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Drugs Used to Treat Gastrointestinal Conditions

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Title: Slide 1 Author: Thomas Dunn Last modified by: Betty Lampe Created Date: 1/17/2012 7:52:00 PM Document presentation format: On-screen Show (4:3) – PowerPoint PPT presentation

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Title: Drugs Used to Treat Gastrointestinal Conditions


1
27
Drugs Used to Treat Gastrointestinal Conditions
2
Multimedia Directory
  • Slide 4 Digestive System Animation

3
Figure 27-1 The digestive system.
4
Digestive System Animation
Click on the screenshot to view an animation
showing the digestive system. The animation may
take a moment before playing.
Back to Directory
5
Liver
  • Center of metabolic activity in body
  • Detoxifies blood and secretes bile

6
Peptic Ulcers
  • Caused by hyperacidity and excessive pepsin
    activity
  • Alcohol, caffeine, and smoking have been linked
    to peptic ulcers
  • Many cases of gastric ulcers or gastritis are due
    to Helicobacter pylori

7
Table 27-1 Drugs Commonly Used in Peptic Ulcer
Disease
8
Table 27-1 (continued) Drugs Commonly Used in
Peptic Ulcer Disease
9
Table 27-1 (continued) Drugs Commonly Used in
Peptic Ulcer Disease
10
Antacids Uses
  • Alkaline compounds that neutralize hydrochloric
    acid
  • Most common types contain aluminum hydroxide and
    magnesium carbonate.

11
Antacids Adverse Effects
  • Common diarrhea or constipation, anorexia,
    weakness, bone pain, tremors
  • Hypermagnesemia may produce nausea, vomiting,
    confusion, renal calculi, metabolic alkalosis,
    and headache

12
Antacids Contraindications
  • Contraindicated in patients with hypercalcemia,
    hyperparathyroidism, vitamin D-overdosage, and
    decalcifying tumors (depending on type of
    antacid)
  • Cautious use in patients with impaired kidney
    function or dialysis, and in lactation

13
Antacids Patient Information
  • Instruct patients to take antacids 1 to 3 hours
    after meals and at bedtime, and not within 1 to 2
    hours of taking other oral medications.
  • Advise patients to increase fluid intake to
    prevent kidney stones.
  • Patients with cardiovascular disease should avoid
    antacids that are high in sodium.

14
Tums Use by Older Adults
  • Calcium carbonate (Tums) should be used with
    caution in older adults. This is because of their
    likelihood of having the following disorders
  • Renal disease or calculi
  • Ventricular fibrillation
  • Cardiovascular disease

15
H2-receptor Antagonists Uses
  • H2-receptor antagonists reduce secretion of
    gastric acid by blocking H2-receptors
  • Used in short-term treatment of active duodenal
    ulcers and prevention of ulcer recurrence
  • Also used for heartburn

16
H2-receptor Antagonists Adverse Effects
  • Common GI disturbances, headache, drowsiness,
    confusion, agitation, hallucinations, and
    reversible impotence
  • Serious cardiac arrhythmias and cardiac arrest
    after IV bolus dose

17
H2-receptor Antagonists Contraindications
  • The agents are contraindicated in
  • Pregnancy and lactation
  • Children younger than 16 years of age

18
H2-receptor Antagonists Patient Information
  • Warn patients to avoid smoking and drinking
    alcohol.

19
Proton Pump Inhibitors Uses
  • Act by blocking hydrochloric acid production
  • Used to heal stomach and duodenal ulcers and
    relieve symptoms of GERD and esophagitis

20
Proton Pump Inhibitors Adverse Effects
  • Common headache, dizziness, fatigue, diarrhea,
    abdominal pain, nausea
  • Rare hematuria

21
Proton Pump Inhibitors Contraindications
  • Long-term use is contraindicated.
  • Should not be used in children younger than 18
    years

22
Proton Pump Inhibitors Patient Information
  • Advise patients that treatment is for short term
    only (48 weeks).

23
OTC Gastric Medications in Children
  • Omeprazole (Prilosec and Zegerid) has not been
    significantly tested in children.
  • Do not use in children younger than 18.

24
Prostaglandins Uses
  • Affect GI motility and gastric acid secretion
  • Used to prevent complications of gastric ulcers
    that result from NSAID use

25
Prostaglandins Adverse Effects and
Contraindications
  • Common adverse effects are diarrhea and
    menorrhagia (in women)
  • Contraindicated in pregnancy and lactation

26
Prostaglandins Patient Information
  • Advise women to immediately report pregnancy.
  • Advise patients that diarrhea may occur but will
    disappear after the first month of therapy.

