Professional Documents
Culture Documents
Simple Nursing Pharm
Simple Nursing Pharm
1. Cancer drugs:
o Finish medication to prevent super infection (take until all med is finished and DO NOT
stop taking when feeling better)
o Accidental pregnancy (oral contraceptives are ineffective so use additional contraception
like IUD)
C: Childcare
C: “-cillins” like penicillin and amoxicillin
C: “-cycline” like doxycycline and tetracycline
o NO alcohol with these drugs
o NO food for MTF “move the food” (take on empty stomach with full glass of water)
M: Macrolides -Azithromycin
T: Tetracycline -Doxycycline
F: Fluoroquinolones -Levofloxacin
o NO sun AVOID “Fun the sun”
F: Fluoroquinolones -Levofloxacin
T: Tetracycline -Doxycycline
S: Sulfa drugs = sun burns (Trimethoprim -sulfa methox azole)
Sulfonylureas (glyburide) and diuretics (thiazide/loops)
Photosensitivity -avoid direct sun exposure and sun burns (wear sunblock)
o Super toxic to the kidneys (nephrotoxicity) and ears (ototoxicity)
Vancomycin, gentamicin, and neomycin
2. Antibiotics:
Penicillin
o End in -cillin
o Ex: Amoxicillin and Ampicillin and Piperacillin Tazobactam
o Pregnancy and breastfeeding safe
Accidental pregnancy since it bumps the pill
Oral contraceptive are ineffective so use additional contraception -NCLEX tip
Cross sensitivity (anaphylaxis allergy) -check allergy before giving and do not mix
with other dugs -NCLEX tip and clarify prescription and request a new med
o During a reaction:
Stop “hold” medication
Assess the type of reaction -always auscultate the lungs -NCLEX tip
Prepare epinephrine to administer
o Administration:
Take with food if GI is upset (nausea/vomiting/diarrhea)
Shake well before use
Measuring device doppler or oral syringe to give med -NCLEX tip
o Common side effect: bleeding (monitor platelet count)
Cephalexin
o Start with -ceph and are cephalosporins
o Ex: Cefazolin, and Ceftriaxone
o Pregnancy and breastfeeding safe
Can cause C-diff -NCLEX tip
Cross sensitivity (anaphylaxis allergy) -check allergy before giving and do not mix
with other dugs -NCLEX tip and clarify prescription and request a new med
o Common side effect: diarrhea
Metronidazole
o Number 1 drug to treat C-diff infection -NCLEX tip
o Also treats STI (Trichomoniasis)-sexually transmitted infection
o End in “dazole”
o AVOID alcohol (ETOH) both during and 3 days after treatment -NCLEX tip
Patient will have violent vomiting and cramping if alcohol is consumed
o Side effects that are normal -no need to report
Dark urine “discoloration” (brown and rusty)
Metallic taste (metro-metallic taste)
o Deadly side effect is report, any new rash or skin peeling =steven Johnson syndrome
Trimethoprim sulfamethoxazole
o Sulfonamides antibiotics or UTI medication
o Stops folic acid synthesis and is a sulfa drug so think “SULF”
S: Sunburn -teach to use sunblock and avoid sun
U: Urine crystals and specific gravity -high and dry
L: Love the water -drink 2-3 liters of water per day
F: Folic acid -take daily
o Contraindications we have hypersensitivity to sulfa drugs, always assess for sulfa
allergies
To glyburide (oral anti-diabetic drug)
Rash while on glyburide -potential allergy to sulfa drugs
NOT pregnancy safe
Levofloxacin and Ciprofloxacin
o Fluoroquinolones or UTI meds
o Given to pneumonia and UTI patients
AVOID sun “direct sun exposure”
Achilles tendon rupture -NCLEX tip
Report new muscle pain
Contraindication: Tendonitis
Phenazopyridine -not an antibiotic
o UTI analgesic given for pain relief during that burning and irritation of UTIs
o Normal to have red and orange urine and body fluids -no need to report
o REPORT liver toxicity symptoms like yellow skin/sclera = jaundice -NCLEX tip
Teach patient to wear sanitary pads and also wear glasses instead of contacts
NEVER stop antibiotic therapy not even when feeling better -NCLEX tip
