Foundations Theory 1413: Medications

Nonopioid Analgesics

Acetaminophen (Tylenol) is the most widely used nonopioid analgesic. All of the drugs in the NSAID class (which includes aspirin, ibuprofen, naproxen, the cyclooxygenase-2 [COX-2] inhibitor celecoxib [Celebrex], and others) are nonopioid analgesics. They are used for management of pain, especially pain associated with inflammatory conditions such as arthritis, because they have significant antiinflammatory effects in addition to their analgesic effects.

Stimulant used for

Acute constipation/diagnostic/surgical

Probiotics (intestinal flora modifiers) - Probiotics

Also known as intestinal flora modifiers and bacterial replacement drugs Bacterial cultures of Lactobacillus organisms work by: Supplying missing bacteria to the GI tract Suppressing the growth of diarrhea-causing bacteria Example: Lactobacillus acidophilus (Bacid)

Prochlorperazine (Compazine)

Available by mouth, IM, IV, Rectal Compazine is a antimetic that can mask the toxicity symptoms and Compazine treats severe nausea and vomiting

bronchodilators

Bronchodilators are an important part of the pharmacotherapy for all respiratory diseases. These drugs relax bronchial smooth muscle, which causes dilation of the bronchi and bronchioles that are narrowed as a result of the disease process. Bronchodilators (beta-adrenergic agonists, anticholinergics, and xanthines) are just one type of drug used to treat asthma and COPD.

Define Fentanyl (Sublimaze, Duragesic)

Can be given intramuscular or intra venous. Can quickly make you fall asleep. When giving Fentanyl watch for respiratory depression, monitor vitals administer slowly to prevent muscle rigidity

What is Hyperosmotic used for?

Chronic constipation. diagnostic

What is Saline used for?

Constipation/surgical prep

Corticosteroids

Corticosteroid drugs are classified as pregnancy category C drugs. They can be secreted in breast milk. Their use is contraindicated in patients who have exhibited hypersensitivity reactions to them in the past as well as in patients with fungal or bacterial infections. Corticosteroids are mainly used to reduce inflammation and suppress the immune system.

Antimotility drugs (anticholinergics & Opiates)

Example: belladonna alkaloids ( an anticholinergic) Works by decreasing intestinal muscle tone and peristalsis of GI tract Examples: paregoric, opium tincture, codeine, over-the-counter (OTC) loperamide, diphenoxylate. (Opiates) Works by: Decrease bowel motility and reduce pain by relief of rectal spasms. Decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed

Absorbents

Examples: bismuth subsalicylate (Pepto-Bismol), activated charcoal, and antilipemic drugs colestipol and cholestyramine

What are some pre operative meds?

Fentanyl (Sublimaze, Duragesic) Midazolam (Versed)

Penicillin beta-lactam properties

Generic name: Amoxicillin - The beta-lactam antibiotics are so named because of the beta-lactam ring that is part of their chemical structure - The beta-lactams exhibit time-dependent killing (meaning their concentration must be above the minimum inhibitory concentration to kill bacteria). Because of this property, it is not unusual to see them given by continuous intravenous infusion.

Macrolides generic names

Generic name: Azithromycin - Azithromycin has excellent tissue penetration, so that it can reach high concentrations in infected tissues. It also has a long duration of action, which allows it to be dosed once daily. - Include better adverse-effect profiles, including less gastrointestinal tract irritation, and more favorable pharmacokinetic properties - Used for the treatment of both upper and lower respiratory tract and skin structure infections. Azithromycin is available in oral and injectable forms,

Angiotensin-converting enzyme (ACE) inhibitors generic name

Generic name: Captopril Captopril (Capoten) was the first available ACE inhibitor and is considered the prototypical drug for the class. Several large multicenter studies have shown its clinical efficacy in minimizing or preventing the left ventricular dilatation and dysfunction (also called ventricular remodeling) that can arise in the acute period after an myocardial infarction (MI) and thereby improving the patient's chances of survival. It can also reduce the risk for heart failure in these patients. It has the shortest half-life of all of the currently available ACE inhibitors The therapeutic effects of the ACE inhibitors are related to their potent cardiovascular effects. They are excellent antihypertensives and adjunctive drugs for the treatment of heart failure. They may be used alone or in combination with other drugs such as diuretics in the treatment of hypertension or heart failure.

