GEORGIA BAPTIST COLLEGE OF NURSING
OF MERCER UNIVERSITY
NUR 312 Pharmacology in Nursing II
Unit III: Drugs that Affect Digestion and Elimination:
Bowel Elimination and Digestion
Lesson Objectives: At the completion of this lesson the student will:
1.
Relate drug therapy to physiology of bowel elimination.
2.
Describe the classification system related to laxatives.
3.
Discuss the pharmacodynamic and pharmacolinetic agents that affect
elimination.
4.
Identify the side effects and potential for abuse of laxatives.
5.
Discuss the rationale for giving digestant agents.
6.
Discuss the rationale for giving medications for hyperacidity.
7.
Outline the side effects associated with antacid medication for hyperacidity.
8.
Utilize the nursing process to identify specific nursing considerations with
individuals receiving drugs that affect elimination.
Content Outline:
1.
Review of physiology of digestion and elimination
2.
Digestive enzymes: Dynamics/Kinetics, Therapeutics, Side Effects/Adverse
Reactions, and Nursing Considerations
2.1
Pancreatic enzymes
2.2.1 pancreatin (Dizymes)
2.2.2 pancrelipase (Cotazym, Creon, Pancrease, Viokase)
3.
Gallstone-solubilizing agents: Dynamics, Therapeutics, Side Effects/Adverse
Reactions, and Nursing Considerations
3.1
ursodiol (Actigall)
3.2
monoctanoin (Moctanin)
4.
Medications for hyperacidity: Dynamics/Kinetics, Therapeutics, Side
Effects/Adverse Reactions, and Nursing Considerations
4.1. Overview of physiology
4.1.1. Factors contributing to hyperacidity
4.1.2. Therapeutic approaches to hyperacidity
4.2
Antacids
4.2.1. Calcium preparations (Calcium Carbonate, Alka-2)
4.2.2. Aluminum products (Aluminum Hydroxide gel, AlternaGel,
Amphogel)
4.2.3. Magnesium products (Magnesium Hydroxide; M.O.M.)
4.3
Anticholinergics - propantheline (Pro-Banthine)
4.4. Histamine receptor antagonist
4.4.1. cimetidine (Tagament)
4.4.2. ranitidine HC1 (Zantac)
4.5. Anti-ulcer drugs
4.5.1. sucralfate (Carafate)
4.5.2. misoprostol (Cytotec)
4.6. Proton pump inhibitors
4.6.1. omeprazole (Prilosec)
4.6.2. lansoprazole (Prevacid)
5.
G. I. Stimulant
5.1. metoclopramide (Reglan)
6.
Antiflatuents: Dynamics/Kinetics, Therapeutics, Side Effects/Adverse Reactions,
and Nursing Considerations
6.1. simethicone (Mylicon)
7.
Antiemetic Medications: Dynamics, Therapeutics, Side
Effects/Adverse Reactions, and Nursing Considerations
7.1. Overview of physiology
7.1.1. Review of vomiting reflex
7.1.2. Causes of vomiting
7.2. Antiemetic agents
7.2.1. Antihistamine
7.2.1.1. hydroxyzine (Atarax, Vistaril)
7.2.1.2. dimenhydrinate (Dramamine)
7.2.2. Phenothiazine
7.2.2.1. chlorpromazine (Thorazine)
7.2.2.2. promethazine (Phenergan)
7.2.2.3. prochlorperazine (compazine)
7.2.3. Anticholinergic
7.2.3.1. scopolamine (Hysocine, Transderm-Scop)
8.
Drugs affecting fecal elimination: Laxatives - Dynamics, Therapeutics, Side
Effects/Adverse Reactions, and Nursing Considerations
8.1.
8.2.
8.3
8.4.
8.5.
8.6.
8.7.
Introduction
8.1.1. Therapeutic use for laxatives
8.1.2. Potential for abuse of laxatives
Stimulants (irritants)
8.2.1. bisacodyl (Ducolax)
8.2.2. senna (Senokot)
Bulk forming
8.3.1. psyllium (Metamucil)
Saline
8.4.1. magnesium hydroxide (M.O.M.)
Hyperosmotic
8.5.1. lactulose(Cephulac)
Stool softnener8.6.1. docusate sodium (Colace, Surfak)
Lubricant
8.7.1 mineral oil (Milkinol)
9.
Antidiarrheal agents: Dynamics/Kinetics, Therapeutics, Side Effects/Adverse
Reactions, and Nursing Considerations
9.1. Causes for diarrhea
9.2. Locally acting antidiarrheal agents
9.2.1. loperamide (Immodium)
9.2.2. bismuth (Pepto-Bismol)
9.3. Systemically acting antidiarrheals
9.3.1. diphenoxylate HCL (Lomotil)
10.
Irritable Bowel Syndrome Medications
10.1. dicyclomine (Bentyl)
11.
Summary of nursing considerations related to drugs that affect bowel elimination
Teaching/Learning Activities:
1.
Lecture/discussion
2.
Handouts
3.
Selected media
Critical Thinking Component:
Describe the drug treatment for H. pylori.
Required Reading:
Aschenbrenner, D. S., Cleveland, L., & Venable, L. J. (2002). Drug Therapy
in Nursing. (pp. 671-703; 704-720;1134-1135). Philadelphia: Lippincott.
Rev. 12/00 BR; 5/01 EL; 12/01 EL
Rev. 5/02 BR;11/02LC; 05/04/BBR