Indication:
Antiemetics
To treat nausea and vomiting especially post-operative or with chemotherapy.
Mechanism of action:
Antiemetics
Works on the CNS to suppress nausea and vomiting.
Generic names:
Antiemetics
- ondansetron
- metoclopramide
- promethazine
Most common side effects:
Antiemetics
- sedation
- anticholinergic
Nursing considerations:
Antiemetics: sedation
Assess for falls and implement fall and safety precautions.
Side effects and Nursing considerations:
Antiemetics: anticholinergic side effects
- causes blurry vision - implement safety / fall precautions
- causes urinary retention - monitor intake and output
- causes dry mouth - give candy or ice chips
- causes constipation - encourage fluids/fiber/walking
“can’t see, can’t pee, can’t spit, can’t shit”
Indication:
Antidiarrheal
To treat:
- diarrhea
- ulcerative colitis
- irritable bowel syndrome
Generic names:
Antidiarrheal
- diphenoxylate/atropine
- loperamide
- bismuth subsalicylate
Most common side effects:
Antidiarrheal
Sedation or drowsiness: take safety and falls precautions.
When should a client with diarrhea not take an antidiarrheal medication?
Do not give a client with an active gastrointestinal infection.
The client will be unable to get rid of the infection if they can’t excrete it.
With what type of medication is there a cross-sensitivity with bismuth subsalicylate?
Cross-sensitivity with aspirin and NSAIDs.
Do not give if there is an allergy.
Indication:
Laxatives / Stool softeners
To prevent or treat constipation.
Generic names:
Laxatives / Stool softeners
- polycarbophil, psyllium
- lactulose
- milk of magnesia
- bisacodyl
- senna glycoside
- docusate sodium
Nursing considerations:
Laxatives / Stool softeners
- drink with a full glass of water to help pass stool
- teach that daily use is not necessary because daily movements are not needed
Indication:
Antilipidemic
To decrease cholesterol for those at risk for stroke and myocardial infarction.
Generic names:
Antilipidemic
- atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin
- ezetimibe
Most common adverse reactions and nursing considerations:
Antilipidemic: -statin
Rhabdomyolysis (muscle breakdown)
- assess for severe muscle pain, spasms, and dark-colored urine
- hold medication and notify HCP
Medication may cause muscle cells to break down.
What is the food-med interaction with Antilipidemic (-statin)?
Avoid grapefruit juice.
Will increase drug level and cause toxicity.
What labs should be checked for a client taking antilipidemics?
Before meds are started and every 6 - 12 months for a client on antilipidemics, check: liver function tests such as ALT and AST.
This is to assess if the medications are affecting the liver adversely and to evaluate if the medicine is working.
Indication:
Proton pump inhibitor
Decreases acid secretion and treats:
- GERD
- heartburn
- ulcers
Generic names:
Proton pump inhibitor
dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole
Nursing considerations:
Proton pump inhibitor
Give 30 - 60 minutes before meals.
To protect stomach before eating.
Indication:
H-2 receptor blocker
To heal and prevent ulcers by limiting gastric acid secretion.
Generic names:
H-2 receptor blocker
- famotidine
- ranitidine
- cimetidine
Generic names:
Antacids
- aluminum hydroxide
- calcium carbonate
- magnesium oxide
Indication:
Antacid
- to treat acid indigestion and GERD
- to treat ulcers
Nursing considerations:
Antacid
- don’t take with other meds: prevents absorption
- wait at least 1 hour when taking other meds
- take ~2 hours after meals with water
Generic names:
Pancreatic enzymes
- pancrelipase
- pancreatin
Indication:
Pancreatic enzymes
To treat:
- cystic fibrosis
- pancreatitis
Nursing considerations:
Pancreatic enzymes
Take right before meals to help with food digestion.
Indication:
sucralfate
To treat and prevent duodenal ulcers.
Indication:
vitamin B12 / cyanobalamin
To treat pernicious anemia: common after gastric surgery.
Indication:
ferrous sulfate / iron
- to treat iron deficiency anemia
- to prevent anemia during pregnancy
What color can iron turn stool?
greenish-black
Side effect and nursing consideration:
ferrous sulfate / iron
May cause constipation: taking with vitamin C helps absorption.
If iron is absorbed into the bloodstream, it won’t just stay in the gut leading to constipation.
Indication:
folic acid / folate
- to prevent folate deficieny anemia from diet or alcoholism
- to prevent neural tube defects during pregnancy
What color can folic acid / folate turn urine?
bright yellow
Indication:
vitamin B3 / niacin
To lower cholesterol.
Side effect:
niacin
facial flushing
Adverse reaction and nursing consideration:
niacin
Hepatotoxic: check liver function tests before giving (ALT and AST).
Mechanism of action:
Antidiarrheal
Slows the passage of stool.
Mechanism of action:
Laxatives / Stool softeners
Pulls fluid into colon and/or adds bulk to soften the stool.
Adverse reaction:
Laxatives / Stool softeners
Fluid and electrolyte imbalances: assess F&E status.
Mechanism of action:
Antilipidemic
Prevents enzyme that makes cholesterol.