Tetracycline and Doxycycline
o Indication if mainly used for skin -acne
o End in “-cycline”
o NOT pregnancy safe
o Tooth discoloration
o Sun burns -wear sunscreen
o Patient education:
Use additional contraception
Take on empty stomach usually 1-2 hours before or after meals
Sit up 30 minutes after taking -DO NOT LAY DOWN -NCLEX tip
AVOID calcium products -NO daily (milk, cheese), NO antacids (tums, milk of
mag) and NO iron
Azithromycin and Erythromycin
o Macrolides ending in “-thromycin”
o Prolonged QT intervals -could lead to cardiac arrest
o Monitor ECG -report changes to HCP
o Liver toxic -monitor AST/ALT and report increases to the HCP
o Side effects: -normal (do not stop drug for these)
Nausea/vomiting, fever and decrease WBCs
Vancomycin
o Glycopeptides class -very toxic to the kidneys and ears
o Monitor the drug concentration in the blood
o Peak and Trough -NCLEX tip
Check 15-20 minutes before next dose or before the next administration
Draw and review levels (therapeutic range 10-20)
Report and hold over 20 for vancomycin
o Report signs of toxicity
Ear damage “ototoxicity” -monitoring for hearing and balance changes
Vertigo (loss of balance) and ataxia (inability to walk) -NCLEX tip
Tinnitus (ringing of the ears) -NCLEX tip
Kidney damage “nephrotoxic” -report to HCP of increasing BUN and creatinine
Creatinine over 1.3 and BUN over 20
o Vancomycin given for MRSA and C-diff -powerful drug and burns during administration
Usually given via PICC as a preferred route
Assess site every 30 minutes for pain, redness and swelling
o Vancomycin can cause red mans syndrome caused by a rapid infusion
Sudden onset of severe hypotension, flushing and pruritus (itching) and red rash
on face, neck, chest and extremities
Simply slow the infusion
o Key words for vancomycin
Monitor BP and infuse slowly at least over 60 minutes -NCLEX tip
NO effect on mag levels, NO effect on mental status or deep tendon reflexes,
and NO need for anti-nausea meds
Tobramycin, Gentamicin, Neomycin
o Aminoglycosides class, and indication used to treat infections in cystic fibrosis
o NO red mans syndrome
o Neomycin is very toxic in combination with vancomycin
o Notify HCP of increasing BUN/creatinine -ototoxicity and nephrotoxicity
Increased risk for toxic effects in the elderly population and those with
decreased renal function as well as when giving at high doses -NCLEX tip
Normal to have muscle aches and cramping
3. Respiratory Drugs:
Bronchodilators: “BAM”
o B: Beta 2 Agonist -Albuterol and Levalbuterol
Increases HR
End in “-buterol”
B- brutal asthma attacks
1st drug we use for severe asthma attacks -fasting acting bronchodilator
The ONLY “rescue inhaler” during acute asthma attacks -NCLEX tip
Before steroid inhaler -NCLEX tip
S: salmeterol = S: slower acting (NOT rescue inhaler)
NCLEX question: DO NOT use fluticasone or salmeterol for first sign of acute
asthma attack
Acute asthma attacks we give 3 drugs: (SEQUENCE IS KEY) “AIM” -NCLEX tip
A: Albuterol 1st
I: Ipratropium 2nd
M: Methylprednisolone (steroid) last
Expected Side Effects for Albuterol: 3 T’s
T: Tachycardiac and palpitations
T: Tremor
T: Toss and turning at night (insomnia and difficulty sleeping) -NCLEX tip
Do not take at bedtime -NCLEX tip
AVOID beta blockers (atenolol) and NSAIDS (naproxen, ibuprofen) -NCLEX tip
During attack we instruct patent to take 2-4 puffs every 20 minutes for 3 rounds
If not working after 3 doses? -Notify HCP
Drug was effective: decrease in RR, and oxygen sat. is at least 90% or higher
Expected finding after treatment: -normal
Increased productive cough
Reports of decreased anxiety
Mild bilateral hand tremors
Administration: shake it before you take it -shake it well
Breath all the way out
Place inhaler in mouth
Push the med from inhaler into the mouth
