Drug name
Generic name; cimetidine
Brand name: Tagamet
Dosage: 300mg/5mL
Frequency: twice a day, with
breakfast and at bedtime. For
patients with duodenal or
benign gastric ulceration, a
single daily dose of 800mg at
bedtime is recommended.
Route: Per Orem
Mode of Action
Drug classification: Anti-ulcer
agents H2 antagonist It works by
reducing the amount of acid in
your stomach.
Therapeutic Action: Competitive
antagonist at the H2 receptor.
Blocks H2 receptors in parietal
cells which suppresses basal and
meal-stimulated acid secretion
in a dose-dependent manner.
Drug Effects Nursing Responsibilities
Side effects:  Monitor pulse of patient
 headache during first few days of
 diarrhea drug regimen.
 dizziness Bradycardia after PO as
 drowsiness well as IV administration
 breast enlargement should be reported
Adverse effect:  Monitor I&O ratio and
 confusion pattern: Particularly in
 excitement the older adult, severely
 depression ill, and in patients with
 nervousness impaired renal function
 seeing things or hearing  Check BP and report an
voices that do not exist elevation to the
(hallucinating) physician, if patient
complains of severe
headache
 Seek advice about self-
medication with any OTC
drug.
 Report breast tenderness
or enlargement.
 Report recurrence of
gastric pain or bleeding
 Avoid driving and other
potentially hazardous
activities until reaction to
drug is known.
 Maintenance therapy at
reduced dosage after
healing of active
duodenal ulcer appears
 to limit recurrence,
particularly if patient
undertakes other
antiulcer therapeutic
measures: no smoking,
life-style that promotes
reduced stress.

Drug name Mode of action Drug Effects Nursing Responsibilities

Generic name: sodium Drug classification: Anti-ulcer Side effects:  Assess the client’s fluid
bicarbonate agents Antacid  Gas (with tablet form) balance throughout the
 Bloating (with tablet therapy. This assessment
form) includes intake and
output, daily weight,
Therapeutic Action: reduces edema and lung sounds.
stomach acid. It is used as an Adverse effects:  Symptoms of fluid
Brand name; Bakin Soda, Bell- antacid to treat heartburn,  Increased level of body overload should be
Ans, Citrocarbonate, Neut, Soda indigestion, and upset stomach. pH (metabolic alkalosis) reported such as
Mint Sodium bicarbonate is a very  Worsening congestive hypertension, edema,
quick-acting antacid. It should be heart failure difficulty breathing or
used only for temporary relief.  Seizures dyspnea, rales or crackles
 Severe muscle spasms and frothy sputum.
and contractions  Sigs of acidosis should be
(tetany) assessed such as
Dosage: 325 mg  Swelling in feet, ankles, disorientation, headache,
and lower legs weakness, dyspnea and
 High levels of sodium in hyperventilation.
the blood  Assess for alkalosis by
monitoring the client for
confusion, irritability,
Frequency: 2 grams one to four paresthesia, tetany and
times a day. altered breathing
pattern.
 Hypernatremia clinical
manifestations should be
assessed and monitored
which includes: edema,
weight gain,
hypertension,
Route: Per orem tachycardia, fever,
flushed skin and mental
irritability.
 Hypokalemia should also
 be assessed by
monitoring signs and
symptoms such as:
weakness, fatigue, U
wave on ECG,
arrhythmias, polyuria and
polydipsia.
 IV sites should be
observed closely.
Extravasation should be
avoided as tissue
irritation or cellulitis may
occur when taking
sodium bicarbonate.
 If infiltration occurs, the
physician should be
notified immediately.
Confer with the doctor or
other health care staff
regarding warm
compresses and
infiltration site with
lidocaine or
hyaluronidase.
 Monitor the client’s
serum calcium, sodium,
potassium, bicarbonate
concentrations, serum
osmolarity, acid-base
balance and renal
function before and
throughout the therapy.
 Tablets must be taken
with a full glass of water.
  For clients taking the
medication as a
treatment for peptic
ulcers it may be
administered 1 and 3
hours after meals and at
bedtime.

