NURA 407 Pharm GI Drugs
Ondansetron (Zofran) is an example of __________ receptor blocker.
5-HT3
Misuse of over-the-counter antacids can lead to __________, which results from the stomach's attempt to maintain normal acid levels.
Acid Rebound
Bismuth subsalicylate (Pepto-Bismol) is an example of a(n) __________ drug, which is designed to coat the GI tract lining and soothe irritation that causes excessive GI activity.
Antidiarrheal
Drugs that are used in treating nausea and vomiting are called __________.
Antiemetics
Which of the following side effects is most likely associated with Cimetidine?
CNS changes, Anti-androgen effects
Antacids are organic compounds that have long been safely used with very few adverse effects and are tolerated by most people. T/F
False
Cimetidine (Tagamet) is recommended for the treatment of peptic ulcer and gastroesophageal reflux in children under 16 years of age. T/F
False
Laxatives are recommended for use in pregnant women to prevent straining from constipation, which can lead to premature labor. T/F
False
Misoprostol (Cytotec) is given to pregnant women with gastric reflex because it increases bicarbonate and mucous production to protect the stomach with minimal systemic effects. T/F
False
Older adults are less likely to develop adverse effects associated with antiemetics due to increased renal and/or hepatic impairment. T/F
False
Patients with a head injury will benefit from an antiemetic to decrease increased intracranial pressure from vomiting. T/F
False
Which of the following mechanisms of action is most likely associated with Cimetidine?
H2 Receptor Blocker
Histamine 2(H2) antagonists block the release of __________ in response to __________.
HCL Gastrin
The only nonphenothiazine currently available for antiemetic use is __________.
Metoclopramide (Reglan)
Bisacodyl (Dulcolax) is the drug of choice to empty the bowel before surgeries or diagnostic tests because it can be administered either __________ or __________.
Orally or Rectally
Erosions in the lining of GI tract and stomach are called __________.
Peptic Ulcers
__________ is a common adverse effect that has been associated with the use of antiemetics, and patients should be reminded to wear sunglasses and sunblock.
Photosensitivity
Which of the following diseases or disorders is most likely a side effect associated with Cimetidine?
Pneumonia
Prochlorperazine is the antiemetic of choice for patients with __________ nausea and vomiting.
Postanesthesia
Omeprazole (Prilosec) is an example of a(n) __________, which is designed to suppress gastric acid secretion by inhibiting the hydrogen-potassium adenosine triphosphatase.
Proton Pump Inhibitor
__________ is designed for short-term treatment of duodenal ulcers by forming an ulcer-adherent complex coating at the eroded ulcer sites in the GI system, which protects the sites against acid, pepsin, and bile salts.
Sucralfate
Which of the following mechanisms of action is most likely associated with Cimetidine?
Suppress gastric acid secretion
Antacids can profoundly affect the absorption of many drugs, so patient teaching should include the information that antacids should be taken 2 hours before or after other medications. T/F
True
Calcium carbonate (Tums) is, in reality, precipitated chalk. T/F
True
Dependence on laxatives can occur with overuse and misuse over a long period of time. T/F
True
Laxatives should not be given to patients with suspected appendicitis because of an increased potential of rupture. T/F
True
Mineral oil is the oldest lubricating laxative and works by forming a slippery coat on the intestinal tract, which prevents the stool from becoming hard and impacted. T/F
True
Patients should be taught that most antiemetics cause some central nervous system depression, which can cause dizziness and drowsiness. T/F
True
The effects of antidiarrheal drugs depend on their method of action and should be chosen based on the patient's illness. T/F
True
A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? A) Avoid driving or activities requiring alertness. B) If you miss a dose, double the next dose. C) Rinsing the mouth with alcohol-based mouthwash can reduce dryness. D) Having 1 glass of wine each night can improve med effectiveness.
A) Avoid driving or activities requiring alertness. Can cause drowsiness and dizziness.
The health care professional instructs a client about the therapeutic actions of sucralfate. She explains that this drug promotes ulcer healing by which action? A) Creates a protective barrier B) Increased gastric pH C) Inhibits the proton pump D) Neutralizes gastric acid
A) Creates a protective barrier Promotes ulcer healing by forming a protective barrier that coats the ulcer. This coating protects the ulcer from further erosion from acid and enzymes and allows the ulcer to heal.
A nurse is assessing a client who has administered ondansetron IV one hour ago. Which of the following findings should the nurse recognize as an adverse effect of this drug? A) Dizziness B) Bradycardia C) Tardive dyskinesia D) Dyspepsia
A) Dizziness Dizziness and lightheadedness are most common side effects
Frequent laxative use or abuse may lead to the adverse effect called _________, which develops when the GI tract becomes dependent on the vigorous stimulation of laxatives.
Cathartic Dependence
A nurse is caring for an older adult client who has renal impairment and a new prescription for cimetidine. The nurse should instruct the client to report which of the following? A) Lethargy B) Cellulitis C) Dry Mouth D) Myalgia
A) Lethargy Older patients who have kidney impairments are at risk for CNS effects like lethargy, depression, confusion, and seizures. Report to provider.