Inhale the med and hold for a few seconds then exhale
Clean the mouthpiece 1-2 times per week with warm water
o A: Anticholinergics -Ipratropium
End in “-tropium”
Ex: Ipratropium and Tiotropium -dry the body out
Used for moderate to severe asthma and COPD
Used 2nd in line after albuterol
Mechanism of action:
Blocks secretions so you can see, pee, spit or shit called anticholinergic
Common side effects:
Dry mouth and hoarseness
Treat the dry mouth and throat for all anticholinergics by using
gym/candy and drink fluids -NCLEX tip
NO swallowing tiotropium capsules -NCLEX tip
Contraindication to ALL anticholinergics we never give for patients who are
already DRY
Patients with glaucoma, urinary retention and BPH, bowel obstructions
o M: Methylxanthines -Theophylline
End in “-phylline”
Ex: Theophylline and Aminophylline
3 T’s:
T: Toxic over 20 -do frequent blood draws -NCLEX tip
T: Tonic clonic seizures -severe toxicit 1st priority (s/s of toxicity like
anorexia, nausea/vomiting, restlessness and insomnia)
T: Tachycardia and dysrhythmias -NCLEX tip
Teach patient to AVOID beta blockers that lower the HR while on Theophylline
Alert HCP of tachycardia BEFORE giving next dose
Two drugs that increase toxicity risk -NCLEX tip
Cimetidine (H2 blocker) and Ciprofloxacin (antibiotic)
Take in the morning and AVOID caffeine
STOP before cardiac stress test
Anti-inflammatory agents “SLM”
o S: Steroids -Beclomethasone
End in “-sone”
S- Steroids = S-stress and swelling hormone -decrease the swelling
Prescribed to patients with COPD, rheumatoid arthritis, psoriasis, lupus, and
allergic reactions where everything swells up
S’s:
Swelling and inflammation (water gain=weight gain), words like “sudden,
excessive, or rapid” -report 1 lb in 1 day and 2-3 lb in 2 days
Respiratory (beclomethasone, fludrocortisone, methylprednisolone)
Total body swelling (Prednisone, dexamethasone, hydrocortisone)
Slow onset and slowly taper off (never abruptly stop) -NCLEX tip
Sepsis (infection or illness) -low WBC fever is priority -NCLEX tip
Sugar increase -hyperglycemia -NCLEX tip
Skinny -muscle and bones “osteoporosis” risk for fractures
Sight -cataracts risk so refer to optometrist -NCLEX tip
Stress or surgery (increase dose) -NCLEX tip
Sores in mouth(infection)-most at risk for infection someone on steroids
Use spacers to prevent oral THRUSH (candida)
Rinse mouth after each use and DO NOT swallow the water
Always wash mouthpiece out with warm water after each use
o L: Leukotriene inhibitor -Montelukast
End in “-lukast”
Ex: Montelukast and Zafirlukast
3 L’s:
L: Luke likes to sing (airway open)
L: Long term management
L: Long Onset (1-2 weeks to reach therapeutic range)
Given for prevention of asthma attacks NOT during acute asthma attacks
NOT a rescue drug
This med will prevent inflammation that causes asthma attacks
o M: Mast cell stabilizers – Cromolyn
Blocks massive swelling
Prevents activity induced asthma like before sports or exercise
Take 10-15 minutes before exertion for maximum effects/physical activity
4. Antipsychotic Drugs:
5. Bi-polar Drugs:
Carbamazepine
o Bi-polar, also given for seizures and treatment of trigeminal neuralgia (neuropathic pain)
o Side effects:
Leukopenia -low WBCs increased risk for massive infection
Report fever and sore throat -NCLEX tip
Accidental pregnancy so oral contraceptive are ineffective and will need
alternative birth control methods -NCLEX tip
Valproic Acid
o L: Liver toxic -monitor for jaundice and liver labs (ALT/AST)
o L: Low platelets -thrombocytopenia big bleed risk
o Not pregnancy safe
o Teach not to STOP this drug abruptly
Lithium (big momma)
o Long term treatment for bipolar and schizoaffective disorder
o Narrow therapeutic range: 0.6-1.2
o Toxicity over 1.5
Highest risk are those with decreased renal function
Be cautious with patients in kidney disease and elderly patients who naturally