Beta Blocker generic name

Generic name: Carvedilol Carvedilol (Coreg) has many effects, including acting as a nonselective beta blocker, an alpha1 blocker, a calcium channel blocker, and possibly an antioxidant. It is used primarily in the treatment of heart failure but is also beneficial for hypertension and angina. It has been shown to slow the progression of heart failure and decrease the frequency of hospitalization in patients with mild to moderate (class II or III) heart failure.

Cephalosporins generic name

Generic name: Ceftriaxone cephalosporins are bactericidal and work by interfering with bacterial cell wall synthesis. They also bind to the same penicillin-binding proteins inside bacteria that were described earlier for the penicillins. Cephalosporins can destroy a broad spectrum of bacteria, and this ability is directly related to the chemical changes that have been made to their basic cephalosporin structure. Ceftriaxone is an extremely long-acting third-generation drug. It also has the unique characteristic of being able to pass easily through the blood-brain barrier. For this reason, it is one of the few cephalosporins that is indicated for the treatment of meningitis, an infection of the meninges of the brain.

Cephalosporins another generic name

Generic name: Cephalexin Cephalexin is a prototypical oral first-generation cephalosporin. It also provides excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria. It is available only for oral use.

Stool softeners generic name

Generic name: Docusate sodium - Docusate sodium is available in both capsule and liquid forms. - Docusate salts (calcium and sodium) (Colace) are stool-softening emollient laxatives that facilitate the passage of water and lipids (fats) into the fecal mass, which softens the stool. These drugs are used to treat constipation, soften fecal impactions, and prevent opioid-induced constipation. Docusate does not cause patients to defecate; it simply softens the stool to ease its passage. In addition to the docusate salt formulations, combination products are also available. Docusate use is contraindicated in patients with intestinal obstruction, fecal impaction, or nausea and vomiting.

Tetracyclines generic name

Generic name: Doxycycline One of the more common food-drug interactions is that between milk or cheese and tetracycline, which results in decreased gastrointestinal absorption of tetracycline. Infants and children may not be able to take certain antibiotics such as tetracyclines, which affect developing teeth or bones; quinolones, which may affect bone or cartilage development in children; and sulfonamides, which may displace bilirubin from albumin and precipitate kernicterus (hyperbilirubinemia) in neonates The tetracyclines are bacteriostatic drugs that inhibit bacterial protein synthesis by binding to the 30S bacterial ribosome. Tetracyclines have a wide range of activity. They inhibit the growth of many gram-negative and gram-positive organisms and even of some protozoans. Traditionally used to treat acne in adolescents and adults, they are also considered the drugs of choice for the treatment of the following infections caused by susceptible organisms: • Chlamydia: lymphogranuloma venereum, psittacosis, and nonspecific endocervical, rectal, and urethral infections • Mycoplasma: Mycoplasma pneumonia • Rickettsia: Q fever, rickettsial pox, Rocky Mountain spotted fever, and typhus

Generic name for histamine-2 (H2)

Generic name: Famotidine (Pepcid, Pepcid AC) Indications: Dyspepsia, heartburn, Ulcers, GERD, Pathologic hypersecretion Famotidine (Pepcid) was the last H2 receptor antagonist introduced and has very few drug interaction concerns. It is available in oral and injectable forms. The dosing is the same for both forms. Famotidine may be given orally in tablet or suspension form and without regard to meals or food. Rapid-release forms of famotidine dissolve quickly under the patient's tongue and can be taken without water.

