hyperacidity caused by:

• heartburn
• acid indigestion
• sour stomach
• GERD
• peptic ulcer 

• Maylox
• MOM - milk of magnesia

what is a common s/e of antacids that contain

aluminum and calcium

• Aluminum carbonate (Basajel)
• Aluminum hydroxid (Amphojel, Alternagel)
• Calcium carbonate (Tums)

• cardiovascular problems
• sodium restricted diets

ex: clients with

• ↑ B/P
• asites
• edema

Nursing consideration with antacids

instructions on adminisration

inhibits the action of histamine at the H2 receptor;

reduces secretion of gastric acid and pepsin

• dizziness
• confusion (especially in elderly)

• the elderly
• severely ill

Rapid IV infusion of the Histamine H2 Antagonist -

Pepcid (Famotidine) may cause what s/e?

• Tagamet (Cimetidine)
• Pepcid (Famotidine)
• Zantac (Rantidine)

"tidine" 

BID or HS for maintenance

HS = night time, bedtime

PPI - proton pump inhibitors

Drugs

• Nexium (Esomeprazole)
• Prevacid (Lansoprazole)
• Prilosec (Omeprazole)
• Protonix (Pantoprazole)
• Aciphex (Rabeprazole )

"prazole"

• Administer 1 hour before meals
• Swallow tablets whole
• Nexium and Prevacid capsules may be sprinkled on food

• dry mouth
• blurred vision
• urinary hesitancy
• urinary retention
• constipation
• nausea
• vomiting
• palpitations
• headache 

• Belladonna
• Bently (Dicyclomine) for IBS
• Robinul (Glycopyrrolate) for PUD

nursing interventions and client education

anticholinergics

• offer sips of water to ↓ dry mouth
• monitor for urinary retention and hesitancy
• DO NOT administer to cts with BPH
• keep room semi-dark if photophobia occurs, sunglasses if outside
• supervise ambulation, if dizziness occurs
• Encourage fluids to prevent constipation

Pepsin Inhibitor

Suralfate (Carafate) action

mucosal protective drug

coats the stomach lining

• take on empty stomach - 1 hour before meals
• therapy continues for 4-8 weeks 

Prostaglandin Drugs

Misoprostol (Cyotec)

Prostoglanding Drug / Misoprostol (Cytotec)

Pregnancy Category

nursing considerations

X

Can cause abortion or birth defects

• Instruct ct to use affective contraception 
• Notify the physician if pregnant

used to treat delayed gastric emptying and emesis

by ↑ the motility of the upper GI tract

without ↑ increasing production of secretions

• IIopan (Dexpanthenol)
• Reglan (Metroclopramide)

• GERD
• gastic stasis 

• dopamine
• acetylcholine 

• Chiorpromazine (Thorazine)
• Prochlorperazine (Compazine)
• Promethazine (Phenergan) comes with codine
• Trimethobenzamide (Tigan)

s/e of

Antidopaminergic Antiemetic Drugs

• hypotension
• drowsiness
• restlessness
• dizziness 

Antidopaminergic Antiemetic Drugs

5 - HT3 Receptor Antagoinist Antiemetics

"setron"

• Gransetron (Kytril)
• Ondasetron (Zofran)

• drowsiness
• euphoria
• dizziness
• vomiting 

when are emetics contraindicated

• used to supplement or replace pancreatic enzymes
• breakdown fats, starches, and proteins
• necessary for the breakdown and digestion of food

• Creon (pancreatin)
• Cotazym (Pancrelipase)

• cystic fibrosis
• pancreatitis
• pancreatic cancer
• malabsorption syndrome
• gastrectomy
• pancreatectomy

Aminosalicylates

• asprin like compounds with anti-inflammatory action
• used to treat IBD (inflammatory bowel disease)

• intestinal obstruction
• children < 2 (Reyes Syndrome) 

• Mesalamine (Asacol)
• Sulfasalazine (Azulfidine) 

• Crohn's disease
• ulcerative colitis
• RA

• Difenoxin (motofen)  
• Diphenoxylate (Lomotil)

Difenoxin (motofen) and  Diphenoxylate (Lomotil)

action and chemical relation of drugs

chemically related to opiod drugs and

↓ intestinal peristalsis

sedative and euphoric effects

(no analgesic effects)

dry mouth

drys secretions

causes confusion in elderly

risk for constipation

• may temporarily cause stools and tongue to turn dark
• may cause salicylate toxicity such as tinnitus, rapid respirations  

• dry skin and mucous membranes
• nausea
• constipation
• urinary retention
• lightheadedness 

• somnolence
• constipation

• Use caution when driving
• avoid the use of alcohol or other CNS depressants and other nonprescription drugs 

• diarrhea
• loss of water and electrolytes
• prolonged use can cause dependence 

possible s/e of bulk forming laxatives

obstruction of:

• esophagus (monitor for dysphagia) 
• stomach
• small intestine
• colon

if not given with adequate fluid or cts with intestinal stenosis

• persistent abdominal pain
• nausea or vomiting
• signs of appendicitis
• fecal impaction
• intestinal obstruction
• acute hepatitis

bulk producing laxative drugs

nursing considerations

• Methylcellulose (Citrucel, Unifiber) - used for constipation, IBS, and severe watery diarrhea

*take with 8 oz glass of water followed by another 8 oz glass of water

Mineral Oil - used to releve constipation and fecal impaction

• may impair absorption of vitamins A, D, E, K
• take at HS on empty stomach 

Stool Softners

(Surfactants)

Docusate (Colace, Surfak)

used to relieve constipation and prevent straining

Irritant or Stimulant Laxatives

use

s/e

Sennosides (Ex-Lax, Senokot)

used to relieve constipation

may cause brownish color to urine,

yellow-green color to stool

• long term use can cause dependence and electrolyte imbalance
• Do NOT use if abdominal pain, nausea or vomiting is present
• notify doctor id constipation is not relieved or rectal bleeding or other symptoms occur
• drink plenty of fluids, get exercise, and eat food ↑ in bulk or roughage
• Cascara sagrada or senna → pink-red, red-violet, red-brown, yellow-brown, or black discoloration of urine