Antibiotics
What are the adverse effects of clarithromycin?
nausea, diarrhea, and distortion of taste
What are the most common adverse effects of cimetidine?
anti-androgenic effects (gynecomastia, reduced libido, and impotence); will reverse when med is stopped
PPIs are the most effective drug for?
suppressing gastric acid secretion
How often are antacids administered?
7x per day; 1-3 hours after each meal and at bedtime
Chew thoroughly and follow with water or milk
Ondansetron is more effective when combined with?
Ondansetron can cause potentially fatal dysrhythmias d/t what adverse effect?
dexamethasone
OT prolongation
Amoxicillin works best when given in combination with?
antisecretory agent (omeprazole)
How long should treatment be for a duodenal ulcer? Gastric ulcer?
duodenal = 4-6 weeks
gastric = 8-12 weeks
Treatment with PPIs should be limited to?
4-8 weeks
What is important to know about the liquid preparation of antacids?
liquids are more effective
Aprepitant is used for?
Aprepitant is combined with _______ because it is only moderately effective?
acute and delayed CINV d/t prolonged duration
glucocorticoids
What is the most serious adverse effect of bismuth?
black discoloration of tongue and stool
What are the three key differences between ranitidine and cimetidine?
ranitidine is more potent, fewer adverse effects, and fewer drug interactions
What is a distinguishing adverse effect of omeprazole related to the decreased absorption of ____?
Calcium; osteoporosis and fractures
Sodium compounds of antacids should be avoided in who?
patients with heart failure and hypertension
Promethazine is the most widely used antiemetic in which age group?
Which route is preferred?
Why should you avoid in children under 2 and caution in children over 2?
Combine with lorazepam to...
children
IM route - less local tissue injury
respiratory depression and tissue injury
control extrapyramidal reactions
Metronidazole and Tinidazole should not be combined with what and why?
Famotidine and Nizatidine is different from other H2RAS in that...
it does not inhibit hepatic drug metabolizing enzymes; it does not suppress the metabolism of other drugs.
What is Omeprazole's MOA?
irreversible inhibition of H+, K+, ATPase
Aluminum compounds and calcium compounds produce what adverse effect, and for this reason, should be combined with?
What is the antacid of choice?
constipating, magnesium compounds
magnesium compounds
Long-term use of which drug causes irreversible tardive dyskinesia?
Metoclopromide is contraindicated in patients with?
metoclopromide
bowel obs., hemorrhage, or perforation beccuse it increases upper GI motility
Tetracycline absorption is reduced by what and what should you do if need to take in combination?
Why should tetracycline be avoided in pregnancy or children under 10 y/o?
food, Ca supplements, milk products, iron supplements, laxatives, and antacids; take 1 hours before or 2 hours after
stains developing teeth
What are the nursing considerations for H2RAS?
- monitor liver and renal function
- avoid alcohol and smoking
- avoid antacids within 1 hour of administration
- avoid NSAIDs and aspirin (they can be the underlying cause of ulcer)
When should omeprazole be taken?
before the 1st meal of each day
Do aluminum compounds have a high or low ANC
Do magnesium compounds have a high or low ANC
Do calcium compounds have a high or low ANC
low
high
high
Cannabinoids can stimulate _____ in AIDs patients?
Cannabinoids should be used with caution in which patients because it is a derivative or marijuana?
Is there a potential for abuse?
appetite
psych patients
yes