Antihistamines generic name 1st

Generic name: Loratadine Allergic rhinitis, chronic urticaria Loratadine is a nonsedating antihistamine and is taken once a day and is used to relieve the symptoms of seasonal allergic rhinitis, hay fever, urticaria

Generic name for ARBs

Generic name: Losartan Losartan (Cozaar) is beneficial in patients with hypertension and heart failure. The use of losartan is contraindicated in patients who are hypersensitive to any component of this product. It is to be used with caution in patients with renal or hepatic dysfunction and in patients with renal artery stenosis. Breastfeeding women must not take losartan, because it can cause serious adverse effects on the nursing infant and should be avoided in pregnancy

Sulfonamides generic names

Generic name: Trimethoprim/Sulfamethoxazole The administration of antibiotics such as sulfonamides, nitrofurantoin, and dapsone to a person with G6PD deficiency may result in the hemolysis, or destruction, of red blood cells. Sulfonamides do not actually destroy bacteria but rather inhibit their growth. For this reason, they are considered bacteriostatic antibiotics. They inhibit the growth of susceptible bacteria by preventing bacterial synthesis of folic acid. Folic acid is a B-complex vitamin that is required for the proper synthesis of purines, one of the chemical components of nucleic acids (DNA and RNA). Sulfonamides have a broad spectrum of antibacterial activity, including activity against both gram-positive and gram-negative organisms. These antibiotics achieve very high concentrations in the kidneys, through which they are eliminated. Therefore SMX-TMP is often used in the treatment of UTIs. SMX-TMP is also used for respiratory tract infections. However, it is now less effective against streptococci infecting the upper respiratory tract and pharynx. Another specific use for SMX-TMP is prophylaxis and treatment of opportunistic infections in patients with human immunodeficiency virus (HIV) infection, especially infection by Pneumocystis jirovecii, a common cause of HIV-associated pneumonia. SMX-TMP is also a drug of choice for infection caused by the bacterium Stenotrophomonas maltophilia.

Promethazine (Phenergan)

Given by mouth, IM, IV Promethazine is used for motion sickness, vertigo, pre op nausea and vomiting Watch for drowsiness, restlessness, hypotension, confusion, and urinary retention

There are two types of cellular receptors for histamine

Histamine-1 (H1) receptors mediate smooth muscle contraction and dilation of capillaries. H1-antihistamines are used to treat allergy symptoms. histamine-2 (H2) receptors mediate acceleration of the heart rate and gastric acid secretion. H2-antihistamines are used to treat gastrointestinal conditions.

Hyperosmotic Laxatives

Hyperosmotic laxatives work by increasing fecal water content, which results in distention, increased peristalsis, and evacuation. The site of action of these agents is limited to the large intestine. Hyperosmotic laxatives can cause increased depression of the CNS if they are given with barbiturates, general anesthetics, opioids, or antipsychotics. With hyperosmotic laxatives (e.g., polyethylene glycol, lactulose, sorbitol, glycerin), assess baseline fluid and electrolyte levels to identify any deficits before use.

Hyperosmotic Mechanism of Action

Increase fecal water content Results in bowel distention, increased peristalsis, and evacuation Examples: Polyethylene glycol (PEG), Sorbitol, glycerin,Lactulose (also used to reduce elevated serum ammonia levels)

Saline Mechanism of Action

Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines Results in bowel distention, increased peristalsis, and evacuation Examples: Magnesium hydroxide (Milk of Magnesia), Magnesium citrate (Citroma)

Stimulant Mechanism of Action

Increases peristalsis via intestinal nerve stimulation Examples: Senna (Senokot), Bisacodyl (Dulcolax)

Define L. acidophilus (Bacid)

L. acidophilus (Bacid) is a probiotic often used in the treatment of antibiotic-induced diarrhea. The other agents are usually not used in the treatment of antibiotic-induced diarrhea.

What can Laxatives alter?

Laxatives alter intestinal function; therefore they can interact with other drugs because many drugs are absorbed in the intestines. Bulk-forming laxatives can decrease the absorption of antibiotics, digoxin, salicylates, tetracyclines, and warfarin. Mineral oil can decrease the absorption of fat-soluble vitamins (A, D, E, and K). Hyperosmotic laxatives can cause increased depression of the CNS if they are given with barbiturates, general anesthetics, opioids, or antipsychotics. Oral antibiotics can decrease the effects of lactulose.

Drugs for Antidiarrheals and nursing implications

Loperamide (imodium) and Diphenoxylate Hydrochloride (Lomotil) - Watch for sedation and GI discomfort and constipation - Do not take longer than 48 hrs

Macrolides

Macrolides are considered bacteriostatic; however, in high enough concentrations they may be bactericidal to some susceptible bacteria

Adverse effects of ACE inhibitors

Major CNS effects of the ACE inhibitors include fatigue, dizziness, mood changes, and headaches. A characteristic dry, nonproductive cough may occur that is reversible with discontinuation of the therapy. A first-dose hypotensive effect can cause a significant decline in blood pressure. Other adverse effects include loss of taste, hyperkalemia, angioedema, and renal impairment.

