Gastrointestinal Medications Lecture

Introduction

• Presenter: Cathy from Level Up RN
• Topic: Gastrointestinal medications, focusing on anti-ulcer agents
• Reference: Pharmacology second edition flashcards (green section)
• Includes a quiz at the end

Histamine-2 Receptor Antagonists

• Medications: Ranitidine, Famotidine
• Uses: GERD, duodenal and gastric ulcers, Zollinger-Ellison syndrome
• Mode of Action: Blocks H2 receptors in the stomach to reduce gastric acid secretion
• Side Effects: Minimal, may include headache and GI upset
• Mnemonic: Medications end in "-dine" (D-I-N-E), which helps your stomach feel better when you dine (eat)

Proton Pump Inhibitors (PPIs)

• Medications: Omeprazole, Pantoprazole
• Uses: GERD, ulcers, Zollinger-Ellison syndrome
• Mode of Action: Inhibits enzyme required for gastric acid secretion, leading to decreased gastric acid
• Side Effects: GI upset, C. diff, long-term use can cause bone fractures
• Nursing Care: Monitor for diarrhea, cramping, bloody stools
• Mnemonic: "PRAZ" in the middle of the name (e.g., oma-praise-all)

Sucralfate

• Type: Mucosal protectant
• Uses: Duodenal ulcers
• Mode of Action: Reacts with stomach acid to form a thick paste that adheres to ulcers
• Side Effects: Constipation
• Administration: One hour before meals and at bedtime (4 times a day)
• Patient Education: Increase fiber and fluid intake
• Mnemonic: Sucralfate gets sucked (S-U-C) down into ulcers

Antacids

• Example: Aluminum hydroxide
• Uses: Peptic ulcer disease, GERD
• Mode of Action: Neutralizes stomach acid
• Side Effects: Constipation
• Administration: After meals and at bedtime (not at the same time as other medications)
• Mnemonic: A for Antacids, A for After meals

Misoprostol

• Type: Prostaglandin
• Uses: Prevents gastric ulcers in patients taking NSAIDs, induces labor by ripening the cervix
• Mode of Action: Decreases stomach acid secretion, increases protective mucus and bicarbonate, causes uterine contractions
• Side Effects: Dysmenorrhea, GI upset
• Black Box Warning: Can cause miscarriage, premature birth, birth defects
• Nursing Care: Perform pregnancy test for females of childbearing age before administration
• Mnemonic: "Miso" soup is okay when pregnant, but "misoprostol" is not

Quiz Questions

1. When should sucralfate be taken?
   • Answer: One hour before meals and at bedtime
2. Should aluminum hydroxide be administered at the same time as other medications?
   • Answer: False (should be given 1-2 hours before or after other medications)
3. What nursing assessment is required before administering misoprostol?
   • Answer: Pregnancy test for women of childbearing age

Conclusion

• Encouragement to subscribe, share, and comment
• Invitation to leave additional mnemonic suggestions