointestinal Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. Chapter 19 1.

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Presentation on theme: "Gastrointestinal Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. Chapter 19 1."— Presentation transcript:

1 Gastrointestinal Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. Chapter 19 1

2 Learning Objectives Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 2 Identify common uses for antacids and histamine H 2 -receptor antagonists Compare and contrast the actions of anticholinergic and antispasmodic medications on the gastrointestinal (GI) tract Compare the actions and adverse reactions of the five major classifications of laxatives

3 Antacids, H 2 -Receptor Antagonists, Proton Pump Inhibitors Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 3 Action and Uses Antacids neutralize hydrochloric acid which decreases gastric pH; inhibit pepsin Histamine H 2 -receptor antagonists displace histamine from the receptor site and prevent stimulation of the secretory cells (neutralize acid and promote healing of ulcers) Proton pump inhibitors irreversibly stop the acid secretory pump embedded in the parietal cells for the length of time they are taken

4 Antacids, H 2 -Receptor Antagonists, Proton Pump Inhibitors (cont.) Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 4 Nursing Implications and Patient Teaching Assessment: interaction possibilities Diagnosis: smoking/alcohol intake, stress Planning: increase fluid intake Implementation: forms and routes of administration vary Evaluation: continued symptoms of GI distress Patient and Family Teaching: administration times and drug specificity, adverse reactions, drug storage and efficacy, medical follow-up, drug interactions

5 Antacids Tums calcium carbonate Riospan magaldrate Milk of Magnesia magnesium hydroxide Mag Ox magnesium oxide Generics: aluminum carbonate sodium bicarbonate Antacid combinations Maalox magnesium hydroxide & aluminum hydroxide Gelusil aluminum hydroxide, magnesium hydroxide & simethicone **Aluminum tends to constipate a person.

6 H2 Receptor antagonists (-tidines) Tagamet cimetidine Pepcid famotidine Axid nizatidine Zantac ranitidine

7 Gastric medications Treatment for H pyloriMiscellaneous Helidac/ Pylera Bismuth subsalicylate, metronidazole & tetracycline Get 4 pills with each dose QID Chew the bismuth and swallow the Metro. & tetra. Cytotec misprostol acts to increase gastric mucus layer/ protects Carafate sucralfate coats stomach wall/ protects ulcers so they can heal

8 Proton Pump Inhibitors (PPIs) -prazoles Nexium esomeprazole Prevacid lansoprazole Prilosec omeprazole Protonix pantoprazole Aciphex rabeprazole

9 Anticholinergics and Antispasmodics Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 9 Action and Uses Anticholinergic-antispasmodic preparations reduce GI tract spasm and intestinal motility, acid production, and gastric motility, thus reducing pain Use: peptic ulcer, pylorospasm, biliary colic, hypermotility, irritable colon, and acute pancreatitis Antidiarrheals reduce the fluid content of the stool and decrease peristalsis and motility of the intestinal tract; increase smooth-muscle tone and diminish secretions Use: treatment of nonspecific diarrhea or diarrhea caused by antibiotics

10 Anticholinergics Belladonna AlkaloidsAnticholinergics Sal-Tropine atropine sulfate Scopace scopolamine Librax clidinium Robinul glycopyrrolate Pro-Banthine propantheline Anticholinergic combo drug Donnatol hyoscyamine, atropine, scopolamine & phenobarbital

11 Gastrointestinal medications antispasmodicGI Stimulant Bentyl dicyclomine Reglan metaclopramide Increase speed at which the stomach empties

12 Antidiarrheals Pepto-Bismol Bismuth subsalicylate (think ASA) Lomotil – ‘Lo motility’ diphenoxylate and atropine sulfate Kaopectate kaolin & pectin Bacid / Lactinex lactobacillus Immodium loperamide Asacol – for ulcerative colitis mesalamine Azulfidine – for ulcerative colitis sulfasalazine

13 Question 1 Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 13 Antidiarrheals act by: 1. increasing the fluid content of the stool. 2. decreasing peristalsis in the intestinal tract. 3. increasing digestive secretions. 4. decreasing smooth muscle tone.

14 Laxatives Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 14 Action and Uses Bulk-forming laxatives absorb water and expand, increasing the bulk and moisture content of the stool; peristalsis increases, and absorbed water softens the stool Fecal softeners lower the surface tension, which allows the fecal mass to be softened by intestinal fluids Hyperosmolar laxatives produce an osmotic effect by drawing water into the bowel, thereby promoting peristalsis and bowel movement

15 Laxatives (cont.) Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 15 Action and Uses (cont.) Lubricant laxatives create a barrier between feces and the colon, preventing colon reabsorption and causing softening of the stool Stimulant or irritant laxatives work according to the agent

16 Laxatives Bulk formingFecal softener Citrucel methylcellulose Metamucil / Fiberall psyllium seed Colace docusate

17 Laxatives cont. Saline / hyperosmolarLubricants Philips Milk of Magnesia magnesium Fleet’s enema sodium salts Emulsoil castor oil Stimulant / Irritant Dulcolax / Correctol bisacodyl Cascara cascara sagrada Senekot / Ex-Lax senna

18 Antiflatulents Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 18 Break up and prevent mucus-surrounded pockets of gas from forming in the intestine; reduce gastric pain Intended for short-term use

19 Miscellaneous GI Medications Antiflatulents activated charcoal (think liquid briquettes from the grill) Mylanta Gas Relief / Mylicon Simethicone – makes the bubbles smaller so they are easier to pass Emetics Syrup of Ipecac – ipecac (will clean out entire GI tract!!)

20 Gallstone-Solubilizing Agents Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 20 Act on the liver to suppress cholesterol and cholic acid synthesis; biliary cholesterol desaturation is enhanced, and breakup occurs Used in selected patients with radiolucent stones in gallbladder Adverse reactions: dose related; diarrhea, anorexia, constipation, cramps, dyspepsia, epigastric distress, flatulence, heartburn, nausea, nonspecific abdominal pain, and vomiting Gallstone Dissolvers – Actigall - ursodiol

21 Digestive Enzymes Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 21 Promote digestion by acting as replacement therapy when the body’s natural pancreatic enzymes are lacking, not secreted, or not properly absorbed Digestive enzymes Creon pancreatin Pancrease pancrelipase

22 Disulfiram Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc. 22 Used in the management of alcoholism Unpleasant reaction when combined with alcohol Anti-alcoholic product: Antabuse - disulfiram

23 Questions?


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