Antacid Agents

Magnesium hydroxid, aluminum hydroxide, calcium carbonate, sodium bicarbonate

Use: reduce pain of peptic ulcers by neutralizing acid in the stomach, decreasing irritation of the stomach lining, inhibiting production of pepsin.

Side Effects: aluminum; constipation, magnesium; diarrhea

Patient Teaching: nonprescription w/side effects, can be abused, shake before pouring, interfere with absorption of oral drugs if given within 1-2 hours of eachother, chew tablets before swallowing.

H2-Receptor Antagonist Agents

Tagamet, Zantac, Pepcid, Axid

Use: reduce secretion of gastric acid and promote healing of ulcers

Side Effects: Diarrhea, muscle pain, rash, confusion, drowsiness, Tagament; impotence, gynecomastia, impairs metabolism of common drugs

Patient Teaching: With or after meals, don't give Zantac w/other antacids, older pt's may have confusion and drug interactions w/Tagament

Proton Pump Inhibitor Agents

Prilosec, Nexium, Prevacid, Protonix, Aciphex

Use: inhibit gastric acid secretion w/ peptic ulcer disease, GERD, Zollinger-Ellison Syndrome.

Side Effects: Nause, diarrhea, headache

Patient Teaching: Swallow the capsule whole

Mucosal Barrier Agents

Carafate

Use:permit healing of an ulcer, forming protective gel coats surface

SE: constipation, dry mouth, drowsiness, rash, itching

PT: empty stomach 1hr b4 meals

Synthetic Prostoglandin Agents

Cytotec

Use: decrease gastric acid secretion and protect gastric mucosa. Prevent ucers caused by NSAID's

SE: contra during preg, diarrhea, abd pain, miscarriage, headache, flatulence, nause/vomiting.

PT: w/meals & at bedtime

Anticholinergic Agents

Gastrozepin

Use: block action of acetocholine, decrease salivary and gastric secretions, reduce pain by reducing smooth muscle tone in GI tract.

SE: dry mouth, constipation, visual disturbance, urine retention, older adults; confused, agitated, drowsy

PT: contra; narrowangle glaucoma, renal disease, prostatic hypertrophy, intestinal obstruction. 1/2 to 1 hr b4 meals & at bedtime, provide oral hygiene, monitor stools and urine, report behavior changes.

5-Hr Receptor Antagonist Agents

Zofran, Kytril, Aloxi

Use: prevent nausea, vomiting from chemotherapy

SE: constipation, diarrhea, abd. pain, muskuloskeletal pain, shivering, fever, hyoxia, urinary retention

PT: IV 30 min b4 chemotherapy, advise pt drowsiness may occur, ask about diarrhea, constipation, diff voiding. Encourage fluids, fiber, activity  

Laxative Agents and Stimulants

Dulcolax, Senokot, Castro Oil

Use: facilitate bowel elimination, stim. GI tract by irritating mucosa, Diarrhea like stools

SE: Dulcolax irritate anus, Cascara & Senna urine pink or brownish, Oily laxative agents contra. 4 older alduts r/t risk for aspiration can cause lipid pneumonia

PT: Monitor stool, Encourage fluid & fiber, Chill castor oil wash it down w/fruit juice

Bulk-Forming Laxative Agents

Metamucil, Citrucel

Use: retain water in stool to increase bulk and fluid, stimulates peristalsis

SE: Obstruction can occur if not taken w/adequate fluids or if passagae through intestine is arrested

PT: adequate fluids for mass to harden (aprox. 3 days), prevention of constipation

Saline (Osmotic) Laxative Agents

Magnesium Citrate, Milk of Magnesia, Fleet phospho-soda, MiraLax

Use: draw water into bowel to distend and stimulate evacuation

SE: dehydration w/prolonged use

PT: contra: kidney disease, heart failure, hypertension, edema

Lubricant Agents

Mineral Oil

Use: lubricate feces for easier passage

SE:  lipid pneumonia if product aspirated

PT: give on empty stomach

Fecal Wetting Agents

Surfak, Colace

Use: soften fecal mass (prevention of constipation)

SE: n/a

PT: liquid forms w/milk or juice for taste

Lactulose, Cephulac

Used to increase fecal water content to stimulate evacuation. Promotes passage amonia through rectum. For; hepatic encephalopathy. (oral or rectal administration)

SE: cramps, flatulence, diarrhea, hyperglycemia w/diabetes

PT: mixed w/juice, milk, water on empty stomach, tell nurse if diarrhea

Polyethylene glycoelectrolyte solution (GoLYTELY)

suppository or enema

cleanse bowel before diagnostic procedures

PT: used with cardiac or renal disease doesn't disturb electrolyte balance. comprises 4 L. Pt must drink 350-300 mL every 10 min over 2-3 hrs. Make sure pt has immediate access to toilet.

