Digestants Drugs Affecting Gallbladder Promote the process of

Digestants & Drugs Affecting Gallbladder • Promote the process of digestion in GI tract • pancrealipase (Pancrease) - contains digestive enzymes • Side effect: nausea, abd. cramps, & loose stools • Take before or with meals • ursodiol (Actigall) dissolves radiolucent noncalcified gallstones • Side effect: N & V

Antacids • Drugs that buffer, neutralize or absorb hydrochloric acid in the stomach • Should be taken 1 hour after meals & @ bedtime • Watch for drug interactions • Magnesium (MOM) - diarrhea • Aluminum carbonate (Amphojel) constipation • Maalox (aluminum hydroxide with & magnesium)

Peptic Ulcer Treatment • Multi-drug treatment • Usually 2 antibiotics & a proton pump inhibitor or histamine blocking agent & then add bismuth subsalicylate - Pepto-Bismol

Cytoprotective Agents • Sucralfate (Carafate) – tx duodenal ulcer • forms a protective, acid-resistant shield in the ulcer crater • give one hour before meals & at bedtime • Do Not Chew the Tablet • Administer antacids within 30 minutes before or after • Side effect: constipation

Proton Pump Inhibitors • Blocks the final step of acid production – decreases acid production • lansoprazole (Prevacid): side effect/diarrhea • omeprazole (Prilosec): side effect/diarrhea & headache • Swallow capsule whole & take before meals • Tx GERD, gastric ulcer, H. pylori

H 2 Receptor Antagonists • Activation of H 2 receptors increases gastric acid secretion so these drugs block this activation • cimetidine (Tagamet) – tx peptic & duodenal ulcer, GERD, hypersecretory conditions – generally well tolerated drug • ranitidine (Zantac) • famotidine (Pepcid) • nizatidine (Axid)

Antiflatulents • Simethicone (Mylicon) • Defoaming agent- causes gas bubbles to unite • Relieves flatulence by dispensing and preventing the formation of mucussurrounded gas pockets in the GI tract

Gastrointestinal Stimulant • Increases ACH – increases peristalsis – tx diabetic gastric stasis • antiemetic • Metoclopramide (Reglan) • AE – drowsiness & depression & Parkinson -like symptoms • When to give

Antiemtics • Prevent or relieve N & V, used with chemotherapy & postop • May exert effect on vomiting center, cerebral cortex, chemoreceptors trigger zone or vestibular apparatus • Side effect: headache, constipation & malaise • ondansetron hydrochloride (Zofran)

Laxatives • Do not give with undiagnosed abdominal pain • Better to treat with increase fluids, vegetables, fruits & bran products • Laxative abuse • Saline (MOM) • Stimulant (Dulcolax, Ex-Lax) • Bulk Forming (Metamucil)

Laxatives (cont. ) • Lubricant (Mineral Oil) • Stool Softener (Colace) • Hyperosmotic (Lactulose & Go. LYTELY)

Antidiarrheal Agents • Adsorbents: coats wall of GI tract, absorb bacteria or toxins causing the diarrhea & passing then out with stool (Kaopectate) • Pepto-Bismol - promotes absorption of fluids & has antimicrobial effect • diphenoxylate HCL with Atropine (Lomotil), “synthetic narcotic”, meperedine