Pharm N211 Final Exam with ATI Questions. 43, 42, 30, 29,34, 33, 32, 19,18
Chapter 32- Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Disease
GERD: Causes: Heartburn, Acid reflux, Esophageal irritation
Peptic Ulcer Disease (PUD): Open sores in the stomach or duodenum
Common causes: Helicobacter pylori infection, NSAID use, Excess stomach acid
Treatment goal: Reduce stomach acid and protect the stomach lining.
There are 4 major drug groups used to treat GERD and ulcers: Antacids, H₂ receptor blockers,
Proton pump inhibitors (PPIs), Mucosal protectants
These medications either neutralize acid, reduce acid production, or protect the stomach lining.
1. Antacids - Ex: Aluminum hydroxide, Magnesium hydroxide, Calcium carbonate (Tums)
Mechanism of Action: Antacids neutralize stomach acid directly.
Uses: Mild GERD, Heartburn, Indigestion
Side Effects: Aluminum – Constipation, Magnesium- Diarrhea, Calcium - Kidney stones,
Hypercalcemia. Nursing Teaching: Take 1–3 hours after meals, May interfere with absorption of
other medications
2. H₂ Receptor Blockers (Histamine-2 Antagonists): Examples- Famotidine (Pepcid),
Cimetidine, Nizatidine
Mechanism of Action: block histamine (H₂) receptors on parietal cells, which reduces stomach
acid production. Uses: GERD, Gastric ulcers, Duodenal ulcers, Hypersecretory conditions
Side Effects: Headache, Dizziness, Constipation or diarrhea
Important ATI Point: Cimetidine: Can cause gynecomastia, Many drug interactions
3. Proton Pump Inhibitors (PPIs)- Examples: Omeprazole, Pantoprazole, Lansoprazole,
Esomeprazole
Mechanism of Action: PPIs block the proton pump in the stomach, which stops acid secretion
almost completely.
Uses: GERD, Peptic ulcers, Zollinger-Ellison syndrome, H. pylori treatment
Side Effects- (Short term): Headache, Nausea, Diarrhea. (Long term): Vitamin B12 deficiency,
Osteoporosis, Hypomagnesemia, C. diff infection
Nursing Teaching: Take before meals, Do not crush delayed-release capsules.
4. Mucosal Protectants: protect the stomach lining instead of reducing acid. Ex. Sucralfate
(Carafate)
Mechanism of Action: Forms a protective barrier over ulcers, Protects from acid, pepsin, and
bile. Uses: Peptic ulcer disease, Stress ulcer prevention. Side Effects: Constipation
Nursing Teaching: Take on an empty stomach, Do not give with antacids within 30 minutes
,5. Drugs for H. pylori Infection: When ulcers are caused by H. pylori, treatment includes: Triple
Therapy (PPI, Clarithromycin, Amoxicillin or Metronidazole)
Purpose: Kill bacteria, Reduce acid, Allow ulcer healing
Drug Class Example Action Key Side Effect
Antacids Calcium carbonate Neutralizes acid Constipation/diarrhea
Decrease acid
H₂ blockers Famotidine Headache
secretion
PPIs Omeprazole Block proton pump B12 deficiency
Mucosal protectant Sucralfate Protects ulcer Constipation
High-Yield Nursing Exam Points
- PPIs are most effective acid reducers
- Antacids work fastest but shortest duration
- Sucralfate coats ulcers
- H₂ blockers block histamine on parietal cells
Chapter 33 - Drugs Used to Treat Nausea and Vomiting (Antiemetics)
Vomiting is controlled by the vomiting center in the brain. It can be triggered by: Motion
sickness, Chemotherapy, Medications, Gastroenteritis, Pregnancy, Post-operative anesthesia
Treatment goal: block the signals that trigger vomiting. Major Antiemetic Drug Classes:
Serotonin (5-HT₃) antagonists, Dopamine antagonists, Antihistamines, Anticholinergics,
Cannabinoids. Each works on different receptors in the brain or GI tract.
1. Serotonin (5-HT₃) Antagonists- Examples: Ondansetron (Zofran), Granisetron, Dolasetron
Mechanism: Block serotonin receptors, Prevent stimulation of the vomiting center
Uses: Chemotherapy-induced nausea, Post-operative nausea
Side Effects: Headache, Constipation, QT prolongation
Nursing Points: Commonly used for chemo patients, Monitor for heart rhythm issues
2. Dopamine Antagonists- Examples: Metoclopramide (Reglan), Prochlorperazine,
Promethazine. Mechanism of Action: Block dopamine receptors in the brain
Uses: Severe nausea, Postoperative nausea, Migraine-associated nausea
Side Effects: Sedation, Extrapyramidal symptoms (EPS) (Tremor, Muscle rigidity, Restlessness)
Nursing Points: Watch for EPS reactions.
3. Antihistamines- Examples: Dimenhydrinate (Dramamine), Meclizine, Diphenhydramine
Mechanism of Action: Block histamine (H1) receptors. Uses: Motion sickness, Vertigo
Side Effects: Drowsiness, Dry mouth, Blurred vision
Nursing Teaching: Avoid driving or alcohol because of sedation.