27
Table 27-2 Classifications of Antidiarrheal
Drugs
28
Table 27-3 The Most Common Antidiarrheals
29
Opioids Uses
  • Narcotic analgesics act as stimulants on opioid
    receptors in the GI tract to increase mixing
    movements of the gut and decrease peristatic
    movements
  • Used to treat diarrhea

30
Opioids Adverse Effects
  • Constipation
  • Nausea and vomiting
  • Agitation
  • Drowsiness
  • Tachycardia
  • Numbness of hands and feet

31
Opioids Contraindications
  • Contraindicated in intestinal obstruction and in
    children younger than 6 years
  • Not recommended for treatment of chronic diarrhea.

32
Opioids Patient Information
  • Encourage patients to keep a record of bowel
    movements to determine effectiveness or possible
    constipation.
  • Advise patients to drink clear fluids for a few
    days.

33
Opioids in Elderly Patients
  • Monitor opioid use in elderly patients carefully
    because opioids can cause respiratory depression
    and decreased blood pressure in this population.

34
Absorbents
  • Absorb toxins in GI tract that might be causing
    diarrhea
  • Adverse effects constipation
  • Contraindications bowel obstruction, colitis,
    fever, pregnancy, lactation
  • Patient education Instruct patients to report
    diarrhea that is not controlled within 48 hours.

35
Table 27-4 Categories of Laxatives
36
Table 27-4 (continued) Categories of Laxatives
37
Osmotic Laxatives Uses
  • Sodium and magnesium ions attract water into
    bowel causing a more liquid stool.
  • Used for short-term treatment of occasional
    constipation

38
Osmotic Laxatives Adverse Effects
  • Common nausea, vomiting, abdominal cramps,
    diarrhea, weakness, lethargy, electrolyte
    imbalances
  • Serious hypotension, bradycardia, mental
    depression, coma

39
Osmotic Laxatives Contraindications
  • Contraindicated in renal impairment and
    hypertension

40
Osmotic Laxatives Patient Education
  • Instruct patients that 24 to 48 hours are needed
    for effect to occur.
  • Women should not breast feed while taking these
    drugs.

41
Laxative Abuse
  • Evaluate laxative use in patients suspected of
    having bulimia or anorexia.
  • Elderly patients may perceive constipation and
    overuse laxatives. Be alert for volume depletion
    in older adults.

42
Stool Softeners
  • Uses to ease bowel movements in constipated
    patients
  • Adverse effects mild abdominal cramps, diarrhea,
    nausea
  • Contraindications Atonic constipation, abdominal
    pain, intestinal obstruction, heart failure,
    edema, diabetes

43
Stool Softeners
  • Patient education Instruct patients to drink
    lots of fluids and not use these drugs for a long
    period.

44
Laxative Stimulants
  • Uses temporary relief of constipation
  • Adverse effects anorexia, nausea, gripping,
    rebound constipation, melanosis
  • Contraindications abdominal pain, fecal
    impaction, GI bleeding, ulcerations, pregnancy,
    heart failure

45
Laxative Stimulants
  • Patient education Advise patients that prolonged
    use disrupts normal colon function.

46
Bulk-forming Laxatives
  • Work by absorbing free water in intestinal tract
    use in atonic or spastic constipation
  • Adverse effects nausea, vomiting, diarrhea,
    abdominal cramps
  • Contraindications esophageal and intestinal
    obstruction, fecal impaction, children younger
    than 2 years

47
Bulk-forming Laxatives
  • Patient education Advise patients with diabetes
    that these drugs contain sugar.

48
Emetics
  • Use to induce vomiting (emergency)
  • Adverse effects stiff muscles, myopathy,
    convulsions, coma, arrhythmias, fatal myocarditis
  • Contraindications shock, seizures, impaired
    cardiac function, sedation
  • Patient education Advise patients not to use
    before calling poison control center.

49
Table 27-5 The Most Commonly Used Antiemetics
50
Table 27-5 (continued) The Most Commonly Used
Antiemetics
51
Antiemetics
  • Uses to prevent or treat nausea and vomiting
  • Adverse effects drowsiness, dry mouth,
    confusion, hypotension, blurred vision
  • Contraindications coma, CNS depression,
    pregnancy, and lactation
  • Patient education Advise patients to avoid
    driving and alcohol.
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