Pharm II (GI drugs)

blocks H2 receptors in the stomach; decreases stomach acid; increases pH in stomach

Rare to have side effects

• if they do: impotence, gynecomastia, confusion and arrhythmias

• Increases serum levels of Warfarin and Phenytoin

• Interacts with Theophylline

• take oral doses with or without food

• Administer IV doses slowly to avoid bradycardia

• avoid antacids within 1 hour

• avoid products that increase GI irritation

• suppresses gastric acid production

• decreased calcium absorption; hypomagnesemia

• Risk of osteoporosis with long term use (>8 weeks)

• Interacts with Warfarin, Phenytoin, diazepam

• Lowest dose for shortest possible duration

• Calcium and Vitamin D supplements

• weight bearing activities

• coats ulcers and creates a barrier between the stomach and gastric secretions

constipation

• affects absorption time of other drugs

  • administer 2 hours before or after other oral drugs

• administer on an empty stomach (4x per day); 1 hour before meals and bedtime)

• monitor bowel function

• stool softener

• increase fluid and fiber

• neutralizes gastric acid

constipation

• Affects absorption of other drugs

  • do not give within 1 to 2 hours of other meds

• Increase fluid and fiber

• chew tablets thoroughly

• decreases gastric acid secretion

• increases bicarbonate

• increases protective mucous

• increases vasodilation of submucosal blood flow

• diarrhea and abdominal pain

• menstrual cramping

• stimulate uterine contractions and can cause miscarriage and premature labor

• increase fluids

• avoid alcohol or foods that irritate GI tract

• pregnancy test (HCG)

• blocks receptors in the CTZ (in the brain near the cerebellum)

• used for N/V secondary to chemotherapy or post-op

CNS: headache, dizziness, constipation, diarrhea

ADVERSE:

• serotonin syndrome (HTN, tachycardia, rigidity, tremors)

• Stevens Johnson Syndrome

risk for falls

Timing: prior to anticipated need (30 minutes-1hour) and then regularly after

• SSRIs

• SNRIs

• MAOIs

• etc

• blocks the release of histamine (H1) receptors in the inner ear, and those that affect the CTZ

• antiemetic and antivertigo

• used for motion sickness

• sedation

• drowsiness

• anticholinergic effects

• urinary retention

• bladder infection

• avoid activities that require alertness

• increase fluids and fiber

other CNS depressants (alcohol)

• dopamine receptor blocker

• increase threshold of CTZ

• increases tone of lower esophagus

• used for N/V associated with chemo, opioids; reflux and gastroparesis

• sedation, restlessness, diarrhea

• extrapyramidal symptoms (akathisia, tardive dyskinesia, Parkinson;s-like symptoms, dystonia)

contraindicated for bowel obstructions

• monitor for extrapyramidal symptoms

• avoid activities that require mental alertness

other CNS depressants (alcohol)

• assure adequate intake with fiber supplement (8 ounces

  • can cause esophageal or intestinal obstruction without adequate fluid intake

• take 1-3 times a day

• expect results in 1-3 days

• mix with 8 ounces of water or juice and drink immediately

change the surface tension of the stool

• administration: give with 8 ounces of fluid

  • expect results in several days

• diarrhea

• mild cramping

stimulate intestinal motility

• encourage dietary changes and exercise

• diarrhea

• abdominal cramping

• risk for abuse, especially in clients who have eating disorders

decrease peristalsis

• drowsiness

• constipation

• cardiac arrhythmias

• anticholinergic effects

• risk for fluid and electrolyte imbalances

• fall risk

• CNS depression

  • avoid activities that require alertness

• increase fluids

• avoid caffeine (diuretic effect and increases intestinal motility)

• only with women with IBS and diarrhea for greater than 6 months

• decreases visceral pain, slows peristalsis, increases absorption of water

constipation

• impaction, perforation, obstruction

monitor bowel patterns closely

• treatment agreement (Risk Management Program)

decreases visceral pain, increases peristalsis

• IBS with constipation

• N/V/D

• flatulence

• take with food or water

• maintain hydration

decrease inflammation in the intestine

• yellow/orange discoloration of urine (EXPECTED)

• photosensitivity (EXPECTED)

• nausea (goes away over time)

• fever

• rash

• hematologic disorders (agranulocytosis [low white count], anemia, thrombocytopenia)

  • Intervention: monitor closely for symptoms of hematologic disorders

should not be given to patients with sulfa drug allergies or those allergic to aspirin

decreases immune response

• N/V

• anorexia

• hepatoxicity

• fever

• bone marrow suppression

• SAFETY ALERT: risk for infection

• Neutropenic precautions (handwashing, avoid unnecessary invasive procedures, restrict visitors, avoid raw fruits and vegetables, no flowers in room)

• Monitor CBC

• monitor Liver function

• antibiotics