4. Anticholinergics- Example: Scopolamine patch
Mechanism of Action: Blocks acetylcholine in the vestibular system
Uses: Motion sickness prevention. Side Effects: Dry mouth, Blurred vision, Urinary retention
, Nursing Teachinh: Patch applied behind the ear, Used before travel
5. Cannabinoids- Examples: Dronabinol, Nabilone
Mechanism of Action: Affect cannabinoid receptors in the brain
Uses: Chemotherapy-induced nausea, Appetite stimulation
Side Effects: Drowsiness, Euphoria, Dizziness
Quick ATI Table
Drug Class Example Use
Serotonin blockers Ondansetron Chemotherapy nausea
Dopamine blockers Metoclopramide Severe nausea
Antihistamines Meclizine Motion sickness
Anticholinergic Scopolamine Motion sickness prevention
Cannabinoids Dronabinol Chemo nausea
Easy Memory Trick (Helpful for Exams). High-Yield Exam Points
Think “S-D-A-A-C” Ondansetron → chemotherapy nausea
S → Serotonin blockers Scopolamine patch → motion sickness prevention
D → Dopamine blockers. Metoclopramide → risk for EPS
A → Antihistamines Antihistamines - drowsiness
A → Anticholinergics Promethazine – strong sedation
C → Cannabinoids
Chapter 34- Drugs Used to Treat Constipation and Diarrhea
These medications either: Promote bowel movements (laxatives) or Slow intestinal movement
(antidiarrheals)
PART 1: Drugs Used to Treat Constipation (Laxatives)
Constipation = infrequent or difficult bowel movements
Causes: Low fiber diet, Dehydration, Medications (opioids), Immobility, Post-surgery
Types of Laxatives:
1. Bulk-Forming Laxatives- Example: Psyllium (Metamucil)
Action: Absorb water, Increase stool bulk, Stimulate normal bowel movement
Uses: Chronic constipation. Side Effects: Bloating, Gas
Nursing Teaching: Take with full glass of water
2. Stool Softeners- Example: Docusate sodium (Colace)
Action: Softens stool, Allows water and fats to enter stool
Uses: Prevent straining, Post-surgery, Post-MI, Hemorrhoids. Side Effects: Mild diarrhea
Nursing Teaching: Encourage fluids and fiber
3. Stimulant Laxatives- Examples: Bisacodyl (Dulcolax), Senna
Action: Stimulate intestinal nerves, Increase bowel movement
Uses: Severe constipation, Bowel prep
Side Effects: Abdominal cramping, Electrolyte imbalance
Chapter 32- Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Disease
GERD: Causes: Heartburn, Acid reflux, Esophageal irritation
Peptic Ulcer Disease (PUD): Open sores in the stomach or duodenum
Common causes: Helicobacter pylori infection, NSAID use, Excess stomach acid
Treatment goal: Reduce stomach acid and protect the stomach lining.
There are 4 major drug groups used to treat GERD and ulcers: Antacids, H₂ receptor blockers,
Proton pump inhibitors (PPIs), Mucosal protectants
These medications either neutralize acid, reduce acid production, or protect the stomach lining.
1. Antacids - Ex: Aluminum hydroxide, Magnesium hydroxide, Calcium carbonate (Tums)
Mechanism of Action: Antacids neutralize stomach acid directly.
Uses: Mild GERD, Heartburn, Indigestion
Side Effects: Aluminum – Constipation, Magnesium- Diarrhea, Calcium - Kidney stones,
Hypercalcemia. Nursing Teaching: Take 1–3 hours after meals, May interfere with absorption of
other medications
2. H₂ Receptor Blockers (Histamine-2 Antagonists): Examples- Famotidine (Pepcid),
Cimetidine, Nizatidine
Mechanism of Action: block histamine (H₂) receptors on parietal cells, which reduces stomach
acid production. Uses: GERD, Gastric ulcers, Duodenal ulcers, Hypersecretory conditions
Side Effects: Headache, Dizziness, Constipation or diarrhea
Important ATI Point: Cimetidine: Can cause gynecomastia, Many drug interactions
3. Proton Pump Inhibitors (PPIs)- Examples: Omeprazole, Pantoprazole, Lansoprazole,
Esomeprazole
Mechanism of Action: PPIs block the proton pump in the stomach, which stops acid secretion
almost completely.
Uses: GERD, Peptic ulcers, Zollinger-Ellison syndrome, H. pylori treatment
Side Effects- (Short term): Headache, Nausea, Diarrhea. (Long term): Vitamin B12 deficiency,
Osteoporosis, Hypomagnesemia, C. diff infection
Nursing Teaching: Take before meals, Do not crush delayed-release capsules.