have decreased kidney function
Creatinine over 1.3 = BAD kidney
Urine 30mL/hr or less = kidneys distress
S/S of tinnitus (ringing of the ears) = ototoxicity
o L: Levels over 1.5 = toxic -blood is drawn regularly to maintain that therapeutic dose (can
take up to 3 weeks)
NCLEX question: is lithium at a therapeutic level, if yes then continue at current dose
o I: Increase fluid and sodium -since lithium lets go of the fluid
Contraindication: CANNOT give lithium during dehydration and low sodium
(hypernatremia below 135)
DO NOT limit sodium or water intake
Highest risk patient for toxicity is someone with stomach flu (diarrhea and
vomiting)
Teach patients to drink 1-3 liters of water a day and limit diuretics including food
that have diuretic properties like coffee, colas, and teas
o T: Toxic signs: -report to the HCP
Report excessive urination and extreme thirst -lead to dehydration
Vomiting and diarrhea -add more dehydration
Neuro muscular excitability (tremors/myoclonic jerks/horse hand tremors, ataxia
or confusion or agitation)
o H: Hold NSAIDS (ibuprofen, naproxen)
NSAIDS (Ibuprofen) decrease renal blood flow increasing risk for toxicity
AVOID!! Need further teaching if still wanting to use, instead use Tylenol
Common expected side effects -don’t need to report to HCP
Dry mouth and thirst -teach clients to use ice chips, gum, or sugarless
candy and plenty of fluids and also do oral hygiene
Drowsiness and fatigue -teach clients to avoid driving and other
hazardous activities
Weight gain -teach proper diet and exercise
Decreased appetite -client has weight loss = anorexia and mild GI upset
6. Anxiolytics:
Benzodiazepines -given for anxiety, seizures, alcohol withdrawal and sedation (induced coma)
o Dangerous they are sedatives
o End in “-lam” like Alprazolam and Midazolam
o End in “-pam” like Temazepam and Clonazepam
o Fast acting but highly addictive and hard to come off, not safe for long-term use
o Side effects:
Sedation -low and slow
Low HR, BP, and low RR (bradypnea) -leading to deadly respiratory depression
o Patient Teaching: Sedation, sleepiness, and the suppression of ABCs
Take at bedtime -NCLEX tip
Do not skip doses -NCLEX tip -sedation and rebound anxiety are the dangers
Keep taking even when patient is feeling okay
Always taper off and never abruptly or suddenly stop taking
STOP drinking alcohol (wine) and do not operate dangerous machines
AVOID valerian root, and muscle relaxants
o Antidote for Benzos: Flumazenil -NCLEX tip
o Antidote for Opioids: Naloxone -NCLEX tip
Barbiturates -given for anxiety and seizures
o Dangerous they are sedatives
o End in “-barbital” like Phenobarbital
o Lasts longer in the body usually 3-5 days but takes longer to get out of the body
o Higher risk for toxicity leading to hypotension and respiratory depression
Buspirone -given for anxiety and seizures
o Not a sedative, slow acting (takes a long time to kick in) and very easy to quit
o Atypical anxiolytic -no depressant effects
o 2-4 weeks for full effect
o NO withdrawal symptoms! -NCLEX tip
Not addictive, no dependence, no tolerance, and no sedation
o Patient teaching:
Driving is okay, not for acute attacks usually taken on a regular basis
7. Antidepressants:
4 rules for Antidepressants:
1. Increased risk of suicide -elevated the mood it gives patient energy to go out and carry out the
suicide (can increase suicidal thoughts in first few weeks of treatment) in young adults 18-24
o Notify provider of any suicidal thoughts
o Clarify any new prescription and monitor for
o New thoughts of suicide, unusual behavior, worsening depression, sudden change mood
2. Slow onset and slow taper off
o Never STOP abruptly
o Takes a few weeks to reach therapeutic level
o Teach about sexual dysfunction so they are aware and won’t stop taking the drug
