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GI Medications and Related Disorders NUR 154 Ivy Tech Community College Pharmacotherapeutics.

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Presentation on theme: "GI Medications and Related Disorders NUR 154 Ivy Tech Community College Pharmacotherapeutics."— Presentation transcript:

1 GI Medications and Related Disorders NUR 154 Ivy Tech Community College Pharmacotherapeutics

2 Gastrointestinal A & P  Esophagus  Stomach  Small intestine Duodenum Jejunum Ileum  Large Intestine

3 Gastrointestinal Reflux Disease (GERD)  Signs and Symptoms “Heartburn” Bloating/eructation Regurgitation “Hiccups” Angina (chest pain)  Causes Weak cardiac sphincter Leads from esophagus to stomach Delayed emptying Hiatal hernia Obesity Overeating Constriction Increased acid

4 Peptic Ulcer Disease  Risk Factors Acid/defense imbalance Genetic predisposition Stress Smoking NSAID’s Food/alcohol  Signs & Symptoms Epigastric pain Bloating N & V Anorexia

5 Treatment of GERD and PUD  Reduce acid  Neutralize acid  Heal by coating ulcers in stomach  Antibiotics for Helicobacter pylori (H. pylori)

6 Antacids  Maalox  Mylanta  Limit use for 2 weeks for indigestion  Use Low Na diet for renal, cardiac, pregnant clients  Tablets ineffective for PUD  Call MD if S&S worsen  No Mg if renal patient

7 Antacids  Side Effects Constipation (Ca & Al) Diarrhea (Mg) Chalky taste  Nursing Actions Alternate between types may help constipation & diarrhea Switch brands, try different flavors Try liquids, not tabs

8 H2 Antagonists  Side Effects Dizziness, HA’s, somnolence Diarrhea, constipation Confusion, hallucinations Gynecomastia (long- term use) Hepatotoxicity  Related Nursing Actions Safety – resolves with time Hydration/bulk; stool softeners Monitor; Safety Monitor Monitor; report labs, S/S

9 GI Prostaglandin  Misoprostol (Cytotec)  Used for NSAID- induced ulcers  Contradindicated with pregnancy (induces uterine contractions  Side Effects Diarrhea  Nursing Action Take with meals and hs Avoid Mg antacids Roughage may help

10 Gastric Acid Pump Inhibitors  Omeprazole (Prilosec)  Used for severe esophagitis, GERD, PUD, hypersecretion  Give before meals (ac)  Swallow capsule whole  Side Effects Diarrhea HA Muscle pain Fatigue Rash  Nursing Actions Usu. mild S/S Fluids/Fiber may help diarrhea Report rash

11 Prokinetic Agents  Metoproclamide (Reglan)  Used for GERD, post- barium, anti-emetic for chemotherapy  PO or IV Dilute IV with 50 ml diluent/infuse over >15 minutes Contraindicated with epilepsy  Side Effects Extrapyramidal S/S (esp. with elderly, children, or higher doses) Drowsiness, nausea May alter absorption of food and drugs  Nursing Actions Monitor at-risk clients; report Drowsy, nausea usu. mild, Resolves with time Watch for signs of increased or decreased action of other routine meds

12 Antispasmodics  Dicyclomine (Bentyl) Used for irritable bowel, colic, PUD, ulcerative colitis Do not use with closed- angle glaucoma Give with food or milk  Side Effects Anticholinergic effects Blurred vision, constipation, urinary retention, dry mouth Confusion, depression, nightmares, hallucinations Orthostatic hypotension Palpitations; arrhythmias  Nursing Actions Assess, treat S/S Baseline VS and mental state-continued monitoring IV; safety measures Report problems/changes

13 Drugs used for Nausea/Vomiting  Causes?  Drug therapy utilized Anti-emetics

14 Anti-Emetics  Phenothiazines Promethazine (Phenergan); Prochlorperazine (Compazine)  Serotonin Antagonists ondansetron (Zofran)  Anticholinergics Dimenhydrinate (Dramamine) Scopalamine (Trans- derm-Scop)  For mild-mod. N/V  Used with chemo, rad. therapy, Pre/post-op  Used for motion sickness; Transdermal Patch commonly used for Hospice pt.s

15 Phenothiazines  Side Effects Drowsiness Orthostatic hypotension Anticholinergic S/S (e.g. dry mouth, urinary retention) Extrapyramidal symp.s Photosensitivity  Nursing Actions Safety Monitor; Safety Monitor; treat S/S Monitor; Report Avoid UV exposure; Protection

16 Serotonin Antagonists  Zofran  Side Effects HA Diarrhea Constipation Sedation  Nursing Actions Usually mild Tx symptoms Be alert for allergic rxn Seems to be more common with this drug Stop drug Give Benadryl IV

17 Anti-Cholinergics  Side Effects:  Sedation  Anticholinergic S/S E.g,. dry mouth  Nursing Actions:  Safety  Treat S/S

18 Drugs used for Constipation and Diarrhea  Causes? Major cause of constipation is what category of meds? Common cause of diarrhea is what category of meds? Other causes?  Treatment

19 Laxatives  Stimulant (Dulcolax) PO: 6-10 hrs action PR: 60-90 minutes action  Saline (MOM) 1-3 hrs action  Lubricant (Mineral oil) 6-8 hrs action  Bulk (Metamucil) 12-24 hrs action Give with H20  Stool Softeners (Pericolace) 72 hrs action

20 Laxatives  Side Effects Cramping, diarrhea Abdominal pain, bleeding, vomiting, distention  Nursing Action Assess before administration Hold PRN Report to MD

21 Diarrhea  Causes?  Treatments

22 Anti-Diarrheal Meds  Locally-acting (Kaopectate)  Systemic-acting Lomotil (diphenoxylate with atropine)  Give dose with loose BM  Addiction potential r/t systemic effects (atropine added to minimize this potential)

23 Anti-Diarrheal Meds  Side Effects Abd. Distention Nausea Constipation Dizziness and drowsiness (with Lomotil)  Nursing Actions Monitor Report increased diarrhea

24 Disclaimer  This workforce solution was funded by a grant awarded under the President’s Community-Based Job Training Grants as implemented by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. This solution is copyrighted by the institution that created it. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner.

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