Drug Name Mode of action Drug effects Nursing responsibilities

Generic name: omeprazole Drug classification: Anti-ulcer
agents Belongs to the class of
proton pump inhibitors. Used in
the treatment of peptic ulcer
and gastro-esophageal reflux
Brand name: disease (GERD).
Dosage: 20 mg or 40 mg Therapeutic action: is a
substituted Benz imidazole
gastric ant secretory agent and is
also known as proton pump
inhibitor (PPI). It blocks the final
step in gastric acid secretion by
specific inhibition of adenosine
Frequency: OD triphosphates (ATPase) enzyme
system present on the secretory
surface of the gastric parietal
cell. Both basal and stimulated
acid are inhibited.
Route: PO
Adverse effects/Side effects  Assess patient routinely
 Significant: for epigastric or
Hypomagnasaemia, abdominal pain and frank
cutaneous lupus or occult blood in the
erythematosus, SLE, stool, emesis, or gastric
osteoporosis-related aspirate.
fractures, fundic gland  Assess dizziness that
polyp, carcinoma, might affect gait,
Clostridium difficile- balance, and other
associated diarrhea, functional activities
interstitial nephritis,  Monitor bowel function.
Vitamin B12 deficiency Diarrhea, abdominal
(long-term therapy), cramping, fever, and
gastrointestinal infection bloody stools should be
(e.g. salmonella, reported to health care
Campylobacter). professional promptly as
 Gastrointestinal a sign of
disorders: Nausea, pseudomembranous
vomiting, diarrhea, colitis.
constipation, flatulence,  Monitor any chest pain
abdominal pain. and attempt to
 General disorders and determine if pain is drug
administration site induced or caused by
conditions: Weakness, cardiovascular
malaise. dysfunction (e.g., angina
 Hepatobiliary disorders: that occurs during
Increased liver enzymes. exercise
 Immune system  Monitor INR and
disorders: Urticaria. prothrombin time in
 Metabolism and patients taking warfarin
nutrition disorders:  Report balance problems
Peripheral edema. and functional limitations
 Musculoskeletal and to the physician, and
connective tissue caution the patient and
 disorders: Back pain. family/caregivers to
 Nervous system guard against falls and
disorders: Headache, trauma.
dizziness, somnolence,  Advise patient to avoid
paraesthesia, vertigo. alcohol, products
 Psychiatric disorders: containing aspirin or
Insomnia. NSAIDs, and foods that
 Respiratory, thoracic and may cause an increase in
mediastinal disorders: GI irritation.
Cough. Skin and  Advise patient to report
subcutaneous tissue onset of black, tarry
disorders: Rash, stools; diarrhea;
dermatitis, pruritus. abdominal pain; or
persistent headache to
health care professional
promptly
 Instruct patient to take
medication as directed
for the full course of
therapy, even if
feeling better
 Instruct patient to notify
health care professional
of all Rx or OTC
medications, vitamins, or
herbal products being
taken and consult health
care professional before
taking any new
medications.
 Drug name
Generic Name: sucralfate
Brand Name: Carafate
Dosage; 1g
Frequency; 1 g PO q6hr initially;
maintenance: 1 g PO q12hr
Take on empty stomach 1 hour
before or 2 hours after meals
Route: PO
Mode of Action
Drug classification: Anti-ulcer
agent’s miscellaneous GI agents
Sucralfate systemic is used to
treat duodenal and stomach
ulcers and to prevent duodenal
ulcers.
Therapeutic Action: is a complex
of aluminum hydroxide and
sucrose octasulfate. It
dissociates in the acid
environment of the stomach to
its anionic form, which binds to
the ulcer base. This creates a
protective barrier to pepsin and
bile and inhibits the diffusion of
gastric acid.
Drug effects Nursing Responsibilities
Side effects:  Give drug on an empty
 difficulty in swallowing stomach, 1 hr before or 2
 dry mouth hr after meals and at
 feeling of fullness bedtime.
 flushed, dry skin  Monitor pain; use
 fruit-like breath odor antacids to relieve pain.
 hoarseness  Administer antacids
 increased hunger between doses of
 increased sweating sucralfate, not within 30
 increased thirst min before or after
 increased urination sucralfate doses.
 loss of appetite  Measure and record
 nausea regular weight to
 pale skin monitor mobilization of
 slow or irregular edema fluid.
breathing  Avoid giving food rich in
 stomach pain potassium.
 sweating  Arrange for regular
evaluation of serum
 swelling of the face,
electrolytes, BUN.
mouth, lips, or throat
 swelling of the legs and  Take the drug on an
empty stomach, 1 hour
ankles
before or 2 hours after
 tightness in the chest
 troubled breathing meals and at bedtime.
 If you are also taking
 unexplained weight loss
antacids for pain relief,
 unusual tiredness or
weakness do not take antacids 30
 vomiting minutes before or after
taking sucralfate.
Adverse effects:  You may experience
 Back ache these side effects:
Dizziness, vertigo (avoid
  bloated
 constipation
 diarrhea
 dizziness or
lightheadedness
 excess air or gas in the
stomach or intestines
 feeling of constant
movement of self or
surroundings
 headache
 hives, itching, skin rash
 indigestion
 passing gas
 sensation of spinning
 sleepiness
 stomach cramps
 trouble sleeping
driving or operating
dangerous machinery);
indigestion, nausea (eat
frequent small meals);
dry mouth (use frequent
mouth care, suck on
sugarless lozenges);
constipation (request
aid).
 Report severe gastric
pain.