3. NEVER mix
o SSRI with St. John’s Wort
o MAOI with any Antidepressant (TCA, SSRI, SNRI)
o 2-week washout period is needed -NCLEX tip
o NEVER start a new antidepressant while tapering off an MAOI or another
4. ALL psych drugs
o Decrease BP (slow position changes)
o Cause weight changes -mostly weight gain
SSRI
o Sertraline, Citalopram, Escitalopram -NCLEX tip
o Also have Paroxetine and Fluoxetine
o Given for depression, anxiety, and PTSD
o Common side effects that usually improve after 3 months
Weight gain
Sexual dysfunction -NCLEX tip
NO sedation usually cause insomnia
o Priority key points: “SSSRI”
S: Suicide risk increased when starting med or changing dose
Reports of more energy without change in depression -NCLEX tip
S: Slow onset and slow taper off -usually takes 2-4 weeks to reach full effect
S: Serotonin Syndrome -NEVER MIX SSRI with St. John’s wort, MAOI, or tramadol
Sweaty and hot with fever -not cold and clammy
R: Rigid muscles and restlessness and agitation -tremors, hyperreflexia,
increased deep tendon reflexes
I: Increased heart rate “tachycardia”
SNRI
o Duloxetine
o Give for depression and pain like with neuropathy and fibromyalgia
o Patient teaching -helps with chronic pain and improves sleep in patients = fibromyalgia
TCA
o Amitriptyline (slow position changes) and Imipramine (inhibit my peeing)
o Given for depression and anxiety and also helps with neuropathy
o Orthostatic hypotension -slow position changes and urinary retention
o Side effects -big dry the anticholinergic effects
Cannot see -blurred vision and photophobia -teach to wear sunglasses and
eyedrops
Cannot pee -urinary retention -NCLEX tip -drinking the fluids
Cannot spit -dry mouth -teach to chew gum
Cannot shit -constipation -give fiber
Sweating, seizures, and sedation = drowsiness/dizziness
MAOI
o Phenelzine, Selegiline, and Isocarboxazid
o These are the first and oldest antidepressants known as the big guns
o Very powerful used for depression, panic disorder and social phobia
o M: Massive hypertension crisis risk
Key sign is a massive headache and increased agitation -NCLEX tip
o A: Avoid tyramine
NO Wine and cheese (NO wine tasting)
NO Bear and sausage, salami (NO beer festival)
NO Chocolate
Start this diet at least 2 weeks before starting an MAOI and continue 2 weeks
after stopping MAOI
o O: OTC drugs = hypertension crisis
C: Calcium
A: Anti acids
A: Acetaminophen
N: NSAIDS (naproxen, ibuprofen)
o O: Other antidepressants to avoid
SSRIs, SNRIs, TCAs -trigger a serotonin syndrome
2-week washout period when changing or swapping out antidepressants
Fully tapper off the other before starting the next -NCLEX tip
o I: Increased suicide risk
When starting med or increasing the dose -NCLEX tip
Usually in children, adolescents, or young adults
Patient states: “This med is not working after 2 weeks” -1st assess
Further expressions of: hopelessness, despair, suicidal thoughts, or
thoughts of self-harm =report to the HCP
8. Atypical Antidepressant:
Trazodone:
o Makes you sleepy and sedated
o Avoid ETOH (alcohol) and other sedatives (benzos and antihistamines)
o Take at night
o Causes orthostatic hypotension -teach slow position changes
o Rare complication is a priapism -teach if erection lasts longer that 4 hours to go to the
hospital
Bupropion SR (sustained release), XL (extended release):
o Given for depression and an aid to stop smoking
o Side effects:
Insomnia
Headache
Weight loss
o Teaching:
NEVER double up on missed doses
Nicotine gum may be prescribed in addition to help stop smoking
o Administration:
XL (extended release), SR (sustained release) pill -NEVER crush, chew, or cut
Swallow whole with or without food
9. Blood Thinners:
10. Thrombolytics
11. GI Drugs:
Ondansetron -antiemetic
o Given to decrease nausea and vomiting
o Can cause serotonin syndrome which is a high risk for injury including