A female client of childbearing potential is starting therapy with misoprostol to prevent a gastric ulcer. Which of the following instructions should you include when teaching this client? SATA A) Mid-cycle spotting can occur B) Take a pregnancy test prior to therapy C) Report excessive menstrual pain D) Use effective contraception E) Avoid taking the drug at bedtime
ABCD Has teratogenic effects. It can induce uterine contractions and abort a pregnancy. Instruct females of childbearing age to confirm that they are not pregnant, use effective contraception throughout drug therapy, can cause dysmenorrhea so monitor for excessive menstrual pain or bleeding. Take with meals and again at bedtime.
A client is starting therapy with psyllium. You explain to the client that psyllium will have which of the following therapeutic effects? SATA A) Relieve constipation B) Increase gastric pH C) Reduce diarrhea D) Decrease gastric acid secretion E) Alleviate nausea
AC Treats constipation and reduces diarrhea by increasing bulk to create soft, formed stools.
A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron which of the following actions should the nurse plan to take? SATA A) Infuse the drug 30 min. prior to chemotherapy B) Administer the drug when the client reports nausea C) Infuse the drug slowly over 15 min. D) Administer the drug immediately following chemotherapy E) Repeat the dose 4 hours after chemotherapy
ACE To prevent chemo-induced n/v. For max effectiveness, re-administer 4 and 8 hours after chemo.
Laxatives commonly are divided into three types, which include __________, __________, and __________, which describe their action.
Chemical stimulants, Bulk, Lubricants
Knowing the adverse drug reactions of cimetidine, the primary care provider's assistant should instruct a client to watch for and report which of the following? A) Hyperactivity B) Confusion C) Hypertension D) Bone Pain
B) Confusion Can cause confusion, drowsiness or dizziness. Patient should watch for and report any of these effects, as they might require adjustments in their drug therapy or possibly additional therapy.
You are about to administer ondansetron to a client to prevent anesthesia-induced n/v. You prepare to monitor the client for which adverse effects of this drug? A) Bronchospasm B) Dizziness C) Hypertension D) Anxiety
B) Dizziness Serotonin antagonist, can cause dizziness, lightheadedness, and sedation. Can cause a headache. Also causes ECG changes so should be used cautiously with clients who have abnormal heart rhythm or electrolyte imbalance.
A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instruction should the nurse include? A) Take the med with food B) Swallow the capsules whole C) Dissolve the tablets in water D) Take the med at bedtime
B) Swallow the capsules whole Should swallow capsule or tablets whole and not the crush/chew
The nurse should recognize that misoprostol is contraindicated for a client who has which of the following conditions? A) A seizure disorder B) Rheumatoid arthritis C) A positive pregnancy test D) Heart failure
C) A positive pregnancy test Misoprostol is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion. Patients must be on contraception.
A nurse is providing teaching to a client who has a new prescription for loperamide. Which of the following instruction should the nurse include? A) Dissolve the powder thoroughly in 8 oz. of water B) Take with diphenhydramine to prevent extrapyramidal effects C) Avoid activities that require alertness D) Take 30 min. before activities that trigger nausea
C) Avoid activities that require alertness Can cause sedation and dizziness
A client is about to start taking omeprazole to treat a duodenal ulcer. Which of the following instructions should you include when talking with the client about taking this drug? A) Take it with food B) Avoid using aluminum-based antacids C) Consume adequate amounts of fluids D) Do not drink grapefruit juice
C) Consume adequate amounts of fluids Food can reduce the absorption of omeprazole, so instruct clients to take this drug 1 hour before a meal and with plenty of fluids.
A nurse is providing teaching to a client who is about to start taking psyllium to treat constipation. Which of the following instructions should the nurse include? SATA A) Expect results in 6 to 12 hr. B) Urinate every 4 hr. C) Take the drug with at least 8 oz (237 mL) of fluid. D) Avoid activities that require alertness. E) Increase fluid and fiber intake.
CE To prevent esophageal obstruction, patients should take psyllium with at least 8 oz. of fluid and after mixing the powdered form should drink it immediately.
A nurse is caring for a client who has a new prescription for famotidine to treat Gerd. The nurse should instruct the client to wait at least one hour between taking famotidine and which of the following over the counter drugs? A) Gingko biloba B) Antidiarrheals C) St. John's wort D) Antacids
D) Antacids Antacids can decrease absorption of famotidine. Wait at least an hour before administration.
Which of the following instructions should the healthcare professional give a client about taking sucralfate to treat an acute duodenal ulcer? A) Take it with a prescribed antacid B) Reduce potassium intake C) Take it with food D) Increase fluid and fiber intake
D) Increase fluid and fiber intake It can cause constipation, so the patient should increase intake of fluids and fiber.
A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium has which of the following therapeutic effects? A) Reduces inflammation B) Reduces gastric acid C) Prevents diarrhea D) Prevents straining
D) Prevents straining Stool softener, prevents straining during defecation and prevents elevation in blood pressure that can result from straining. Helps relieve constipation and reduces painful elimination of hard stools.
A nurse is caring for a client who is taking phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least two hours apart for which of the following reasons? A) Phenytoin increases the metabolism of sucralfate B) Phenytoin reduces effectiveness of sucralfate C) Sucralfate increases the risk for phenytoin toxicity D) Sucralfate interferes with the absorption of phenytoin
D) Sucralfate interferes with the absorption of phenytoin Decreases phenytoin. Allow 2 hours before administering