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Nurs 329 week 1 - other gastrointestinal drugs

by: Mary Eke

Nurs 329 week 1 - other gastrointestinal drugs 330

Marketplace > Drexel University > Nursing and Health Sciences > 330 > Nurs 329 week 1 other gastrointestinal drugs
Mary Eke
GPA 3.83

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About this Document

This notes covers other gastrointestinal drugs from week 1 lectures. It is detailed, yet containing key points to know for study.
Dr. Amendolia
Class Notes
antiemetic, antidiarrhea, IBS, IBD, prokinetic, emesis, Drugs
25 ?




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This 2 page Class Notes was uploaded by Mary Eke on Wednesday September 28, 2016. The Class Notes belongs to 330 at Drexel University taught by Dr. Amendolia in Summer 2016. Since its upload, it has received 4 views. For similar materials see Pharmacology in Nursing and Health Sciences at Drexel University.

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Date Created: 09/28/16
Other Gastrointestinal Drugs  Antiemetic: given to suppress nausea and vomiting. The vomiting center is located in the medulla oblongata. It could be activated directly or indirectly (by chemoreceptor trigger zone). Receptors involved in vomiting response include: serotonin, dopamine, acetylcholine, and histamine.  Serotonin antagonists: Ondansetron (Zofran) - most effective for suppressing n/v related to chemo or anesthesia. Should be given 30 – 60 minutes before chemotherapy. Most effective when combined with dexamethasone. Side effects: headache, diarrhea, and dizziness.  Dopamine antagonists: Prochlorperazine (Compazine)/Promethazine (Phenergan) –reduce emesis related to surgery, chemo or toxins. Side effects: acute dystonia, akathisia. Avoid in children less than 12 yrs.  Cannabinoid: Dronabinol (Marinol): can also be used to stimulate appetite in AIDS patients. Adverse effect: dissociation, dysphoria. Use with caution for cardiac patients.  Prokinetic agents: given to increase tone and motility of the GI tract. It is indicated for GERD, chemo induced n/v, and diabetic gastroparesis.  Metoclopramide (Reglan): works by sensitizing tissues to the effect of acetylcholine, increasing peristalsis and gastric emptying. Adverse effects: CNS depression, tardive dyskinesia, acute dystonia, akathisia, diarrhea. Given prior to symptoms of n/v and 30 minutes before meal or chemotherapy.  Anti-spasmodic: cholinergic nerve fibers are throughout the GI and when stimulated, cause increases motility and secretion of acids and enzymes. Antispasmodic agents are anticholinergic agents. They make you dry, causing urinary retention, blurred vision, dry mouth, constipation.  Anticholinergic/muscarinic antagonist: Scopolamine – most effective for motion sickness. Adverse effects: dry mouth, drowsiness, blurred vision. Given PO, SQ and TD.  Anticholinergic/antihistamine: Dimenhydrinate (Dramamine). Side effects: sedation, dry mouth, blurred vision drowsiness.  Antidiarrheal agents: diarrhea is a symptom of GI disease. It is caused by infection, maldigestion, inflammation and functional disorders. Most serious complications are dehydration and electrolyte imbalance. All antidiarrheal must be used with caution in patients with IBD.  Diphenoxylate: it is an opioid used with atropine, to discourage abuse or misuse. It is contraindicated with diarrhea of infectious nature, obstructed jaundice and children under 2.  Loperamide (Imodium): used in treatment of acute or chronic diarrhea (gastroenteritis). It does not contain atropine and has less adverse effects so it’s a first choice.  Other antidiarrheal: Bismuth Subsalicylate (Pepto Bismol), Kaolin and Pectin (kaopectate) IBD vs IBS IBS – Irritable Bowel Syndrome. Includes: hypersensitive/hyper-responsive bowel.  Alosteron (Lotronex): for use in women only with severe disease, and need to follow strict criteria. It can decrease abdominal pain related to diarrhea. IBD – Inflammatory Bowel Disorder. Includes: Ulcerative Colitis and Crohn’s disease  5-aminosaclicylic acid derivate  Sulfasalzine (Azulfadine) – anti-inflammatory effect. Contraindicated with sulfur allergy. Give with food  Mesalamine (Asacol) – better tolerated than Sulfasalzine  Corticosteroids: to relieve IBD symptoms. Given IV (hydrocortisone/methylprednisolone) or PO (Prednisone/methylprednisolone  Immunosuppressant: Azathiprine (Imuran) – for long term therapy. Onset may take up to 6 months. Adverse effect: pancreatic and bone marrow suppression. Know lab values


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