Agitation, hypertension, muscle rigidity and tachycardia
o Side effect is headache and dizziness -normal
Priority side effect is Torsades de pointes
o Give before going to chemo and before or with pain medications
o NCLEX question: During infusion, child reports nausea and vomits what is the priority
intervention? -STOP the chemo, flush the line and administer ondansetron
Metoclopramide -antiemetic
o Given for nausea and vomiting but also for delayed gastric emptying called gastroparesis
o Works by accelerating gastric emptying by increasing intestinal motility -basically gets
food out of the stomach very quickly
o Contraindicated for patient with a bleed in the GI -bleeding duodenal ulcer -NCLEX tip
o Side effects the extrapyramidal
Especially tardive dyskinesia -especially in older adults
Question prescription “order” and report to HCP immediately
Lip smacking, sucking lip motion, puffing of the cheeks, and excess blinking of
eyes, protruding and twisting of the tongue, chewing movement -NCLEX tip
Sodium Docusate -only one tested on NCLEX
o Stool softener
o Teach patients to increase their fluid, fiber, and they’re walking
o Contraindicated for bowel obstruction -huge risk for death
o Other drugs are psyllium husk -bulking fiber and magnesium hydroxide -considered a
laxative and anti-acid
Lactulose
o Loosens the bowels to lower the ammonia levels -usually in cirrhosis patients
L: Laxative for
A: Ammonia levels -decreased
C: Cognition returns “improved mental status” -NCLEX tip
o Treats hepatic encephalopathy -helps the body poop out all that ammonia basically
massive explosive diarrhea
o NOT a diuretic, so NO renal excretion of ammonia, NO it does not decrease portal
hypertension and NO abdominal distention will not improve with lactulose -NCLEX tip
o How does a nurse evaluate the effectiveness of this drug?
2-3 soft stool per day -NCLEX tip
Ammonia levels decrease
Cognition improved “improved mental status” -NCLEX tip
Sodium polystyrene Sulfonate
o Given for hyperkalemia that high potassium
o Administration: PO is the most effective or we can also use an enema
o Patient teaching:
Helps the large intestine to remove excess K+ within the body -NCLEX tip
Encourage patient to drink fluids after administration
o Nursing Care:
We ensure normal bowel function prior to administration to prevent intestinal
necrosis
Asses the abdomen
Recent bowel patterns and frequency of stools
Bowel function
Potassium within normal limits (3.5-5.0)
o NCLEX question: focus on bowel assessment first
o Ensure close assess to the bathroom due to frequent loose stools
Loperamide -anti-diarrheal opioid
o Given for active diarrhea to decrease the motility or movement of the intestines
o Makes thing low and slow and especially making the bowel low and slow
o Biggest side effect is constipation slowing things down too well
Dicyclomine
o Anti-diarrheal given to patients with irritable bowel syndrome (IBS)
o Can have up to 20 loose stools per day
o Dicyclomine = helps to get the bowels on a regular cycle
o Side Effects:
Constipation, dry mouth, and urinary retention
Cannot see, pee, spit or shit -dries everything up so diarrheal is NOT a common
side effect -NCLEX tip
o Contraindications to AVOID:
NOT for patients with paralytic ileus or bowel obstruction -NCLEX tip
So we always question the prescription
NOT for narrowed-angle glaucoma patients (cataracts are ok)
NOT for a full bladder (over 400 mL) “urinary retention”
Sulfasalazine
o Sulfa-drug given for inflammatory bowel disease (IBD) including Crohns disease and
ulcerative colitis
o This med decreases colon inflammation by inhibiting prostaglandins
o Continue medication even after symptoms subside
o Contraindicated in patients with a sulfa allergy -NCLEX tip
o Side effects that are normal include
