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Index
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Med surge II
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Chapter 1
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Level 1
level: Level 1
Questions and Answers List
level questions: Level 1
Question
Answer
most used (D) anticholinergic drug decr cramping, intestinal spasms, side effects: blurred vision, dry mouth, urinary retention
dicyclomine
bile acid sequestrant to prevent diarrhea r/t absorption of bile acids in Chron's and illeal disease.
Cholysteramine
works quickly, dont combine w other meds SIDE effects: risk for infection-shingles vaccine prior to med recommended
Janus Kinase (JAK)
decreases inflammation to achieve remission methylprednisolone prednisone budesonide MMX- provides controlled release throughout the colon, less side effects than prednisone main side effect if used long term are: osteoporosis diabetes, HTN, weight gain, etc
corticosteroids
inhibit prostaglandin production incr risk of ulcer, then bleeding
NSAIDs
best treatment to prevents stress ulcers block hydrogen secretion from parietal cells, are good for long term do NOT administer w FOOD ADVERSE EFFECTS: incr risk of fractures may affect the effectiveness of clopidrogel inc gastric pH may interfere w absorption of other drugs
PPI
block histamine stimulated HCl secretion less effective than proton pump inhibitors smoking interferes w drug action INc gastric pH may interfere w absorption ADMIN at bedtime
H2 blockers
does not interfere w cytochrome p-450 in liver less drug interactions
famotidine
less likely to cause CNS side effects and fewer drug interactions than cimetidine 2019 recall d/t risk of cancer from contamination w MDMA in some drugs
Ranitidine
interferes w cytochrome p-450 in liver more drug interactions ADVERSE EFFECTS: confusion, especially in elderly, liver d, renal impairment pt fatigue, depression gynecomastia and impotence r/t antiadrogenic effects
cimetidine
ACTION: combines w proteins in ulcer to form a protective coating taken on an empty stomach qid ADVERSE EFFECTS- NOT common, NOT systemic constipation binds w some drugs ( digoxin, Antacids) so do not give at the same time
sucralfate
macrolide antibiotic used to fight bacteria and eradicate H pylori take it at the same time if Gi upset occurs take it w milk or food SIDE EFFECTS: produces bad taste in mouth NVD + headache
clarithromycin
antibiotic SIDE EFFECT: vomiting, diarrhea, rash, contraindicated d/g pregnancy or before age 8 d/t staining of the child's teeth
tetracycline
metallic taste when eating certain foods disulfiram reaction in combination w alcohol: - sudden, severe headache, incr BP, nausea, cramps, diaphoresis, avoid alcohol during and 1 week after
metronidazole
toxic to H pylori tongue and stool turns black
bismuth subsalicylate
prevents gastric NOT duodenal ulcers in pt taking NSAIDs replaces gastric prostaglandin E1 ADVERSE EFFECTS: miscarriage, nausea, abdominal pain, craps, diarrhea, dizziness
misoprostol and enprostil
antispasmodic medication used for Dumping syndrome
dicylcomine
used for bile reflux gastritis and binds to bile acids if mixed w noncarb fluid or apple sauce.
cholestyramine
incr gastric emptying to help w hiatus hernia ac and pc ADMIN ( before meals and after meals ) ADVERSE EFFECTS: restlessness, insomnia, headaches tardive DYSKINESIA
metoclopramide
lay on the side for 30 min used for ulcerative colitis
budenoside
anti-inflammatory med effect on intestinal mucosa enhance delivery to the desired part of the GI tract take with FOOD SIDE EFFECTS: anorexia, NV headache
mesalamine
work SLOWLY ( not for a flare) used for Crohn's D. to alter immune response maintain remission after steroids chemo drugs such as: methotrexate 6- Mercaptopurine SIDE EFFECTS: bone marrow depression (dec blood count, especially WBC) dec resistance to infection
immunosupresants
originally to prevent organ transplant rejection risk of infection risk of lymphoma
cyclosporine
expensive parenteral anti-tumor necrosis factor (TNF) SIDE EFFECTS: injection/infusion reaction or allergic reaction flu-like symptoms infection -no LIFE VIRUS vaccine cancer later -lymphoma
Biologics
gut selective monoclonal antibody alpha 4 integrin receptor antigonist used when TNF meds are NOT appropriate SIDE EFFECTS: Anaphylaxis risk for injection hepatotoxicity
vedolizumab
less side effects: drowsiness dry outh constipation dysrhythmia with high doses
loperamide
together gives anticholinergic effects such as: dry mouth blurred vision urinary retention
diphenoxylate w atropine
must be signed by 2 RN controlled substance, rarely used SIDE EFFECTS: drowsiness resp depression N& vomiting addiction
tincture of opium
pull water into the colon to make the stool more solid
bulk laxative
control cramping , but NOT diarrhea used to dec intestinal muscle spasms SIDE EFFECTS: Dry mouth blurred vision urinary retention
anticholinergics
inhibit thrombin formation SIDE EFFECTS: bleeding, bruising do not give to pt w incr risk of fall and those going to surgery
anticoagulants