ATI Pharm GI

metoclopramide brand name & class
Reglan—> prokinetic

Reglan (metoclopramide) contraindications
GI obstruction, hemorrhage, perforation
Uncontrolled seizure disorder
Pneochromocytoma (hormone-secreting tumor arising from the adrenal glands
Use cautiously with: heart failure, hypertension, asthma, Parkinson’s disease, Hypokalemia, Porphyria,
seizure disorders, liver or kidney dysfunction, and older adults

Reglan (metoclopramide) interacts with:
CNS depressants–> increase risk for sedative effects and seizures
Opioids and anticholinergics decrease therapeutic effects

Reglan (metoclopramide) client education
Do not drive or perform activities that require mental alertness
Advise pt to sit/lie down if feeling drowsy. Change positions gradually
Advise client to report diarrhea
Drink plenty of fluids
Suck on hard candy, chew gum, or sip water if dry mouth.
Advise client to report extrapyrimidal symptoms (restlessness, anxiety, or spasms of face/neck, lip-smacking, writhing motions, and involuntary movements)

ranitidine brand name & drug class
Zantac & Histamine 2- receptor antagonists

ranitidine (zantac) drug interactions
drug-drug: decreases absorption of ketoconazole, itraconazole, atazanavir, delavirdine, geftinib, and cephalosporins
Antacids can reduce absorption
Increase absorption of triazolam and glipizide
Increase procainamide levels

ranitidine (zantac) contraindications
children <12 yr acute porphyria (abd. pain, vomiting, neuropathy, mental disturbances) PKU patients Older adults- more susceptible to CNS reactions Kidney or liver dysfunction Patients at high risk for infection Lactation

ordansetron brand name and class
Zofran— serotonin antagonists

ordanestron (zofran) adverse effects

ordanestron (zofran) procedure before chemo
administer drug slowly (over 15 min) starting 30 minutes before chemo, and then 2 and 6 hrs later

sulfasalazine brand name and class
Azulfidine and 5 aminosalicylate

sulfasalazine (azulfidine) given for
moderate inflammatory disease

sulfasalazine (azulfidine) adverse effects
Nausea, vomiting, diarrhea
Arthralgia (pain in a joint)
Hematologic disorders (agranulocytosis, macrocytic, or hemolytic anemia)

sulfasalazine (azulfidine) contraindications
Sensitivity to salicylates, sulfonamides, trimethoprim (Proloprim)
Folate deficiency
Megaloblastic anemia
Renal failure
GI or urinary tract obstruction

sulfasalazine (azulfidine) precautions
Older adult
Renal or hepatic dysfunction
Blood dyscrasias
G6PD deficiency- ezyme of deficiency effects production of RBC

dimenhydrinate brand name and class
Dramamine antihistamine

dimenhydrinate (Dramamine) given for
motion sickness (antivertigo) anti emetic

dimenhydrinate (Dramamine) contraindications & interactions
children < 2yr Angle-closure glaucoma Prostatic hypertrophy GI or urinary tract obstruction CNS depression Jaundice Interactions: other CNS depressants (increase sedative effects) tricyclic antidepressants (increase anticholinergic effects)

dimenhydrinate (Dramamine) use cautiously with:
seizure disorders
asthma, COPD
Phenylketonuria PKU
Severe liver dysfunction
Older adults

dimenhydrinate (Dramamine) Client education
Do not take prior to driving or activities requiring mental alertness
Sit or lie down if feeling drowsy
Change positons gradually
Suck on hard candy or chew gum, sip water for dry mouth
Increase fluid and fiber intake
Increase activity levels
Urinate every 4 hr and report any undesirable changes in urinary elimination

Aluminum hydroxide brand name and class
Amphojel antacids

aluminum hydroxide (amphojel) is given for
peptic ulcer disease

aluminum hydroxide (amphojel) nursing considerations
abdominal pain
Renal dysfunction
Dehydration, fluid restriction
Reduced motility

Interacts with: warfarin, digoxin, cimetidine, NSAIDs, ciprofloxacin, phenytoin, INH, tetracycline–>drug absorption decreases

