GI Meds - ergwgq PDF

Preview

Summary

ergwgq...

Description

1

GI Medications

Gastrointestinal Medications Classification Antacids

Mechanism (Pharmacology) Neutralizes gastric acids, increases serum bicarbonate (raises pH), or binds to intestinal phosphates

Action (What it Really Does) Raises the pH in the GI tract by either increasing HCO3 from the kidneys or decreasing / neutralizing the HCL acid released by stomach

Examples Aluminum Hydroxide (Amphogel); Maalox, Mylanta (Aluminum hydroxide/magnesium hydroxide/simethicone), Titralac, Alternagel, Calcium Carbonate (TUMS, Maalox), Sodium Bicarbonate

Proton Pump Inhibitors (PPI)

Inhibits gastric acid (gastrin) production and secretion at the level of parietal cells in the stomach

Reduces acid secretion in the stomach therefore helps ulcers heal and prevents further gastric ulcer formation.

Omeprazole (Prilosec), Pantoprazole (Protonix),

Antisecretory Agent Prostaglandin E Analog Gastric Mucosal Protectant

Inhibits gastric acid secretion and protects gastric mucosa

Eliminates gastric acid, therefore protects mucosa from damage

Misoprostol (Cytotec)

Adheres to site of ulcerations in order to prevent further breakdown

Helps to heal and protect gastric mucosa by adhering to surface

Sucralfate (Carafate)

Histamine Blockers (H2)

Selectively antagonizes histamine H2 receptors to block gastric acid secretions

Reduces gastric acids by blocking histamine receptors (histamine is normally released to block unwanted “invaders”….therefore increases acidity).

Ranitidine (Zantac), Famotidine (Pepcid), Cimetidine (Tagamet), Nizatidine (Axid)

Aminosalicylates

Reduces prostaglandin synthesis to reduce inflammation

Helps reduce inflammation in the GI tract and elsewhere, thereby helping prevent flare-ups in diseases such as Crohn’s and Ulcerative Colitis

Sulfasalazine (Azulfidine), Olsalazine (Dipenturn), Mesalamine (Rowasa, Asacol)

Emetic

Stimulates the CNS to induce vomiting

Induces vomiting for therapeutic benefit

Sorbitol, Ipecac

2

Antiemetic

Antagonizes acetylcholine receptors

GI Medications

Medications all work on the central >>>> nervous system by blocking receptors to neurotransmitters (promotes anticholinergic responses)

Antagonizes H1 receptors in nervous >>>>>>>>>>>>>>>>>>>>>>>>>>>>>> system

Antidiarrheals

Promethazine (Phenergan), Dimenhydrinate (Dramamine)

Selectively antagonizes Serotonin 5HT3 receptors

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Ondansetron (Zofran), Dolasetron (Anzemet)

Sensitizes tissues to acetylcholine, stimulating upper GI tract motility; antagonizes dopamine receptors

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> **Very important nursing consideration for all antiemetics is to monitor for sedation as anything that works in CNS may cause oversedation.

Metoclopramide (Reglan), Trimethobenzamide (Tigan)

Binds to gut wall opioid receptor, inhibiting peristalsis; increases anal sphincter tone

All medications in this classification >>> reduce peristalsis and gastric secretions to increase the time stool spends in the GI tract. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Loperamide (Imodium), Diphenoxylate/Atropine (Lomotil),

Reduces gastric secretions and possesses topical mucosal effects

Bismuth may turn stools dark – which >> may be misinterpreted as GI bleeding. Check stools for OB to make sure.

Bismuth Subsalicylate (Kopectate, Pepto-Bismol)

Alters gas bubble surface tension

Reduces flatulence. Especially useful in hypermotility disorders

Simethicone (Mylicon, Phazyme, Gas-X)

Binds intestinal bile acids

Antiflatulents

Meclizine (Antivert), Prochlorperazine Maleate (Compazine), Scopolamine (Scopace)

Colestipol (Colestid), Cholestyramine (Questran, Prevalite)

3

Laxatives Bulk Laxative

GI Medications

Increases stool bulk

All forms of laxatives are used to relieve constipation and produce normal stools.

Psyllium (Metamucil), Methylcellulose (Citrucel)

Stimulant Laxative

Increases peristalsis in GI tract

All forms of laxatives do have the potential for abuse and also diarrhea

Bisacodyl (Dulcolax), Castor Oil, Sennoside (Ex-lax, Senna)

Osmotic Laxative

Neutralizes gastric acidity and causes water retention in stool which produces laxative effect

Milk of Magnesia, Lactulose, Plythylene glycol (MiraLax)

Stool Softener

Facilitates mixture of stool fat and water Antagonizes acetylcholine at muscarinic receptors, relaxes smooth muscles, and inhibits histamineinduced spasms

Ducusate Sodium (Colace)

Antispasmodics

Reduces GI motility by relaxing smooth muscles in intestines, especially in times of stress (anticholinergic action). Useful with IBS to reduce frequency and urgency

Dicyclomine (Bentyl), Hyoscyamine (Anaspaz, Levsin), or Donnatol (combination of hyoscyamine, atropine, scopolamine, and phenobarbital)...