CABUYADAO, GRAZIELLA BEATRIZ A.

ACTIVITY 12
BSN II-B

ACTIVITY 12. 1. Other agents affecting GI secretions are also available in the market. Make a report on these agents using the table format below.

Drugs Mechanism of Indications Adverse Effects Important Nursing Considerations

affecting GI Action
secretions

sucralfate  Aluminum  Short-term management CNS: dizziness,

(Carafate) salt of of duodenal ulcers drowsiness
sucralfated  Maintenance GI: constipation,
sucrose (preventive) therapy of diarrhea, dry mouth,
reacts with duodenal ulcers gastric discomfort,
gastric acid Unlabeled use: indigestion, nausea
to form a  Managem,ent of gastric Derm: pruritus, rashes
thick paste ulcer or
 Protection of gastroesophageal reflux
ulcers, with  Prevention of gastric
subsequent mucosal injury caused by
healing high-dose aspirin or
other NSAIDs in patients
with rheumatoid
arthritis or in high-stress
situations
CABUYADAO, GRAZIELLA BEATRIZ A. ACTIVITY 12
BSN II-B

misoprostol  Acts as a  Prevention of gastric CNS: headache

(Cytotec) prostaglandi mucosal injury from GI: abdominal pain,
n analogue, NSAIDs including aspirin diarrhea, constipation,
decreasing in high risk patients dyspepsia, flatulence,
gastric acid (geriatric patients, nausea, vomiting
secretion debilitated patients or GU: miscarriage,
and those with history of menstrual disorders
increasing ulcers)
the  With mifepristone for
production termination of
of protective pregnancy
mucus
 Prevention
of gastric
ulceration
from NSAIDs
CABUYADAO, GRAZIELLA BEATRIZ A. ACTIVITY 12
BSN II-B

pancrelipase  Contains  Pancreatic insufficiency EENT: nasal stuffiness

(Pancrease) lipolytic, associated with: chronic Resp: dyspnea, shortness
amylolytic, pancreatitis, of breathing, wheezing
and pancreatectomy, cystic GI: abdominal pain (high
proteolytic fibrosis, GI bypass doses only), diarrhea,
activity surgery, Ductal nausea, stomach cramps,
 Increased obstruction secondary oral irritation
digestion of to tumor GU: hematuria
fats, Derm: hives, rash
carbohydrat Metab: hyperuricemia
es, and Misc: allergic reactions
proteins in
the GI tract
CABUYADAO, GRAZIELLA BEATRIZ A. ACTIVITY 12
BSN II-B

ACTIVITY 12. 2. Other pharmacologic agents are used to affect GIT motility. These are the lubricant
laxatives and antiemetics
GI drug Mechanism of Action Indications Adverse Effects Important Nursing Considerations

Lubricants  works by exerting a  to promote GIT  decreased 1. Assess for conditions that are contraindications or
detergent action on emptying in absorption of cautions in the use of the drugs (pregnancy, acute
the surface of the preparation for fats including abdominal disorders, heart disease)
intestinal bolus surgery or fat-soluble 2. Chemical stimulants have an onset of action from 2
making the stools diagnostic vitamins to 8 hours; therefore, they are preferred if patient
softer (docusate), by procedures  constipation wants drugs to work overnight and experience results
forming a slippery  to prevent secondary to in the morning.
coat on the intestinal straining after GIT 3. Separate administration of laxatives with other
bolus (mineral oil), surgery, MI, exhaustion prescribed agents by at least 30 minutes.
or by exerting a obstetric delivery  fluid and 4. Emphasize the need to take bulk laxatives with
hyperosmolar pull  short-term electrolyte plenty of water.
(glycerin). treatment of imbalance 5. Advise patient that possible effects of laxative may
 these agents are not constipation  GI effects be slow and steady or may cause severe cramping and
absorbed  as management (abdominal rapid evacuation of bowel; hence, patient needs to
systemically of GI poisoning cramping, maintain ready access to bathroom.
(Mg sulfate) diarrhea, 6. Watch out for possible drug interactions especially
nausea) when the patient is also taking nondepolarizing
 CNS effects neuromuscular blockers – increases risk of
(dizziness, neuromuscular blockade when take with magnesium
headache, salts
and 7. Warn patient about the chronic use of laxatives. 8.
weakness) Discuss appropriate dietary measures, fluid intake,
 Palpitations activities, and environmental controls to facilitate
 flushing normal bowel function.
 Sweating
 Cathartic
dependence
CABUYADAO, GRAZIELLA BEATRIZ A. ACTIVITY 12
BSN II-B

Antiemetics - Used in the  Serotonin and  Drowsiness A. Non-prescription Antiemetics

management of neurokinin  Dry mouth Antihistamines/Anticholinergic
nausea and antagonists, such Arrhythmia 1. Adverse effects are secondary to
vomiting caused as ondasetron  Headache anticholinergic effects:
by a variety of and aprepitant,  Anorexia 2. For treatment of vestibular problems and
conditions are highly  Blurred motion sickness – take 30 minutes – 1 hour
- Reduces effective in vision before travel
hyperactivity of treating 3. Check patient’s conditions in which use of
vomiting reflex chemotherapy- medication may be contraindicated
by: induced nausea B. Prescription Antiemetics
a. Locally and vomiting Antihistamines/Anticholinergic
decreasing  Metoclopramide 1. Given for post-op nausea, vomiting and
the stimuli and vertigo
sent to the antihistamines 2. Given 1 patch behind ear at least 4 hour
medulla, or are first-line before antiemetic’s effect
b. Centrally options for 3. Do not use more than 1 patch at a time and
blocking the nausea and alternate ears if to be used longer than 3 days.
CTZ or vomiting in Cannabinoids – approved for use to CA patients who
suppressing pregnancy do not respond or unable to take other antiemetics
the vomiting 1. Given 1-3 hours before and 24 hours after
center chemotherapy
2. Educate client on possible adverse effects:
CNS: mood changes,
confusion, headache
Orthostatic
hypotension/hypertension
Tachycardia

Activated  Physical adsorption  Alleviates gas  Slowing or  for poisoning or drug overdose: it is given at
charcoal of medicines and and bloating blockage of doses 50-100g initially. Followed by doses
toxic agents onto its  Treats alcohol intestinal every 2-4 hours
surface poisoning and tract  doses for children: round 10-25g
CABUYADAO, GRAZIELLA BEATRIZ A. ACTIVITY 12
BSN II-B

helps prevent  Regurgitation  for preventing or reducing intestinal gas: 500-

hangovers into the 1000mg per day
 Mitigates areas lungs  to lower cholesterol level: 4-32g per day
of mold growth  Intestinal  Syrup of ipecac interacts with activated
 Used with bleeding charcoal. Activated charcoal can bind up syrup
emergency toxin  Chronic of ipecac in the stomach. This decreases the
removal dehydration effectiveness of the syrup of ipecac.
 Alcohol interacts with activated charcoal.
Activated charcoal is sometimes used to
prevent poisons from being absorbed into the
body. Taking alcohol with activated charcoal
might decrease how well activated charcoal
works to prevent poison absorption.
 Medications taken by mouth interacts with
activated charcoal. Activated charcoal absorbs
substances in the stomach and intestines.
Taking activated charcoal along with oral
medications can decrease how much medicine
your body absorbs, and decrease the
effectiveness of your medication. To prevent
this interaction, take activated charcoal at least
one hour after oral medications are raken.