Metoclopramide (Reglan)

Makes Smooth muscle move Watch out for sedation, insomnia, diarrhea and constipation Used in treatment of delayed gastric emptying and GERD

Hydrocodone

Morphine-like drugs Hydrocodone is also used in many cough suppressants, either alone or in combination with other drugs. A somewhat weaker but commonly used opioid is hydrocodone, most commonly in combination with acetaminophen

Proton Pump Inhibitors drug names

Omeprazole (Prilosec) Pantoprazole (Protonix) Lansoprazole (Prevacid)

Opioid analgesic

Opioid analgesics are very strong pain relievers. They can be classified according to their chemical structure or their action at specific receptors. The main use of opioids is to alleviate moderate to severe pain.

Oxydocone

Oxycodone hydrochloride is an analgesic drug that is structurally related to morphine and has comparable analgesic activity (Schedule II).

Define Proton Pump Inhibitors

PPIs bind directly to the hydrogen-potassium-ATPase pump mechanism and irreversibly inhibit the action of this enzyme, which results in a total blockage of hydrogen ion secretion from the parietal cells. PPIs are currently indicated as first-line therapy for erosive esophagitis, symptomatic GERD that is poorly responsive to other medical treatment such as therapy with H2 receptor antagonists, short-term treatment of active duodenal ulcers and active benign gastric ulcers, gastric hypersecretory conditions (e.g., Zollinger-Ellison syndrome), nonsteroidal antiinflammatory drug (NSAID)-induced ulcers, and stress ulcer prophylaxis. Long-term therapeutic uses include maintenance of healing of erosive esophagitis and pathologic hypersecretory conditions, including both GERD and Zollinger-Ellison syndrome. All of the PPIs can be used in combination with antibiotics to treat patients with H. pylori infections. The PPIs can be given orally or through an NG or percutaneous enterogastric tube.

magnesium hydroxide

Prevents burning sensation in stomach and keeps it under control Watch for abdominal cramping, diarrhea, dehydration

Diazepam (Valium), Versed

Reduces anxiety & anesthetic need

Meperidine, morphine

Reduces pain narcos

Anticholinergics—atropine

Reduces respiratory tract secretions

Stool Softeners

Stool softeners (docusate salts) work by lowering the surface tension of fluids, which allows more water and fat to be absorbed into the stool and the intestines.

Emollient Mechanism of Action

Stool softeners and lubricants Promote more water and fat in the stools Lubricate the fecal material and intestinal walls Examples Stool softeners: docusate salts (Colace, Surfak), Lubricants: mineral oil

Meds for anesthetics during surgery.

Strong opioid analgesics such as fentanyl, sufentanil, and alfentanil are commonly used in combination with anesthetics during surgery.

postoperative pain meds

Strong opioids such as morphine, hydromorphone, and oxycodone are often used to control postoperative and other types of pain. hydromorphone (Dilaudid) is seven times more potent than morphine.

Zantac (ranitidine) and Tagamet (Cimetidine)

- Decrease in stomach acid may increase growth of candida and bacteria in the stomach Watch for: - Headache - Diarrhea - Depression - GI disturbances - Rash

Penicillin generic name and it's actions

- Penicillins are bactericidal antibiotics, meaning they kill a wide variety of gram-positive and some gram-negative bacteria. However, some bacteria have acquired the capacity to produce enzymes capable of destroying penicillins. - Penicillins are indicated for the prevention and treatment of infections caused by susceptible bacteria. The microorganisms most commonly destroyed by penicillins are gram-positive bacteria, including Streptococcus species, Enterococcus species, and Staphylococcus species.

