Exam Final Study Guide NR565
Week 7 & 8
Antacids: weak bases that react with hydrochloric acid to form salt & water.
-Neutralize Gastric Acidity (causes ^pH of the stomach and duodenal bulb)
-Inhibit proteolytic activity of pepsin
-Increase lower esophageal sphincter tone
-ALL antacids are contraindicated in the presence of severe abdominal pain of unknown cause,
especially if accompanied by fever
-HIGH SODIUM content: pts w/ HTN. CHF need to use low sodium preparation
-Concurrent administration with enteric-coated drugs, destroys the coating= alters absorption, ^
the risk for adverse effects
-Administrations should be separated by at least 2 hours to decrease interactions
1. Calcium based antacids: TUMS, Caltrate, Calcarb
Require Vitamin D for absorption from the GI tract
Prescribed to treat calcium deficient states, i.e. chronic renal failure, post-menopause,
and osteoporosis
Contraindicated in the presence of hypercalcemia and renal calculi
Can cause constipation- increase bulk, fluids and mobility, stool softener
Administered 30min- 1hr on empty stomach or 3hr after meals
Should not be administered with food containing large amounts of oxalic acid (spinach,
rhubarb), or phytic acid (bran, cereals), they decrease the absorption of calcium
Taking w/ foods containing phosphorus (milk, dairy) can lead to milk-alkali syndrome
(N/V, confusion, headache).
Taking with acidic fruit juice improve absorption
2. Aluminum based: AlternaGEL, Amphojel, Mylanta
Inhibit smooth muscle contraction and slow gastric emptying
Aluminum concentrated in the CNS
Aluminum is not easily
removed by dialysis b/c Prolonged use in patients with renal failure may result in dialysis osteomalacia
it is bound to albumin Elevated aluminum tissues levels contribute to the development of dialysis
& transferrin = do not
cross dialysis encephalopathy
membrane Used to treat hyperphosphatemia in pts w/ renal failure & phosphate renal stone
prevention
Can cause constipation- increase bulk, fluids and mobility, stool softener
3. Magnesium based: Milk of mag, Maalox, Mylanta
Can be used to treat magnesium deficiencies from malnutrition, alcoholism, or mag-
depleting drugs
The malfunctioning
kidney can’t excrete Contraindicated in patients with renal failure & used with caution in pts with renal
magnesium=
hypermagnesemia
insufficiency
may result Can cause diarrhea- increase fiber intake
,
, Antidiarrheals:
Diarrhea that lasts for less than 2 weeks is considered acute; if it lasts more than 2 weeks, it is
considered chronic.
Not recommended for children under 12, none of the antidiarrheals are safe for children under 2
years old
Rebound constipation is the main adverse effect
Contraindications: Drugs that decrease gastric motility or delay intestinal transit time have
induced toxic megacolon, especially in those with inflammatory bowel disease
-Bismuth subsalicylate (Pepto bismol): Acute diarrhea, travelers’ diarrhea
For bismuth subsalicylate, additional reactions that all patients should be warned about
The salicylate component of are gray/black stools and black tongue, the results of the bismuth. Patients should be
bismuth subsalicylate
contraindicates its use in told to expect this reaction and that it does not indicate GI bleeding.
children or teenagers during or Bismuth subsalicylate may potentiate the risk for toxicity if taken w/ aspirin
after recovery from chickenpox
or flu-like illness. It is also Is contraindicated in children with flu-like symptoms
contraindicated for patients
with aspirin hypersensitivity.
Has antimicrobial effects against bacterial and viral enteropathogens
-Crofelemer (fulyzaq): Symptomatic relief of noninfectious diarrhea in adult pts w/
HIV/AIDS on antiretroviral therapy
-diphenoxylate w/atropine (Lomotil): Acute diarrhea
Anticholinergics are useful only with inflammatory bowel disease
The atropine component of diphenoxylate and difenoxin contraindicates their use in
narrow-angle glaucoma and requires cautious use in prostatic hyperplasia.
-Difenoxin w/atropine (Motofen): Acute diarrhea
Anticholinergics are useful only with inflammatory bowel disease
The atropine component of diphenoxylate and difenoxin contraindicates their use in
narrow-angle glaucoma and requires cautious use in prostatic hyperplasia.
