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Gastrointestinal and Vitamins

[q] Histamine2-receptor antagonists- suppress the secretion of gastric acid

[a] Ranitidine, Cimetidine, Famotidine, Nizatidine

[q] Cimetidine side effect

[a] block androgen receptors-decreased libido and impotence. CNS effects (lethargy, depression, confusion). It can increase the levels of warfarin, phenytoin, theophylline, and lidocaine.

[q] Proton pump inhibitors (PPI) – reduce gastric acid secretion

[a] Omeprazole, Pantoprazole, Lansoprazole, Rabeprazole, Esomeprazole

[q] PPI long term use effect

[a] Long-term use of proton pump inhibitors increases the risk of osteoporosis

[q] PPI nurse note

[a] Do not crush, chew, or break sustained-release capsules,Do not open capsule and sprinkle contents over food, omeprazole once a day prior to eating in the morning

[q] Sucralfate

[a] Mucosal protectant

[q] Sucralfate side effect

[a] constipation (increase fiber)

[q] Antacids- neutralize gastric acid

[a] Aluminum carbonate, Aluminium Hydroxide, Magnesium hydroxide (milk of magnesia), Sodium bicarbonate, Calcium carbonate (Tums)

[q] Antacid Side Effect

[a] Aluminum and calcium compounds cause constipation. Magnesium compounds cause diarrhea, renal toxic. Aluminum hydroxide – hypophosphatemia and hypomagnesemia.

[q] Antacid Nurse note

[a] Do not mix with other meds. Give 1 hour before or 3 hours after meals.

[q] Dopamine antagonists- Antiemetic

[a] Prochlorperazine, metoclopramide (Reglan), promethazine (Phenergan)

[q] Ondansetron

[a] Antiemetic

[q] Ondansetron side effect

[a] Headache, diarrhea,dizziness

[q] Prochlorperazine side effect

[a] Extrapyramidal symptoms (monitor for restlessness, anxiety, spasms of face and neck; Administer an anticholinergic medication to treat), Hypotension, Sedation, Anticholinergic effects

[q] Scopolamine

[a] Anticholinergic effects, sedation, antinausea, treat motion sickness

[q] Laxatives

[a] Psyllium (Metamucil), Docusate sodium (Colace), Bisacodyl (Dulcolax) Magnesium hydroxide (Milk of Magnesia), senna (Senokot), lactulose (Cephulac)

[q] Laxative contraindication

[a] Contraindicated in clients who have fecal impaction, bowel obstruction, and acute surgical abdomen to prevent perforation. Contraindicated in clients who have nausea, cramping, and abdominal pain

[q] Laxative teaching

[a] Chronic laxative use can lead to fluid and electrolyte imbalances. Increase high-fiber foods in daily diet such as bran, fresh fruits and vegetables. Increase fluid intake (2 to 3 L/day). Maintain a regular exercise regimen

[q] Loperamide (Antidiarrheals) Teaching

[a] Drink small amounts of clear liquids/oral electrolyte solution. Avoid caffeine (increase peristalsis and worsen diarrhea).

[q] Metoclopramide ( controls nausea and vomiting) Adverse Effect

[a] Extrapyramidal symptoms (report restlessness, anxiety, and spasms of face and neck), Sedation (fall precaution, avoid activities that require alertness, such as driving), Diarrhea (monitor for dehydration)

[q] Metoclopramide Contraindication

[a] Contraindicated in clients who have GI perforation, GI bleeding, bowel obstruction, and hemorrhage.

[q] sulfasalazine

[a] Decrease inflammation in IBS, Crohn’s disease, ulcerative colitis

[q] sulfasalazine side effects

[a] Blood disorders (agranulocytosis,hemolytic and macrocytic anemia), Nausea, cramps, rash, arthralgia

[q] sulfasalazine Nurse note

[a] contraindicated in clients who have sensitivity to sulfonamides, salicylates

[q] Ferrous sulfate Side effect

[a] GI distress – nausea, constipation(take with orange juice), Teeth staining (Teach clients to dilute liquid iron with water or juice, drink with a straw, and rinse mouth after swallowing),

[q] Ferrous sulfate notes

[a] Better to take empty stomach, Taking with Vitamin C increases absorption, Z-track technique for IM, increase water and fiber intake to prevent constipation.

[q] Foods high in Iron

[a] liver, egg yolks, muscle meats, yeast, grains, green leafy vegetables

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