Drugs Used to Treat Gastrointestinal Diseases

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Histamine2-Receptor Antagonists cimetidine (Tagamet) nizatidine (Axid) “tidine”
• H2 antagonist- block the action of histamine on parietal cells in the stomach = decrease acid production • Indications: Peptic Ulcer Diseas (PUD), gastroesophageal reflux disease (GERD) • Use decreased r/t Proton Pump Inhibitors (PPIs) use (PPIs more effective)
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• Reduces metabolism of drugs r/t decreased acid production • Increases serum concentrations i.e. – warfarin (Coumadin) – phenytoin (Dilantin) – Cardiac medications i.e. Calcium Channel blockers; Beta blockers

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Proton Pump Inhibitors
omeprazole (Prilosec) pantoprazole( Protonix)

“azole”
• Used for long-lasting reduction of gastric acid production • Most potent / most effective – Short half-life / short-term therapy • Given PO or IV • Adverse effects Most common H/A; Nausea; Diarrhea
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sucralfate (Carafate)
• Locally acting in an acidic environment (pH < 4), reacts with HCL to form a acid buffer • Protective barrier up to 6 hours to 8 hours after a single dose • Uses – Acute ulcers – preferred agent for stress ulcer prophylaxis • Adverse effects – Constipation
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Nursing Implications
• Assess reports of GI complaints • Administration guidelines
– H2RAs: oral: take with or w/o meals IV: must be diluted with 0.9% saline – PPIs: oral: take one hr before meals
IV: must be diluted with 0.9% saline and use an “in-line filter”

• Monitor therapeutic effects

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Antiemetics
Drugs used to prevent or treat N/V induced by drugs, radiation, surgery, and most other stimuli

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Benzodiazepine Antianxiety Drugs • Used in multidrug regimens to prevent N/V r/t cancer chemotherapy • Relax and inhibit cerebral input to vomiting center • Lorazepam (Ativan) commonly used
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5-Hydroxytryptamine3 Receptor Antagonists
• Ondansetron (Zofran), granisetron (Kytril), and dolasetron (Anzemet) • Used to prevent or treat moderate to severe N/V r/t cancer chemotherapy, radiation, and postoperatively • Antagonize receptors and prevent activation by emetogenic anticancer drugs
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Miscellaneous Antiemetics
• metoclopramide (Reglan)
– Agent that increases GI motility and rate of gastric emptying

• phosphorated carbohydrate solution (Emetrol)
– Reduces smooth muscle contraction in GI tract (OTC)

• Scopolamine is an anticholinergic drug
– Active in relieving motion sickness; – available as transdermal patch

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