Treatment of GERD and PUD Reduce acid Neutralize acid Heal by coating ulcers in stomach Antibiotics for Helicobacter pylori (H. pylori)
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
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
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
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
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
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
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
Drugs used for Nausea/Vomiting Causes? Drug therapy utilized Anti-emetics
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
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
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