Drug name Mode of action Drug effects Nursing responsibilities

Generic Name: lubiprostone Drug classification: Anti-
spasmodic Agents IBS Agents;
Laxatives. It works by increasing
the amount of fluid within your
intestines, making the passage
of stool easier.
Brand Name: Amitiza
Therapeutic action: is a bicyclic
fatty acid metabolite analogue
Dosage: 8mcg to of prostaglandin E1. It activates
24mcg specific chloride channels in the
gastrointestinal tract to
stimulate intestinal fluid
secretion, increase
gastrointestinal transit, and
improve symptoms of
Frequency: BID constipation.
Route: Per Orem
Side effects:  Assess for abdominal
 nausea, distention, presence of
 stomach pain, bowel sounds, and usual
 diarrhea, bowel patterns prior to
 gas, and periodically during
 bloating, therapy.
 vomiting,  Assess color, consistency,
 dry mouth, and amount of stool
 runny nose, produced.
 cough,  Administer with food and
 fever, water to decrease
 headache, nausea. Swallow capsules
 dizziness, whole;
 joint/back pain, or  do not crush, break or
 trouble sleeping. chew.
Adverse effects:  Do not administer to
 severe diarrhea, patients severe diarrhea.
 swelling of arms or legs,  Instruct patient to take
lubiprostone as directed.
and
 mental/mood changes  Inform patient that
dyspnea may occur
within 1 hr of first dose;
usually resolves within 3
hrs, but may return with
repeat doses.
 Advise patients that
lubiprostone may cause
diarrhea. Advise patient
to notify health care
professional if diarrhea
becomes severe.
 May cause dizziness.
Caution patient to avoid
driving or other activities
 requiring alertness until
response to medication is
known.
 Advise female patients
that a negative
pregnancy test should be
determined prior to
taking lubiprostone and
to use effective
contraception during
therapy