-Kaolin-pectin (kapectolin): Acute diarrhea
Week 7 & 8
Antacids: weak bases that react with hydrochloric acid to form salt & water.
-Neutralize Gastric Acidity (causes ^pH of the stomach and duodenal bulb)
-Inhibit proteolytic activity of pepsin
-Increase lower esophageal sphincter tone
-ALL antacids are contraindicated in the presence of severe abdominal pain of unknown cause,
especially if accompanied by fever
-HIGH SODIUM content: pts w/ HTN. CHF need to use low sodium preparation
-Concurrent administration with enteric-coated drugs, destroys the coating= alters absorption, ^
the risk for adverse effects
-Administrations should be separated by at least 2 hours to decrease interactions
1. Calcium based antacids: TUMS, Caltrate, Calcarb
Require Vitamin D for absorption from the GI tract
Prescribed to treat calcium deficient states, i.e. chronic renal failure, post-menopause,
and osteoporosis
Contraindicated in the presence of hypercalcemia and renal calculi
Can cause constipation- increase bulk, fluids and mobility, stool softener
Administered 30min- 1hr on empty stomach or 3hr after meals
Should not be administered with food containing large amounts of oxalic acid (spinach,
rhubarb), or phytic acid (bran, cereals), they decrease the absorption of calcium
Taking w/ foods containing phosphorus (milk, dairy) can lead to milk-alkali syndrome
(N/V, confusion, headache).
Taking with acidic fruit juice improve absorption
2. Aluminum based: AlternaGEL, Amphojel, Mylanta
Inhibit smooth muscle contraction and slow gastric emptying
Aluminum concentrated in the CNS
Aluminum is not easily
removed by dialysis b/c Prolonged use in patients with renal failure may result in dialysis osteomalacia
it is bound to albumin Elevated aluminum tissues levels contribute to the development of dialysis
& transferrin = do not
cross dialysis encephalopathy
membrane Used to treat hyperphosphatemia in pts w/ renal failure & phosphate renal stone
prevention
Can cause constipation- increase bulk, fluids and mobility, stool softener
3. Magnesium based: Milk of mag, Maalox, Mylanta
Can be used to treat magnesium deficiencies from malnutrition, alcoholism, or mag-
depleting drugs
The malfunctioning
kidney can’t excrete Contraindicated in patients with renal failure & used with caution in pts with renal
magnesium=
hypermagnesemia
insufficiency
may result Can cause diarrhea- increase fiber intake
,
, Antidiarrheals:
Diarrhea that lasts for less than 2 weeks is considered acute; if it lasts more than 2 weeks, it is
considered chronic.
Not recommended for children under 12, none of the antidiarrheals are safe for children under 2
years old
Rebound constipation is the main adverse effect
Contraindications: Drugs that decrease gastric motility or delay intestinal transit time have
induced toxic megacolon, especially in those with inflammatory bowel disease
-Bismuth subsalicylate (Pepto bismol): Acute diarrhea, travelers’ diarrhea
For bismuth subsalicylate, additional reactions that all patients should be warned about
The salicylate component of are gray/black stools and black tongue, the results of the bismuth. Patients should be
bismuth subsalicylate
contraindicates its use in told to expect this reaction and that it does not indicate GI bleeding.
children or teenagers during or Bismuth subsalicylate may potentiate the risk for toxicity if taken w/ aspirin
after recovery from chickenpox
or flu-like illness. It is also Is contraindicated in children with flu-like symptoms
contraindicated for patients
with aspirin hypersensitivity.
Has antimicrobial effects against bacterial and viral enteropathogens
-Crofelemer (fulyzaq): Symptomatic relief of noninfectious diarrhea in adult pts w/
HIV/AIDS on antiretroviral therapy
-diphenoxylate w/atropine (Lomotil): Acute diarrhea
Anticholinergics are useful only with inflammatory bowel disease
The atropine component of diphenoxylate and difenoxin contraindicates their use in
narrow-angle glaucoma and requires cautious use in prostatic hyperplasia.
-Difenoxin w/atropine (Motofen): Acute diarrhea
Anticholinergics are useful only with inflammatory bowel disease
The atropine component of diphenoxylate and difenoxin contraindicates their use in
narrow-angle glaucoma and requires cautious use in prostatic hyperplasia.
-Kaolin-pectin (kapectolin): Acute diarrhea