Protectants generic name

Sucralfate (Carafate) is a drug used as a mucosal protectant in the treatment of active stress ulcerations and in long-term therapy for peptic ulcer disease. Sucralfate acts locally, not systemically, binding directly to the surface of an ulcer. Sucralfate has sucrose as its basic structure. Once sucralfate comes into contact with the acid of the stomach, it begins to dissociate into aluminum hydroxide (an antacid) and sulfate anions. By binding to the exposed proteins of ulcers and erosions, sucralfate also limits the access of pepsin. Pepsin is an enzyme that normally breaks down proteins in food but can have the same effect on GI epithelial tissue, either causing ulcers or making them worse. Sucralfate also binds and concentrates epidermal growth factor, present in the gastric tissues, which promotes ulcer healing. In addition, the drug stimulates the gastric secretion of prostaglandin molecules, which serve a mucoprotective function. Sucralfate does not display typical pharmacokinetic parameters

Drugs for irritable bowel syndrome (IBS)

Tegaserod (Zelnorm) Lubiprostone (Amitiza) Alosetron (Lotronex)

Angiotensin II Receptor Blockers (ARBs)

The ARBs block the binding of AII to type 1 AII receptors. ACE inhibitors. In contrast to ACE inhibitors, the ARBs affect primarily vascular smooth muscle and the adrenal gland. By selectively blocking the binding of AII to the type 1 AII receptors in these tissues, ARBs block vasoconstriction and the secretion of aldosterone. AII receptors have been found in other tissues throughout the body, but the effects of ARB blocking of these receptors is unknown. Clinically, ACE inhibitors and ARBs appear to be equally effective for the treatment of hypertension. Both are well tolerated, but ARBs do not cause cough. There is evidence that ARBs are better tolerated and are associated with lower mortality after MI than ACE inhibitors. It is not yet clear whether ARBs are as effective as ACE inhibitors in treating heart failure (cardioprotective effects) or in protecting the kidneys, as in diabetes. - ACE inhibitors cause cough, which is less likely with ARBs. Both ACE inhibitors and ARBS can cause elevated potassium and renal failure.

Beta Blocker

The beta-adrenergic-blocking drugs (beta blockers) block SNS stimulation of the beta-adrenergic receptors by competing with norepinephrine and epinephrine. The beta blockers can be either selective or nonselective, depending on the type of beta-adrenergic receptors they antagonize. Beta1-adrenergic receptors are located primarily in the heart. Indications for beta blockers include angina, MI, cardiac dysrhythmias, hypertension, and heart failure. Beta blockers are commonly used in the treatment of angina, or chest pain

Significance of ACE inhibitors with treatment for diabetes?

ACE inhibitors also have been shown to have a protective effect on the kidneys, because they reduce glomerular filtration pressure. For this reason, they are among the cardiovascular drugs of choice for diabetic patients. Numerous studies have shown that the ACE inhibitors reduce proteinuria, and they are considered by many to be standard therapy for diabetic patients to prevent the progression of diabetic nephropathy.

Acetaminophen (Analgesics/antipyretic pain/fever)

The mechanism of action of acetaminophen is similar to that of the salicylates. It blocks peripheral pain impulses by inhibition of prostaglandin synthesis. Acetaminophen also lowers febrile body temperatures by acting on the hypothalamus, the structure in the brain that regulates body temperature. Acetaminophen is indicated for the treatment of mild to moderate pain and fever. It is an appropriate substitute for aspirin because of its analgesic and antipyretic properties. Acetaminophen is also the antipyretic (antifever) drug of choice in children and adolescents with flu syndromes, because the use of aspirin in these populations is associated with a condition known as Reye's syndrome. It is best avoided in patients who are alcoholic or who have hepatic disease. Acetaminophen is available in oral, rectal, and most recently, intravenous IV form.

What happens when release of excessive amounts of histamine takes place?

The release of excessive amounts of histamine can lead to anaphylaxis and severe allergic symptoms and may result in any or all of the following physiologic changes: • Constriction of smooth muscle, especially in the stomach and lungs • Increase in body secretions • Vasodilatation and increased capillary permeability, which results in the movement of fluid out of the blood vessels and into the tissues and thus causes a drop in blood pressure and edema

Therapeutic effects of ARBs

The therapeutic effects of ARBs are related to their potent vasodilating properties. They are excellent antihypertensives and adjunctive drugs for the treatment of heart failure. They may be used alone or in combination with other drugs such as diuretics in the treatment of hypertension or heart failure. The beneficial hemodynamic effect of ARBs is their ability to decrease (systemic vascular resistance SVR) (a measure of afterload).