4. Mucosal Protectants: protect the stomach lining instead of reducing acid. Ex. Sucralfate
(Carafate)
Mechanism of Action: Forms a protective barrier over ulcers, Protects from acid, pepsin, and
bile. Uses: Peptic ulcer disease, Stress ulcer prevention. Side Effects: Constipation
Nursing Teaching: Take on an empty stomach, Do not give with antacids within 30 minutes
,5. Drugs for H. pylori Infection: When ulcers are caused by H. pylori, treatment includes: Triple
Therapy (PPI, Clarithromycin, Amoxicillin or Metronidazole)
Purpose: Kill bacteria, Reduce acid, Allow ulcer healing
Drug Class Example Action Key Side Effect
Antacids Calcium carbonate Neutralizes acid Constipation/diarrhea
Decrease acid
H₂ blockers Famotidine Headache
secretion
PPIs Omeprazole Block proton pump B12 deficiency
Mucosal protectant Sucralfate Protects ulcer Constipation
High-Yield Nursing Exam Points
- PPIs are most effective acid reducers
- Antacids work fastest but shortest duration
- Sucralfate coats ulcers
- H₂ blockers block histamine on parietal cells
Chapter 33 - Drugs Used to Treat Nausea and Vomiting (Antiemetics)
Vomiting is controlled by the vomiting center in the brain. It can be triggered by: Motion
sickness, Chemotherapy, Medications, Gastroenteritis, Pregnancy, Post-operative anesthesia
Treatment goal: block the signals that trigger vomiting. Major Antiemetic Drug Classes:
Serotonin (5-HT₃) antagonists, Dopamine antagonists, Antihistamines, Anticholinergics,
Cannabinoids. Each works on different receptors in the brain or GI tract.
1. Serotonin (5-HT₃) Antagonists- Examples: Ondansetron (Zofran), Granisetron, Dolasetron
Mechanism: Block serotonin receptors, Prevent stimulation of the vomiting center
Uses: Chemotherapy-induced nausea, Post-operative nausea
Side Effects: Headache, Constipation, QT prolongation
Nursing Points: Commonly used for chemo patients, Monitor for heart rhythm issues
2. Dopamine Antagonists- Examples: Metoclopramide (Reglan), Prochlorperazine,
Promethazine. Mechanism of Action: Block dopamine receptors in the brain
Uses: Severe nausea, Postoperative nausea, Migraine-associated nausea
Side Effects: Sedation, Extrapyramidal symptoms (EPS) (Tremor, Muscle rigidity, Restlessness)
Nursing Points: Watch for EPS reactions.
3. Antihistamines- Examples: Dimenhydrinate (Dramamine), Meclizine, Diphenhydramine
Mechanism of Action: Block histamine (H1) receptors. Uses: Motion sickness, Vertigo
Side Effects: Drowsiness, Dry mouth, Blurred vision
Nursing Teaching: Avoid driving or alcohol because of sedation.
4. Anticholinergics- Example: Scopolamine patch
Mechanism of Action: Blocks acetylcholine in the vestibular system
Uses: Motion sickness prevention. Side Effects: Dry mouth, Blurred vision, Urinary retention
, Nursing Teachinh: Patch applied behind the ear, Used before travel
5. Cannabinoids- Examples: Dronabinol, Nabilone
Mechanism of Action: Affect cannabinoid receptors in the brain
Uses: Chemotherapy-induced nausea, Appetite stimulation
Side Effects: Drowsiness, Euphoria, Dizziness
Quick ATI Table
Drug Class Example Use
Serotonin blockers Ondansetron Chemotherapy nausea
Dopamine blockers Metoclopramide Severe nausea
Antihistamines Meclizine Motion sickness
Anticholinergic Scopolamine Motion sickness prevention
Cannabinoids Dronabinol Chemo nausea
Easy Memory Trick (Helpful for Exams). High-Yield Exam Points
Think “S-D-A-A-C” Ondansetron → chemotherapy nausea
S → Serotonin blockers Scopolamine patch → motion sickness prevention
D → Dopamine blockers. Metoclopramide → risk for EPS
A → Antihistamines Antihistamines - drowsiness
A → Anticholinergics Promethazine – strong sedation
C → Cannabinoids
Chapter 34- Drugs Used to Treat Constipation and Diarrhea
These medications either: Promote bowel movements (laxatives) or Slow intestinal movement
(antidiarrheals)
PART 1: Drugs Used to Treat Constipation (Laxatives)
Constipation = infrequent or difficult bowel movements
Causes: Low fiber diet, Dehydration, Medications (opioids), Immobility, Post-surgery
Types of Laxatives:
1. Bulk-Forming Laxatives- Example: Psyllium (Metamucil)
Action: Absorb water, Increase stool bulk, Stimulate normal bowel movement
Uses: Chronic constipation. Side Effects: Bloating, Gas
Nursing Teaching: Take with full glass of water
2. Stool Softeners- Example: Docusate sodium (Colace)
Action: Softens stool, Allows water and fats to enter stool
Uses: Prevent straining, Post-surgery, Post-MI, Hemorrhoids. Side Effects: Mild diarrhea
Nursing Teaching: Encourage fluids and fiber
3. Stimulant Laxatives- Examples: Bisacodyl (Dulcolax), Senna
Action: Stimulate intestinal nerves, Increase bowel movement
Uses: Severe constipation, Bowel prep
Side Effects: Abdominal cramping, Electrolyte imbalance
