BISMUTH COMPOUNDS
Why do we use BISMUTH COMPOUNDS?
What do they treat/prevent?
We utilize BISMUTH COMPOUNDS to treat:
- DYSPEPSIA
- ACUTE DIARRHEA
- PUD
We utilize BISMUTH COMPOUNDS to PREVENT:
- TRAVELER's DIARRHEA
CAN BE USED TO TREAT H. PYLORI!
Why do we use SELECTIVE SEROTONIN ANTAGONISTS?
We utilize SELECTIVE SEROTONIN ANTAGONISTS to treat:
- PONV (post-operative nausea/vomiting)
- CIMV (chemo-induced nausea/vomiting)
- Delayed CIMV
Why do we use BENZAMIDES?
We utilize BENZAMIDES as an:
- ANTIEMETIC
- GI PROKINETIC THAT INCREASES GI MOTILITY!
If a patient has RENAL DYSFUNCTION, what should we do if they are prescribed this medication class?
ADJUST THE DOSE
Why do we use PHENOTHIAZINES?
What do they treat and how do they treat it?
We utilize PHENOTHIAZINES to treat:
- Simple NAUSEA/VOMITTING!
PHENOTHIAZINES treat N/V by BLOCKING DOPAMINE RECEPTORS (in the Chemo-Receptor Zone (CTZ))
What adverse effects do BISMUTH COMPOUNDS cause in patients taking this med class?
- BLACK STOOLS
- INCREASE BLEEDING TIMES
- Constipation if taken too frequently
What adverse effects do SELECTIVE SEROTONIN ANTAGONISTS cause in patients taking this med class?
- Diarrhea
- Headache
- Constipation
- Drowsiness
- PROLONGED QT INTERVAL
How do BENZAMIDES work?
1. BENZAMIDES INHIBITS CTZ STIMULATION
2. BLOCK DOPAMINERGIC RECEPTORS IN THE CTZ
3. STIMULATES CHOLINERGIC ACTIVITY IN THE GUT (INCREASING GI MOTILITY!)
What adverse effects can PHENOTHIAZINES cause in patients taking this med class?
- Extra Pyramidal Symptoms (EPS - tardive dyskinesia)
- DYSTONIA (involuntary muscle movements/twitching)
- EXCESSIVE SEDATION
- CARDIAC ARRHYTHMIAS
- PROLONGED QT INTERVALS
How do BISMUTH COMPOUNDS work?
BISMUTH COMPOUNDS treat (PUD, Dyspepsia, Acute Diarrhea)/prevent (traveler's diarrhea) by:
STIMULATING ABSORPTION OF FLUID and ELECTROLYTES across the INTESTINAL WALL, COATING THE WALLS OF THE GI TRACT!
- EXACT MOA HAS NOT BEEN DETERMINED!
How do SELECTIVE SEROTONIN ANTAGONISTS work?
SELECTIVE SEROTONIN ANTAGONISTS treat PONV and CINV by:
BLOCKING SEROTONIN RECEPTORS!
What adverse effects can BENZAMIDES cause in patients taking this med class?
- TARDIVE DYSKINESIA (irreversible)
- RESTLESSNESS
- Drowsiness
- Diarrhea
- Seizures
What nursing consideration is MOST IMPORTANT?
PUSH PHENOTHIAZINES SLOWLY TO AVOID CV EFFECTS
How do use BISMUTH COMPOUNDS (PETO BISMOL)?
We use BISMUTH COMPOUNDS for SHORT PERIODS ONLY!
How do we administer SELECTIVE SEROTONIN ANTAGONISTS?
PUSH SELECTIVE SEROTONIN ANTAGONISTS SLOWLY!
(OVER 2 MINUTES TO AVOID PROLONGED QT INTERVALS)
How can we avoid EXTRAPYRAMIDAL SYMPTOMS?
GIVE BENZAMIDES WITH IV DYPHENHYDRAMINE
What gero considerations do we need to keep in mind when administering PHENOTHIAZINES?
PHENOTHIAZINES CAUSE EXCESSIVE SEDATION (esp. in elderly populations)
Which patients should avoid BISMUTH COMPOUNDS?
RENAL INSUFFICIENCY!
What important nursing considerations do we need to implement/educate to our patients taking SELECTIVE SEROTONIN ANTAGONISTS?
SELECTIVE SEROTONIN ANTAGONISTS are the most frequently used agents to treat Nausea/Vomitting!
- This med class is generally well-tolerated
- SELECTIVE SEROTONIN ANTAGONISTS have FEW DRUG-DRUG INTERACTIONS!
How should we give BENZAMIDES?
PUSH SLOWLY OVER 2 MINUTES!!!
If a patient has complex N/V, do we still give them PHENOTHIAZINES?
YES, we would administer EMOTOGENIC DOSES of CHEMO in combination for more complex cases of N/V