Contraindications: GI perforation or obstruction

aluminum hydroxide (amphojel) nursing interventions
Monitor bowel function
Administer stool softeners to treat constipation
Monitor for severe diarrhea
Monitor phosphorus and magnesium levels–>decrease drug therapy
Do not give within 2 hr of administering drugs that interact with antacids

Diphenoxylate/atropine brand name and class
Diphenoxylate/atropine=Lomotil opioid

diphenoxylate/atropine (Lomotil) contraindications
children < 2 Inflammatory bowel disease-->increased risk of Megacolon (massive dilation of the colon–>could result in perforation
Advanced hepatic disease
Severe fluid and electrolyte imbalance
Pseudomembranous enterocolitis
diarrhea due to poisoning
GI bleeding

Other CNS depressants increase CNS depression
MAOIs–>increase risk for hypertensive crisis

diphenoxylate/atropine (Lomotil) use precautions with:
ulcerative colitis
renal or liver dysfunction
history of chemical abuse
Prostatic hypertrophy

Other CNS depressants increase CNS depression
MAOIs–> increase risk for hypertensive crisis

Lubiprostone brand name= and class

lubriprostone (Amitiza) is given for
Irritable bowel syndrome with constipation (IBS-C) in women > 18 yr old
Chronic idiopathic constipation (CIC) in men and women

lubiprostone (Amitiza) is contraindicated with

Use caution with:

Severe diarrhea
Crohn’s disease
Ulcerative colitis
GI obstruction

Gastrointestinal disease

cimetidine brand name and class
cimetidine=Tagamet Histamine2 receptor antagonists

cimetidine (Tagamet) adverse reactions
Impotence, reduced libido
CNS effects (lethargy, depressions, restlessness, seizures)
N/V, diarrhea, constipation

Misoprostol brand name and class
misoprostol=Cytotec Prostaglandin E analog

misoprostol (Cytotec) is given for
Prevention of gastric ulcers from long-term NSAID use

to women prior to induction of labor to soften cervix stimulate uterine contractions

misoprostol (Cytotec) contraindications

Use caution with

Preg Risk Category X

Inflammatory bowel disease
Renal dysfunction
Children < 18 yr Interactions: antacids that contain magnesium worsen diarrhea

misoprostol (Cytotec) adverse effects
abdominal pain
dysmennorrhea, uterine cramping, spotting (women)

omeprazole brand name= class=
omeprazole= Prilosec class=Proton pump inhibitors

omeprazole (Prilosec) client education
Report vomiting or diarrhea
Try antacids to help minimize GI symptoms
Drink plenty of fluids
Tell patients to report any signs of obvious or occult GI bleeding, such as coffee-ground emesis

omeprazole (Prilosec) is given for
Gastric and duodenal ulcers
Prolonged dyspepsia
GERD (Gastrointestinal reflux disease)
Erosive esophagitis
Hypersecretory disorders such as Zollinger-Ellison syndrome, systemic mastocytosis

omeprazole (Prilosec) adverse effects
Bone loss (long-term use)

bisacodyl brand name= class=
bisacodyl= Dulcolax class=stimulant laxative

bisacodyl (Dulcolax) is given for
constipation from opioid use or slow intestinal transit
colon evacuation prior to elective procedures

bisacodyl (Dulcolax) is contraindicated with

Use caution with


children < 1 yr GI obstruction, perforation Anal or rectal fissures Ulcerated hemorrhoids Fecal impaction, ileus Proctitis N/V Undiagnosed abdominal pain Eating disorders or other factors that increase the risk of abuse Interactions: antacids dissolve the enteric coating, cause abdominal cramping Excessive use decreases vit K absorption

bisacodyl (Dulcolax) adverse effects
Mild abdominal cramps
Burning sensation (suppositories)
Proctitis (inflammation of the rectum)–>prolonged use of suppositories
Laxative abuse–> long term use can result in dependence

Alosetron brand name=
alosetron= Lotronex

Alosetron (Lotronex) is given for
Severe irritable bowel syndrome with diarrhea (IBS-D) in women only…. lasted more than 6 months… resistant to conventional management

alosetron (Lotronex) evaluation
Depending on therapeutic intent, effectiveness may be evidenced by relief of diarrhea and decrease in urgency and frequency of defecation

alosetron (Lotronex) adverse effects
Constipation, which can result in impaction, perforation, obstruction
Ischemic colitis–>contributes to intestinal injury