Opioid analgesic mechanism of action

They are agonists, agonists-antagonists, or antagonists (nonanalgesic). An agonist binds to an opioid pain receptor in the brain and causes an analgesic response—the reduction of pain sensation. An agonist-antagonist, also called a partial agonist or a mixed agonist, binds to a pain receptor and causes a weaker pain response than does a full agonist.

Trmadol

Tramadol hydrochloride (Ultram) is categorized as a miscellaneous analgesic because of its unique properties. It is a centrally acting analgesic with a dual mechanism of action. Tramadol is indicated for the treatment of moderate to moderately severe pain. Tramadol is rapidly absorbed, and its absorption is unaffected by food

Kayexalate (sodium polystyrene sulfonate)

Use sodium polystyrene sulfonate either by mouth or be enema. Watch for heart rhythm and sodium. treats for high potassium in your blood. Watch for constipation, gastric irritation, diarrhea, sodium retention and hypokalemia

What is Emollient used for?

Used for Acute and chronic constipation, fecal impaction, facilitation of bowel movements in anorectal conditions.

Omeprazole (Prilosec)

Used for Esophagitis, duodenal ulcer, hypersecretory conditions Administer omeprazole before meals and educate the patient that the capsule must be taken whole and not crushed, opened, or chewed. Omeprazole may also be given with antacids, if ordered.

Midazolam (Versed)

administered for IV induction of anesthesia and to produce conscious sedation When using Midazolam to minimize adverse effects, inject it slowly over 2 or more mins and wait another 2 or more mins for full effects to develop before dosing again

Psyllium (Metamucil)

bulk fiber forming laxative to form and thicken diarrhea, fiber helps to smooth fecal products drink lots of water because stool can become hard and watch for signs of nausea and vomiting when taking this med

Histamine-receptor antihistamines

decrease gastric acidity and volume

bronchodilators generic name

generic name: Albuterol Albuterol is available for both oral and inhalational use. Inhalational dosage forms include metered-dose inhalers (MDIs) and solutions for inhalation. Drugs such as albuterol that predominantly stimulate the beta2 receptors have more specific drug effects and cause less adverse effects. By primarily stimulating the beta2-adrenergic receptors of the bronchial and vascular smooth muscles, they cause bronchodilation and may also have a dilating effect on the peripheral vasculature. Albuterol (Proventil HFA, Ventolin HFA, ProAir HFA) is a short-acting beta2-specific bronchodilating beta agonist. Other similar drugs include levalbuterol (Xopenex), and terbutaline (Brethine). Albuterol is the most commonly used drug in this class. If albuterol is used too frequently, dose-related adverse effects may be seen, because albuterol loses its beta2-specific actions, especially at larger dosages. As a consequence, the beta1 receptors are stimulated, which causes nausea, increased anxiety, palpitations, tremors, and an increased heart rate.

Corticosteroids generic name

generic name: Fluticasone propionate Fluticasone is administered intranasally Asthma (prophylaxis and maintenance treatment), Seasonal allergic rhinitis, Exacerbations of asthma or COPD

Stimulant laxatives generic name

generic name: Senna Senna (Senokot) is a commonly used over-the-counter stimulant laxative. Senna is obtained from the dried leaves of the Cassia acutifolia plant. It may be used for relief of acute constipation or bowel preparation for surgery or examination. Because of its stimulating action on the GI tract, it may cause abdominal pain. It can produce complete bowel evacuation in 6 to 12 hours. Senna is available in a variety of dosages as tablets, syrup, and granules. Inform the patient taking senna to avoid other medications within 1 hour of taking it and that it often takes 6 to 12 hours for the laxative effect to occur.

Antihistamines generic name 2nd

generic name: diphenhydramine Allergic disorders, motion sickness, PD symptoms Diphenhydramine (Benadryl) is a traditional antihistamine that works both peripherally and centrally. It also has anticholinergic and sedative effects. It is used as a hypnotic drug because of its sedating effects.