Drug name Mode of Action Drug effects Nursing Responsibilities

Generic name: hyoscyamine
Brand name: Anaspaz,
Cystospaz, Donnamar, Levsin
Dosage: 0.125 mg
Frequency: 1 to 2 tablets orally 3
to 4 times a day
May increase to every 4 hours,
as needed
Route: Per Orem
Drug classification: Anti-
spasmodic Agents also lessens
the amount of certain body
fluids (e.g., saliva, sweat). This
medication belongs to a class of
drugs known as
anticholinergics/antispasmodics.
Therapeutic action: is an ant
muscarinic; i.e., an antagonist of
muscarinic acetylcholine
receptors. It blocks the action of
acetylcholine at
parasympathetic sites in sweat
glands, salivary glands, stomach
secretions, heart muscle,
sinoatrial node, smooth muscle
in the gastrointestinal tract, and
the central nervous system.
Side effects:  Monitor bowel
 drowsiness elimination; may cause
 dizziness or constipation.
lightheadedness  Monitor urinary output.
 headache  Lessen risk of urinary
 blurred vision retention by having
 flushing (feeling of patient void prior to each
warmth) dose.
 dry mouth  Assess for dry mouth and
 constipation recommend good
 difficulty urinating practices of oral hygiene.
 increased sensitivity to  Report any rhythm
light disturbances or
symptoms of increased
Adverse effects: arrhythmias, including
 diarrhea palpitations, chest pain,
 skin rash shortness of breath,
 eye pain fainting, and
 fast or irregular fatigue/weakness.
heartbeat  Be alert for decreased
sweating and
altered/increased body
temperature
(hyperpyrexia). Notify
physician of a prolonged
or persistent elevation in
body temperature.
 Be alert for signs of
allergic reactions and
anaphylaxis, including
pulmonary symptoms
(tightness in the throat
and chest, wheezing,
cough, dyspnea) or skin
 reactions (rash, pruritus,
urticaria)
 Notify physician
immediately if these
reactions occur.
 Avoid excessive exposure
to high temperatures;
drug-induced heatstroke
can develop.
 Do not drive or engage in
other potentially
hazardous activities until
response to drug is
known.
 Use dark glasses if
experiencing blurred
vision, but if this adverse
effect persists, notify
physician for dose
adjustment or possible
drug change.

