Soothe irritation to intestinal wall.

Block GI muscle activity and decrease movement.

Affects CNS activity to cause GI spasms and stop movement.

Names: Bismuth (pepto), Paragoric (opium derivative, stops parastalisis and diarrhea) Lomotil, kapectolin, Imodium(Loperamide increases absorption of fluid and electrolytes)

Proton Pump Inhibitors

PPIs

Ch. 42

Decrease Hydrochloric Acid secretion.

Promotes esophageal healing in 80-90% of patients.

Decreases esophageal strictures.

Names: Omeprazole (prilosec), Esomeprazole (nexium), rebeprazole (Aciphex)

Side Effects: Headaches

ANTACIDS

Quick acting short lived relief.

Neutralizes HCL acids

take 1-3 hours before meals/bedtime

treat patients with mild to intermittent heartburn

Names: Maalox, Mylanta, Gaviscon

Give 1hr before other drugs or 2 hours after

Histamin H2 Aganists

Meds and orders

cimetidine (tagament) 1st

Ranatidine (zantac) longer acting and more potent

Famotidine (pepcid) more potent than zantac

nizatidine (axid)

Histamine H2 Antagonists

Decrease secretion of HCL

Promote healing in 50% of pts

tx for ulcers and Erosive GERD

Names: tagamant, zantac, pepcid, axid

Blood Formers

erythropoetic

Epoten- erythropoetic- increases RBC

SE: SZ, HTN, cephalopathy, CHF

Treatment in endstage renal disease, HIV, Cancer, Retroviral, surgery patients.

Blood Formers

colony stimulating

Neupogen, Neulasta, and Leukine

increase RBC production

BloodFormers

thrombocytes

Neumega- increase Platelets and megakariocytes

SE: thrombocytopenia and bone pain

Urinary Antispasmotics

AKA Anticholinergics AKA Cholinergic Blockers AKA Parasympatholytics AKA pregnancy class C

Trans/patch: hip, abd, buttox

Cream: upper arm, shoulder, abd, thigh (alt sites)

Ditropan: immediate release w.food XL WorW/O food

Add Fluids, fiber, excersise, avoid heat (stroke)

SE: dry mouth (give Sugarfree gum or candy)

sedation weakness, andioedema, blurred vision, drowsy

Names: Detrol (tolterodine), Ditropan (oxybutinin), Vessicare (solfenacin

PPIs

"prazoles"

med names

Omeprazole    Prilosec

Esomeprazole  Nexium

pantoprazole    protonix

lansoprazole    pepsid

dexlansoprazole  kapidex

rabeprazole        Aciphex

Iron Preparations

Oral

Names

Ferrous Fumarate

Ferrouse Gluconate

Ferrous sulfate

Black tarry stools normal, take between meals, with straw

Iron Preparations

Parenteral

Iron Dextran

Ferric Gluconate (ferrlecit)

Iron Sucrose (Venofer)

IM. Change out needle, Z-track, black tarry stools

Antiemetics

Manage Nausea and Vomiting

Block receptors in CNS; Gi Tract

SE: dizzy, drowsy, disoriented, tachy, blurred vision, additive drug effects

Names: odansetron (Zofran) metoclopramidine (Reglan

Digestive Enzymes

Pancreatic Enzyme products

Replacement therapy for pancreatic enzymes

Names: Pancrease, Zenpep, Creon

Diuretics

Osmotics

Works entire nephron, inhibits reabsorption of H20& electrolytes, increases urinary excretion of toxic material

SE: transient volume expansion and hypokalemia, increase risk for digitalis toxicity

Names:Mannatol (osmitol) very potent 1/2 life 100min

Diuretics

Loops

Acts on ascending loop of Henle, rapid diuresis, decrease fluid volume, works well even if renal fx is poor, most effective if ↓ renal fx associated w/ HF

SE: light imbalance, causing weak,irregular pulse, poor muscle tone, neurotoxic, and nephrotoxic, hypovolemia, dehydration, and metabolic alkalosis

Name: Furosimide (lasix) potent, most common, 1/2 life 30-60 minutes PO, IM, IV

Diuretics

Thiazides

Inhibit Na and Cl, reabsorption in distal tubule, relaxes small vessels, ↓preload and afterload

SE: Muscle cramps, Hypokalemia, hyperuricemia (↑levels of uric acid in blood)

Name: Hydrochlorothiazide (HCTZ)

Diuretics

Potassium Sparing

Inhibits aldosteron, interferes w/ Na&K exchange, works in distal tubules, prevents electrolyte imbalance, weakest of diuretics

SE: dizziness, Headache, hyperkalemia, blood abnormalities

Name: Spironolactone (aldactone)

Laxative

uses

Short term relief of constipation

Evacuate bowel for diagnostic procedures

Remove ingested poisons from lower GI tract

Laxatives

Chemical Stimilants

chemically irritate lining of GI tract.

Chemical stimulant laxatives over time cause loss of intestinal tone and lead to dependency.

Names: Cascara, Senokot, Castor oil, Dulcolax

Laxatives

Bulk Stimulants

cause fecal matter to increase bulk

  should be taken with at least 8 ounces of water

 Bulk forming laxatives can cause esophageal obstruction if taken with insufficient water.

 Names: MOM, Metamucil, Fibercon, Lubricating Lax, Fleets enema, Glycerin, Mineral Oil, Hyperosmotic laxatives,Magnesium citrate, Lactulose

Laxatives

Lubricants

help the intestinal contents move more smoothly

Forms a slippery coat on intestinal tract,less water is absorbed out of bolus so bolus is less likely to become hard or impacted

Name: Mineral Oil

Laxatives

Hyperosmotics

draws water into the bowel, softening the stool

Encourage bowel movements by drawing water into the bowel from surrounding body tissues. This provides a soft stool mass and a rapid increase in bowel action. Also can lead to dehydration because it draws water into the bowel from the body tissue

Laxatives

Stool softeners

Used to prevent developing constipation does not alleviate constipation.

Name: Colace, Peri-colace, Surfak

GI stimulants

Action

Increases GI activity, secretions, and parasympathetic activity

Dexpanthenol Ilopan
metochopramide Reglan

Gi Stimulants

Indications

GERD
Prevention of N/V
Diabetic gastroparesis; delay emptying time- leads to N/V
Barium evacuation

Gi Stimulants

Pharmacokinetics

Ilopan given IM; Reglan may be given PO, IM, IV

Gi Stimulants

Contraindications

Acute abdominal illness
Pregnancy/ lactation

Gi Stimulants

Adverse effects

GI upset
Hypotension
Bradycardia
Weakness
Extrapyramidal effects; causes tremors, motor deficit, unrest, muscle rigidity
Parkinson like syndrome

Gi Stimulants

Drug to drug interactions

Increased absorption of digoxin

GI Stimulants

Nursing Implication

Administer 15 minutes before meals and at bedtime
Can alter blood glucose levels
If administering IV, monitor BP