Antidiarrheal Agents

opiate agents: morphine, Lomotil, Imodium

Use: decrease intestinal motility so liquid portion is reabsorbed.

SE: CNS depression, drowsiness, dizziness, constipation, dry mouth, nausea

PT: Do not exceed maximum dose, use saftey prec and maintain good oral hygiene.

Absorbent Agents

Kaolin, aluminum hydroxide

Use: bind substances that may cause diarrhea

PT: shake before pouring, don't administer with oral drugs

Lactobacillus: replace normal bacterial flora, may require refidgeration

Emetic Agents

Ipecac syrup

Use: cause vomiting, treat poisining and oral drug overdose

SE: CNS depressant

PT: Only if recomended by poisin control w/ water

Antiemetic Agents

5-HR Receptor Antagonist Agents

Zofran, Kytril, Aloxi

Use: prevent nausea and vomiting from chemotherapy, Aloxi has a very long half-life (40 hours), initial dose controls initial delayed chemotherapy side effects.

SE: headache, constipation, diarrhea, abdominal pain, musculoskeletal pain, shivering, fever, hypoxia, urinary retention

PT: IV 30 mins before chemo, drowsiness may occur, ask about constipation and difficulty voiding. Encourage fluids, fiber and activity

Antiametic: 5-HR Receptor Antagonist Agents

Substance P/ neurokinin, receptor blocker, aprepitant (EMEND)

Used to prevent nausea and vomiting caused by chemo. Used in combo with other antiametics.

SE: headache, dizziness, diarrhea, constipation, nausea Serious: thrombocytopenia, neutropenia

PT: 3 day course, 1st dose 1 hour before therapy

Antihistamine Agents

Phenergan, Dramamine

Use: prevent and treat nausea. Decrease sensitivity of the vestibular apparatus of the inner ear. Suppresses the vomiting center.

SE: drowsiness and confusion

PT: Use the medications cautiously with asthma, glaucoma, and prostatic hypertrophy

Sedative Agents

hydroxyzine (Atarax)

Atarax

Use: Prevent preoperative nausea and vomiting; anti-anxiety effects.

SE: Drowsiness, confusion, hypotension, tachycardia, dry mouth, nausea, diarrhea, urinary retention

PT: monitor alertness, b/p, urine, assist w/ambulation, bed in lowest position, call bell in reach, oral care

Aticholinergic Agents

Scopolamine (Transderm-Scop)

Use: supress vomiting center. Prevent motion sickness.

SE: confusion, delusions, hallucinations, tachycardia, dry mouth, blurred vision, urinary retention

PT: medicated adhesive disk that is placed behind ear. Contra; narrow angle glaucoma, urinary tract obstruction

Prokinetic Agents

Reglan

Use: speed up gastric emptying into small intestine

SE: CNS depression, GI upset, Parkinson-like symptoms.

PT: GI perforation, obstruction, hemorrhage, epilepsy

Antibacterial Agents

Cipro, E-mycin, Flagyl

Use: treat diarrhea caused by pathogens

Complete entier course of therapy and report worsening symptoms to physician

Antibacterial Agents

Dipentum

Dipentum

Used to treat ulcerative colitis

SE: abdominal pain, diarrhea, headache, nausea

PT: discontinue use if hives, rash, wheezing occur. Encourage fluids.

Antibacterial Agents

Amoxicillin

Amoxil

used to treat helicobacter pylori w/omeprazole

SE: rash, diarrhea, anaphylaxis and superinfections (collitis)

PT: instruct pt. to take full course of treatment

Antifungal Agents

Nystatin (Mycostatin)

Clotrimazole (Mycelex)

Used for candida albicans infections

SE: nausea, vomiting, diarrhea

PT: dissolve lozenges in mouth, shake suspensions well, swish in mouth before swallowing

Mycelex: same use

SE: nausea, vomiting, itching

PT: vaginal preps available