Antihistamines

generic name: diphenhydramine and loradine Antihistamines (histamine 1 [H1] receptor blockers) act by inhibiting vestibular stimulation in a manner that is very similar to that of the anticholinergics. Although they bind primarily to H1 receptors, they also have potent anticholinergic activity, including antisecretory and antispasmodic effects. Thus the antihistamines prevent cholinergic stimulation in both the vestibular and reticular systems. Nausea and vomiting occur when these systems are stimulated. Note that these drugs are not to be confused with histamine 2 [H2] receptor blockers, used for gastric acid control Motion sickness, nonproductive cough, sedation, rhinitis, allergy symptoms, nausea and vomiting

Mineral generic name

generic name: ferrous sulfate Ferrous sulfate (FeSO4) is the most frequently used form of oral iron. It is dosed as 300 mg two to three times a day for most adult patients. Confusion arises with ferrous sulfate because the dose is 300 mg Ferrous sulfate Used for Iron deficiency

Vitamins generic name

generic name: folic acid Folic acid is a water-soluble B-complex vitamin used primarily in the treatment and prevention of folic acid deficiency and anemias caused by folic acid deficiency. Folic acid is available as an over-the-counter medication in multivitamin preparations and by prescription as a single drug. It is contraindicated in patients with uncorrected pernicious anemia. Folic acid is available for both oral and injectable use. Indications: Folate deficiency; tropical sprue; nutritional supplementation; pregnancy-related supplementation

Leukotriene Receptor Antagonists and generic name

generic name: montelukast Modify or inhibit the activity of leukotrienes, which decreases arachidonic acid-induced inflammation and allergen-induced bronchoconstriction. The LTRAs montelukast, zafirlukast, and zileuton are used for the prophylaxis and long-term treatment and prevention of asthma. Because it is dosed once daily, montelukast is the most widely used of these drugs and has also been approved for treatment of allergic rhinitis. These drugs are not meant for the management of acute asthmatic attacks. Improvement with their use is typically seen in about 1 week.

Hyperosmotic Laxatives laxatives generic name

generic name: polyethylene glycol relieve constipation by increasing the water content of the feces, which results in distention, peristalsis, and evacuation. They are most commonly used to treat constipation and to evacuate the bowels before diagnostic and surgical procedures. most commonly given before diagnostic or surgical bowel procedures because it is a very potent laxative that induces total cleansing of the bowel. available in a powdered dosage form that contains mixtures of electrolytes that also help stimulate bowel evacuation contraindicated in patients with GI obstruction, gastric retention, bowel perforation, toxic colitis, toxic megacolon, or ileus.

Stimulant laxatives

stimulant laxatives stimulate the nerves that innervate the intestines, which results in increased peristalsis. They also increase fluid in the colon, which increases bulk and softens the stool. Stimulant laxatives decrease the absorption of antibiotics, digoxin, nitrofurantoin, salicylates, tetracyclines, and oral anticoagulants. Stimulant laxatives induce intestinal peristalsis. They may also cause electrolyte imbalances, so it is important to assess and monitor baseline electrolyte levels.

What is a bulk forming laxative used for?

used for Acute and chronic constipation, irritable bowel syndrome, diverticulosis.

Laxatives: Nursing Implications

´A healthy, high-fiber diet and increased fluid intake should be encouraged as an alternative to laxative use. ´Long-term use of laxatives often results in decreased bowel tone and may lead to dependency. ´All laxative tablets should be swallowed whole, not crushed or chewed, especially if enteric coated.

Types of Antidiarrheals

´Adsorbents ´Antimotility drugs (anticholinergics and opiates) ´Probiotics (also known as intestinal flora modifiers and bacterial replacement drugs)

Laxatives

´Bulk forming ´Emollient (stool softeners, lubricant laxatives) ´Hyperosmotic ´Saline ´Stimulant

Define irritable bowel syndrome (IBS) and how do people cope with it?

´Chronic intestinal discomfort characterized by cramps, diarrhea, or constipation ´Patients usually cope with the symptoms by avoiding irritating foods or taking OTC laxatives and antidiarrheal drugs.

Bulk forming Mechanism of Action

´High fiber ´Absorb water to increase bulk ´Distend bowel to initiate reflex bowel activity ´Examples: Psyllium (Metamucil); Methylcellulose (Citrucel)