Yellow orange discoloration of the skin and urine
o Adverse effects -the ones we worry about “SULF”
S: Sun Dried -sunblock and dry body
Photosensitivity -NCLEX tip teach to wear sunblock and avoid direct sun
U: Urine Crystals -kidney stones
L: Low urine output with high specific gravity over 1.030 -NCLEX tip
Dehydration, elevated urine specific gravity and body is high and dry
F: Fluid and Folic acid
Drink 8 glasses of water daily and take folic acid 1mg/day
o Expected findings with ulcerative colitis we get blood diarrhea and inflammatory
markers will be elevated so do not stop the med, med will actually help -NCLEX tip
Gastritis is an irritation of the stomach
GERD = Gastro Esophageal Reflux Disease -heartburn and acid reflux that
irritates the esophagus
Ulcers -breaking the lining like the holes and open sores
Stomach ulcer -gastric ulcer or a peptic ulcer
Small intestine -duodenal ulcer
Antacids
o Reduce acid and prevent ulcers, goal is to protect the GI from its own acid
o Used for fast immediate relief but don’t last long -think “SCAM”
S: Sodium bicarbonate
C: Calcium carbonate (tums)
A: Aluminum hydroxide
M: Magnesium hydroxide
o Think anti mixing for anti-acids -there never to be taken with other meds -NCLEX tip
So either 1 hour before or after other meds
NOT for heart failure patients and nothing OTC
o Side effects:
For aluminum or calcium they can constrict and cause constipation
Magnesium hydroxide can mellow out the GI tract causing diarrhea
-can upset the stomach and liquid bowel movements
Ranitidine and Famotidine
o H2 Blockers Histamine 2 receptor antagonist -long lasting relief that turns down the
volume of acid production
o End in “-tidine”
o Take 30 minutes before meals -NCLEX tip
o Given for GERD and ulcers both duodenal and gastric
o Patient Education:
DO NOT overeat
NO stress or stress reduction
NO smoking and NO NSAIDS
Omeprazole, Esomeprazole, Pantoprazole
o Proton Pump Inhibitors (PPI)
o End in “-prazole”
o Given for heartburn and GERD but mainly used for ulcer prophylaxis especially in
hospitals due to the hospital related stress
o 3 P’s
P: Prevent holes -stress ulcer prophylaxis -NCLEX tip
P: Porous Bones -regular bone density tests -NCLEX tip
P: Possible GI infections -C-diff
o Usually everyone on Med/Surg gets put on a PPI, so if patient asks why they are put on a
PPI or “stress ulcer prophylaxis” that they don’t use it at home we respond -NCLEX tip
It helps prevent the development of an ulcer due to surgery or hospital stays
Sucralfate
o To protect the lining from those holes or peptic ulcers we use mucosal protectant
o Given to treat and prevent both stomach and duodenum or duodenal ulcers in the small
intestine
o Key point: take on an empty stomach -food and meds at least 1-2 hours before or after
taking this med -NCLEX tip
DO NOT take with any other meds
Taken best at bedtime
Misoprostol
o Mucosal protectant -synthetic prostaglandin to protect against gastric ulcers so it
increases protective mucus inside the stomach
o Usually given to patients on long-term NSAIDS therapy like naproxen and ibuprofen
o Major adverse effects:
Dysmenorrhea
Miscarriage risk NOT for pregnant woman-NCLEX tip
o So we always do a pregnancy test before giving this drug because this drug increases
cervical ripening.
Teach reliable birth control and DO NOT take with any other antacids
If pregnancy is suspected, then we STOP the med and contact HCP -NCLEX tip
Pancrelipase
o Given to replace digestive enzymes in patients with cystic fibrosis
Pancreases = helps break down food
Lipase = fat
Protease = protein
Amylase = carb
o MUST be eaten WITH every meal and snack or med is not effective -NCLEX tip
o Pancrelipase Admin:
Open capsule and sprinkle contents on food without chewing
Reduction in fatty stools is an expected outcome
13. TB drugs