Drug name Mode of Action Drug effects Nursing Responsibilities

Generic name: bisacodyl
Brand name: Dulcolax,
Correctol, BisacEvac, Bisacolax,
Codulax, Alophen, Feen A Mint,
Fleet Stimulant Laxative, Laxit,
Modane, Dulcolax for Women
Dosage: 5 to 15mg
Frequency: OD
Route: Per Orem
Drug classification: Laxatives,
Stimulant
Therapeutic Action: is used to
treat constipation. It may also
be used to clean out the
intestines before a bowel
examination/surgery. Bisacodyl
is known as a stimulant laxative.
It works by increasing the
movement of the intestines,
helping the stool to come out.
Side effects:
 Abdominal cramping
 Electrolyte and fluid
imbalance
 Excessive diarrhea
 Nausea
 Rectal burning
 Spinning sensation
(vertigo)
 Stomach/abdominal pain
 Vomiting
 Weakness
Adverse reaction:
 Persistent
nausea/vomiting/diarrhea
 Muscle cramps/weakness
 Irregular heartbeat
 Dizziness
 Fainting
 Decreased urination
 Mental/mood changes
(such as confusion)
 Monitor patients
receiving concomitant
anticoagulants.
Indiscriminate use of
laxatives results in
decreased absorption of
vitamin K.
 Assess patient for
abdominal distention,
presence of bowel
sounds, and usual
pattern of bowel
function.
 Assess color,
consistency, and amount
of stool produced.
 May be administered at
bedtime for morning
results.
 Taking on an empty
stomach will produce
more rapid results
 Do not crush or chew
enteric-coated tablets.
Take with a full glass of
water or juice
 Do not administer oral
doses within 1 hr of milk
or antacids; this may
lead to premature
dissolution of tablet and
gastric or duodenal
irritation.
 Advise patients, other
 than those with spinal
cord injuries, that
laxatives should be
 used only for short-term
therapy. Prolonged
therapy may cause
electrolyte imbalance
and dependence.
 Advise patient to
increase fluid intake to at
least 1500– 2000 mL/day
during therapy to
prevent dehydration.
 Encourage patients to
use other forms of bowel
regulation (increasing
bulk in the diet,
increasing fluid intake, or
increasing mobility).
Normal bowel habits
may vary from 3
times/day to 3 times/wk.
 Instruct patients with
cardiac disease to avoid
straining during bowel
movements (Valsalva
maneuver).
 Drug Name
Generic name: cascara
Brand name: Caroid Laxative
Dosage: 20 to 30 mg
Frequency: taken in a dose of 2-
5 mL three times daily.
Route: Per Orem
Mode of Action
Drug Classification:  is a type of
laxative called a stimulant
laxative. Stimulant laxatives can
decrease potassium levels in the
body.
Therapeutic Action: More
specifically, anthraglycosides
produce an active secretion of
water and electrolytes within
the lumen of the small intestine
and inhibit their absorption from
the large intestine, causing an
increase in bowel content
volume and strengthening of
intestinal dilatation pressure to
stimulate peristalsis.
Drug effects
Side effects:
 Severe nausea
 Loss of energy
 Headaches
 Muscle weakness,
spasms, or cramps
 Irregular heartbeat
(arrhythmia)
 Skipped heartbeats
(palpitations)
 Rapid heartbeat
(tachycardia)
 Numbness or tingling of
the hands or feet
(neuropathy)
 Reduced urine output
 Confusion
 Depression
 Return of constipation
(rebound constipation)
Adverse effects:
 Signs of a very bad
reaction. These include
wheezing; chest
tightness; fever; itching;
bad cough; blue skin
color; seizures; or
swelling of face, lips,
tongue, or throat.
 Signs of fluid loss. These
Nursing responsibilities
 Monitor electrolyte
balance if significant
diarrhea occurs,
especially with frail older
adults.
 Monitor restoration of
normal bowel function
 Reduce dose in patients
who experience
considerable abdominal
cramping.
 Be aware that drug may
alter urine and feces
color; yellowish brown
(acid), reddish brown
(alkaline).
 Continued use may lead
to dependence. Consult
physician if constipation
persists.
 A single dose taken
before retiring usually
results in evacuation of
soft stool 6–12 h later.
 Frequent or prolonged
use of irritant cathartics
disrupts normal reflex
activity of colon and
rectum and can lead to
drug dependence for
evacuation
 include dark-colored  Advise patient to
urine or no urine for increase fluid intake to at
more than 8 hours, dry least 1500– 2000 mL/day
mouth, cracked lips, dry during therapy to
skin, sunken eyes, lack of prevent dehydration.
energy, feeling faint, or  Encourage patients to
passing out. use other forms of bowel
regulation (increasing
 Signs of low potassium. bulk in the diet,
These include feeling increasing fluid intake, or
tired, weak, numbness, increasing mobility).
or tingling; muscle Normal bowel habits may
cramps; hard stools; vary from 3 times/day to
throwing up; or fast 3 times/wk.
heartbeat.  Instruct patients with
cardiac disease to avoid
 Very bad throwing up straining during bowel
movements.
 Very bad belly pain

