FOUR PROCESSES:
(1) mechanical degradation - chewing and churning
(2) liquefaction - secretion of GI accessory glands- salivary, hepatic,
pancreatic secretions
(3) enzymatic hydrolysis- amylases break starch molecules into
monosaccharide sugar subunits
(4)Absorption via the extensive mucosal membrane surface of lower GI
tract.
GI Drugs targeting
Specificity
Indications for Use
Side and Adverse Effects
Nursing interventions
Gastroesophageal Reflux Disease(GERD)
Peptic Ulcer Disease (PUD)
Laxatives
Antiemetic Agents
Inflammatory Bowel Disease (IBD)
Irritable Bowel Syndrome
Antidiarrheal
Weight Loss
Vitamins
Herbals
Contraindications and Precautions
Drug interactions
GERD Animation
Omeprazole ( Prilosec)
Peptic Ulcers
Peptic Ulcer Development Video
Misoprostol (Cytotec)
Sucralfate (Carafate)
Antacids
 DIFFERENTIATE D BY:
 Acid Neutralizing Capacity
(ANC)
 Onset and Duration of
action
 Effects on the Bowel
 Systemic Effects
 Special applications
Antacids
Magnesium Hydroxide
Calcium Carbonate
BOTH:
Fast acting, high
ANC, producing long
lasting effects
Differ in Adverse
Effects
 http://vimeo.com/42835070/download?t=1380467758&v=100000350&s=
a24f06398417da00f45703b5598e3e06
Actions much like that
of dietary fiber
Preferred agents for
temporary treatment
of constipation
 A “Stool Softener”
 Results in 1 to 3 days
 Alters consistency by
lowering surface tension
 Surfactants inhibit fluid
absorption and stimulate
secretion of fluid into lumen
 Used for Opioid induced
Constipation
 Plant derived
 Containing
anthraquinones
 Semifluid stool in 6 to 12
hours
 Non-absorbable compound
 Alters consistency by
 lowering surface tension
 Surfactants inhibit fluid
absorption and stimulate
secretion of fluid into lumen
 Vomiting
 The expulsion of gastric contents
 -Before treating, the cause of the
vomiting needs to be identified
 Causes
 Motion sickness
 Viral & bacterial infection
 Food intolerance
 Post operative surgery
 Pain, shock, & effects of radiation
 Disturbances of the middle ear
affecting equilibrium.
GI Drugs: Antiemetic
 Dopamine Blockers
 Serotonin
antagonists
 Glucocorticoids
 Cannabinoids
Dopamine Blocker:
Prokinetic Agent:
Drugs used to speed up
the movement of food
through the stomach and
intestines
can cause tardive
dyskinesia which is
irreversible
Serotonin receptor Antagonist:
Prevents emesis and nausea
associated with radiotherapy and
anesthesia and other causes
Increased effectiveness when
combined with dexamethasone
Potentiates prolonged QT
Risk of tardes des pointes
Glucocortocoid:
Used to suppress CINV
Given to treat nausea and
vomiting resulting from
chemotherapy
Suppresses immune system
Cannabinoid:
Used to treat nausea and
vomitting from Chemotherapy
Given as a second choice
medication when nothing else
works
Can be habit forming
IBS Animation
Most common disorder of
the GI tract
Approved in Women only
Can cause severe side
effects-deaths have
occurred due to its
potential for GI toxicity
Both drugs treat diarrhea and reduce the volume of
discharge of ileostomies and suppress the bowel motility by
decreasing fluid secretion into intestinal lumen
 Poorly absorbed
 Does not readily cross the
blood brain barrier
 This is a class V controlled
Substance
 Taken in high doses can elicit
morphine like effects
 Overdose can
occur
Phentermine (Adipex-P)
Appetite suppressant
Belongs to a class of drugs called
sympathomimetic amines.
Decreases appetite while
increasing the amount of energy
used by your body, or by affecting
certain parts of the brain.
 Take on an empty stomach, at
least 1 hour before or 2 hours
after a meal
 Avoid taking antacids or
antibiotics within 2 hours
before or after taking ferrous
sulfate.
 Ferrous sulfate is only part of
a complete program of
treatment that may also
include a special diet.
 Risk of iron poisoning
 Give test dose and have
epinephrine ready to
counter iron poison. Follow
up with dosage 1 hour later
 Used when oral iron is
intolerable
 Risk of anaphylaxis and
cardiac arrest
Used to treat hypokalemia
(commonly caused by taking loop
diuretics)
Causes severe GI upset, bleeding,
perforation
Take with food or a full glass of water
• Essential for DNA synthesis and
influences cell growth and division
by catalyzing folic acid conversion
• Coupled with its intrinsic factor,
absorbed by interacting with
receptor cells in the intestinal wall
•
• Stored in the liver.
• Because it is stored the average
adult requires about 2.4 mcg per
day
Without it DNA replication and cell
division cannot occur
Water soluable B vitamin that is not
stored in the body like B12
Foods with folic acid in them include
leafy green vegetables, fruits, dried
beans, peas and nuts. Enriched breads,
cereals and other grain products also
contain folic acid
Treats: symptoms of menopause,
including hot flushes, vaginal dryness,
palpitations, depression, irritability, and
sleep disturbance.
.
used
primarily for
prophylaxis
of migraine.
Orally:
suppresses
inflammation
influenza and
the common
cold.
Topically:
treats
wounds,
burns,
eczema,
psoriasis,
and herpes
simplex
infection.
Treats dyslipidemia
and constipation also
supplies a vegetarian
source of omega-3
fatty acids.
Reduces levels of triglycerides
and low-density-lipoprotein
(LDL) cholesterol and to raise
levels of high-densitylipoprotein (HDL) cholesterol.
Reduces blood pressure, suppress
platelet aggregation, increase arterial
elasticity
Reduces the formation of
atherosclerotic plaque.
Treats vertigo and to suppress nausea and vomiting caused by
motion sickness, morning sickness, surgery, and perhaps cancer
chemotherapy.
Improves age-related memory impairment, dementia, and associated conditions,
including dizziness, vertigo, tinnitus, headache, and mood changes. Improves painfree walking distance in patients with peripheral artery disease.
HERBALS
Improving mental clarity, weight loss, and prevention and
treatment of stomach, skin, bladder, and breast cancer.
Relieves urinary symptoms
associated with benign
prostatic hypertrophy
(BPH).
Prevention of breast cancer, treatment of menopausal
symptoms (hot flashes), and prevention of osteoporosis
HERBALS
Treats depression
Promotes sleep.
Reduces anxiety-associated
restlessness.
References
Lehne, R. (2013). Pharmacology for Nursing Care (8th Ed.). St Louis Missouri: Elsiever
Saunders
Lippencott, W. (2009). Nursing Pharmacology Made Incredibly Easy (2nd Ed.). Philadelphia, PA:
Vallerand, A. (2013). Davis’s Drug Guide for Nurses (13th Ed.). Philadelphia, PA : F. A. Davis Company
Wolters Kluwer Health/Lippincott Williams & Wilkins
Zerwekh, J. (2009) Mosby’s Pharmacology Notecards (3rd Ed.). St Louis Missouri: Elsiever Saunders