PEPTIC ULCERS & ACID CONTROL
What medication class suppresses gastric acid secretion by blocking histamine H2 receptors?
Histamine-2 receptor antagonists (H2 blockers) such as cimetidine, ranitidine, and famotidine.
What medication class is commonly used to prevent chemotherapy-, radiation-, and postoperative-related vomiting?
Serotonin antagonists, such as ondansetron and granisetron.
Which type of laxative increases stool bulk and softens the fecal mass?
Bulk-forming laxatives, such as psyllium.
What two medications are listed as prototypes for antidiarrheal therapy?
Diphenoxylate plus atropine and loperamide (Imodium).
What is a common adverse effect of aluminum-containing antacids?
Constipation.
What is the prototype medication for proton pump inhibitors (PPIs)?
Omeprazole. It inhibits the H+, K+-ATPase enzyme responsible for gastric acid production.
Which medication is used to prevent and treat motion sickness and is classified as an anticholinergic?
Scopolamine.
What is the prototype surfactant laxative?
Docusate sodium (Colace). It lowers the surface tension of stool, allowing water to penetrate it.
How do nonspecific antidiarrheal medications reduce diarrhea?
They decrease intestinal motility and increase absorption of fluid and sodium, reducing stool frequency and fluid content.
What is a common adverse effect of magnesium-containing antacids?
Diarrhea.
A client is taking omeprazole. When should the client take it?
Once daily on an empty stomach in the morning, 30–60 minutes before eating.
What major adverse effect should the nurse monitor for with dopamine-antagonist antiemetics?
Extrapyramidal symptoms (EPS), hypotension, and sedation.
Which type of laxative draws water into the intestine to increase stool mass and stimulate peristalsis?
Osmotic laxatives, such as magnesium hydroxide, polyethylene glycol, and lactulose.
Which medication is used for severe IBS-D in female clients who have had symptoms for more than 6 months and have not responded to conventional management?
Alosetron.
Why should a client taking sucralfate separate it from medications such as phenytoin, digoxin, warfarin, and ciprofloxacin?
Sucralfate can interfere with their absorption.
Which medication creates a protective barrier over an ulcer and should be taken four times a day, 1 hour before meals and again at bedtime?
Sucralfate. It adheres to the ulcer and protects it from acid and pepsin.
A client taking an antiemetic also drinks alcohol and takes opioids. What is the concern?
Additive CNS depression. Alcohol and other CNS depressants can intensify the CNS-depressant effects of antiemetics.
A client has a bowel obstruction. Why should the nurse question an order for a laxative?
Laxatives are contraindicated with fecal impaction, bowel obstruction, and an acute surgical abdomen because of the risk of perforation.
What serious GI complications can occur with alosetron?
Ischemic colitis, bowel obstruction, impaction, or perforation.
Which GI medication is contraindicated during pregnancy because it can cause cervical ripening?
The slides identify it as Pregnancy Risk Category X and note its use for cervical ripening/labor induction.
A client taking cimetidine is also prescribed warfarin, phenytoin, theophylline, or lidocaine. Why should the nurse be concerned?
Cimetidine can inhibit medication-metabolizing enzymes and increase the levels of these medications, increasing the potential for adverse effects.
Which antiemetic is a substance P/neurokinin-1 antagonist and can decrease the effectiveness of warfarin and ethinyl estradiol?
Aprepitant. It is used with a glucocorticoid and serotonin antagonist for prevention of postoperative nausea/vomiting and chemotherapy-induced nausea/vomiting.
A client asks how to prevent constipation without routinely using laxatives. What should the nurse recommend?
Increase dietary fiber, fluids, and physical activity/exercise. Laxatives should be used occasionally rather than routinely because chronic use can cause fluid and electrolyte imbalances.
A female client has IBS with constipation. Which medication increases intestinal fluid secretion to promote motility?
Lubiprostone. It is used for IBS-C in females and for chronic constipation.
A client is taking sulfasalazine. What important nursing considerations should be remembered?
Administer with food or after meals, monitor for nausea, fever, rash, arthralgia, blood disorders, and rare Stevens-Johnson syndrome, use caution with liver/kidney disease or blood dyscrasias, and ensure adequate fluid intake.