 Very bad loose stools

Drug Name Mode of Action Drug effects Nursing responsibilities

Generic name: bismuth
subsalicylate
Brand name; Pepto-Bismol,
Kaopectate, Pepto-Bismol
Maximum Strength, Stomach
Relief
Dosage: 524 mg
Frequency: orally every 30 to 60
minutes as needed not to
exceed 8 doses in any 24-hour
period.
Route: Per Orem
Drug classification: Anti-
diarrheal is used to treat
diarrhea, heartburn, and upset
stomach in adults and children
12 years of age and older.
Bismuth subsalicylate is in a
class of medications called
antidiarrheal agents.
Therapeutic Action: Like
sucralfate, bismuth coats ulcers
and erosions, creating a
protective layer against acid and
pepsin. It may also stimulate
prostaglandin, mucus &
bicarbonate secretion.
Adverse reaction:
Side effects:  Monitor bowel function;
 abdominal pain note that stools may
 anal discomfort darken and tongue may
 anxiety appear black. These are
 black or 'hairy' tongue temporary effects and
 clay-colored or gray- will disappear without
black stools treatment.
 cold symptoms (stuffy  Assess the frequency and
nose, sneezing, sore consistency of stools,
throat) presence of nausea and
 confusion indigestion, and bowel
 constipation (may be sounds before and during
chronic) therapy.
 dark urine  Assess fluid and
 depression electrolyte balance and
 diarrhea (may be severe, skin turgor for
watery, or bloody) dehydration if diarrhea is
 dizziness Prolonged
 sores in stomach lining  Assess for epigastric or
 indigestion abdominal pain and frank
or occult blood in the
stool, emesis, or gastric
 gas (flatulence) aspirate
 gastrointestinal bleeding  Shake liquid before using.
Chewable tablets may be
 headache (may be
chewed or allowed to
severe)
dissolve before
 difficulty falling asleep
(insomnia) swallowing
 itching  Advise patient to consult
 loss of appetite health care professional
 dark sticky feces before taking other OTC
 lightheadedness  ulcer remedies
concurrently with
 metallic taste in your
bismuth subsalicylate.
mouth
  mild diarrhea  Instruct patient to take
 mouth pain medication exactly as
 muscle spasm directed.
 nausea  Inform patient that
 damage to the brain or medication may
nervous system temporarily cause stools
 pain and tongue to appear
 pain behind your eyes gray-black.
 pale skin  Instruct patient that this
 numbness and tingling medication contains
 rapid heart rate aspirin. Advise patient
taking concurrent aspirin
products to discontinue
bismuth subsalicylate if
tinnitus, ringing in
the ears, occurs
 Instruct patient to notify
health care professional
if diarrhea persists
for more than 2 days or if
accompanied by a high
fever

Drug name Mode of action Drug effects Nursing Responsibilities

Generic name: loperamide
Brand name: Imodium,
Dosage: 16mg per day
Frequency: The usual dose is 4
mg (2 tablets) after the first
loose bowel movement, and 2
mg (1 tablet) after each loose
bowel movement after the first
dose has been taken. No more
than 8 mg (4 tablets) should be
taken in any twenty-four-hour
period.
Route: Per Orem
Drug classification: antidiarrheal
agents It works by decreasing
the flow of fluids and
electrolytes into the bowel and
by slowing down the movement
of the bowel to decrease the
number of bowel movements.
Adverse effects:
Therapeutic action: acts by
slowing intestinal motility and
by affecting water and
electrolyte movement through
the bowel. Loperamide binds to
the opiate receptor in the gut
wall
Side effects:  Monitor therapeutic
 Dizziness effectiveness. Chronic
 Drowsiness diarrhea usually responds
 Dry mouth within 10 d. If
 Vomiting improvement does not
 Constipation occur within this time, it
 Fatigue is unlikely that symptoms
 Stomach pain, will be controlled by
discomfort, or further administration.
enlargement  Discontinue if there is no
improvement after 48 h
 Skin rash of therapy for acute
 Itching diarrhea.
 Hives  Monitor fluid and
 Wheezing electrolyte balance.
 Difficulty breathing  Notify physician promptly
if the patient with
ulcerative colitis develops
abdominal distention or
other GI symptoms
(possible signs of
potentially fatal toxic
megacolon).
 Assess frequency and
consistency of stools and
bowel sounds prior to
and during therapy.
 Assess fluid and
electrolyte balance and
skin turgor for
dehydration
 Administer with clear
fluids to help prevent
dehydration, which may
 accompany diarrhea
 Advise patient not to
exceed the maximum
number of doses
 Advise patient that
frequent mouth rinses,
good oral hygiene, and
sugarless gum or candy
may relieve dry mouth.
 Caution patient to avoid
using alcohol and other
CNS depressants
concurrently with this
medication
 Instruct patient to take
medication as directed.
Do not take missed
doses, and do not double
doses. In acute diarrhea,
medication may be
ordered after each
unformed stool.
 Instruct patient to notify
health care professional
if diarrhea persists or if
fever, abdominal pain, or
distention occurs.