Ct instructions for taking both phenytoin (Dilantin) and sucralfate (Carafate)
Taking sucralfate (Carafate) will decrease the absorption of phenytoin (helps prevent seizures). Decreasing the absorption of phenytoin will increase the chances of having a seizure

phenytoin (Dilantin)

sucralfate (Carafate)

loperamide brand name= class=
loperamide= Imodium class= opioid

loperamide (Imodium) is given to treat
Reduction of volume of ileostomy effluent (waste removal orifice when colon is removed, liquid discharge of feces)

loperamide (Imodium) ct education and instructions
Do not take prior to driving or activities requiring mental alertness
Sit or lie down if lightheaded
Change positions slowly
Suck on hard candy or chew gum if dry mouth occurs
Urinate every 4 hr and report any undesirable changes in urinary elimination
Tell patients with diarrhea to avoid fluid and electrolyte imbalances–> drink commercial oral electrolyte solution
Avoid caffeine b/c it increases motility

What is required before a health care professional can administer Alosetron (Lotronex)
Make sure patients meet specific criteria and sign the required treatment agreement before administration.
Risk management program: Patient, provider, pharmacist outlines potential adverse effects. Outlines criteria that must be met for treatment, only for women who did not improve with traditional therapies

Re-evaluate after 4 weeks without improvement and recommend an increased dosage if the patient is tolerating the drug.

psyllium brand name= class=
psyllium= Metamucil class= fiber supplements

psyllium (Metamucil) is given to treat
Stool regulation for diarrhea and with fecal ostomies

psyllium (Metamucil) client education
Take with at least 8oz of water or juice
Report difficulty swallowing, chest pain, or absence of bowel movements
Report persistent diarrhea
Drink plenty of fluids
Advise patients to increase exercise and fluid intake ( at least 2 to 3 L/day)
Consume high-fiber foods (bran, fresh fruits/vegetables)
Taking it before a meal may reduce appetite
Decreased absorption with antibiotics, salicylates, digoxin (Lanoxin), ntirofurantoin (Furadantin), and warfarin (coumadin)

ducosate sodium brand name= class=
ducosate sodium= Colace class= stool softener
surfactant laxative
ducosate sodium is also Peri-colace, Senna plus, Senokot-S

ducosate sodium (colace) is given to treat
constipation–>acts on intestinal wall by decreasing fluid absorption through intestinal wall

Promotes defecation in older adults with decreased peristalsis

Prevention of fecal impaction (in immobile clients), straining during defecation, painful elimination of hard stools

prevent painful elimination in clients who have conditions such as hemorrhoids or following an episiotomy, cerebral aneurysm, or post MI

azathioprine brand name= class=
azathioprine= Imuran class= immunosuppressants

azathioprine (Imuran) is given for
Inflammatory bowel disease (unlabeled use)
approved to tx organ rejection and rheumatoid arthritis

azathioprine (Imuran) adverse efects
Bone marrow suppression (neutropenia, thrombocytopenia, leukopenia, agranulocytosis)

psyllium (Metamucil) is given to treat

A healthcare professional should question the use of metoclopramide (reglan) for a patient who is taking which of the following drugs? DIGOXIN (LANOXIN) prokinetic drug that can interfere with the absorption of many drugs. A health care progessional is reviewing …

A hcp should question Cytotec for a patient with what? Pregnancy A hcp is going to administer Zofran to a chemo patient. What should the hcp do? Administer 30 minutes before chemotherapy, administer slowly over 15 minutes, repeat 4-6 hours …

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Digoxin (Lanoxin) a healthcare professional should question the use of metoclopramide (reglan) for a patient who is taking which of the following drugs? Ketoconazole a health care professional is reviewing the medical recod of a patiet who is to begin …

A health care professional should question the use of misoprostol (Cytotec) for a patient who has which of the following? A positive pregnancy test A health care professional is about to administer ondansetron (Zofran) to a patient who is receiving …

What are the categories of GI Drugs? PPI H2 Receptor Antagonists Antacids GI Stimulants Antiemetics What is the prototype drug for PPI? omeprazole (Prilosec) WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE …

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