IBD and PUD Pharmacology

mesalamine is a _

Aminosalicylate

MOA of mesalamine

Inhibits prostaglandin production in the colon.

Contraindications for mesalamine

Antacids, NSAIDs, varicella vaccine, alcohol, sun exposure, myocarditis, and liver or kidney impairment.

Side effects of mesalamine

Anemia, GI cramping, and rhinitis.

Adverse effects of mesalamine

Pancreatitis, GI hemorrhage, and cholestatic hepatitis.

Nursing interventions for mesalamine

• Monitor kidney and liver function

• CBC

• Encourage oral fluids

• Monitor for acute intolerance syndrome

These drugs are used for ulcerative colitis

mesalamine and infliximab

azathioprine is a _

T and B cell suppressor

MOA of azathioprine

Alters antibody production and suppresses T-cell effects

Contraindications for azathioprine

Warfarin, ACE inhibitors, alkylating drugs, and liver or kidney dysfunction

Side effects of azathioprine

Anemia, infections, and myalgia

Adverse effects of azathioprine

Pancytopenia, liver toxicity, and fever

Why does azathioprine have a BBW?

Warn patient of the risk of malignancy.

Nursing interventions for azathioprine

• Bleeding precautions

• CBC

• Monitor liver function

• Neutropenic precautions

These drugs are used for Crohn’s Disease

azathioprine and infliximab

infliximab is a _

Tumor necrosis factor blocker

Contraindications of infliximab

Live-virus vaccines, warfarin, echinacea, active infection, seizure disorders, and hematologic abnormalities

MOA of infliximab

Binds to human TNF-alpha to neutralize its activity and inhibit its binding with receptors, reducing the infiltration of inflammatory cells and TNF-alpha production.

Side effects of infliximab

HTN, URI, and pharyngitis

Adverse effects of infliximab

Leukopenia, neutropenia, and dyspnea

Why does infliximab have a BBW?

Discontinue for serious infection, test for TB frequently.

Nursing interventions for infliximab

• Monitor for infusion-related reactions (2 hrs)

• Neutropenic precautions

• Monitor for liver toxicity

• Stop for lupuslike syndrome, CNS reactions, and significant hematologic abnormalities.

Sodium bicarbonate is a _

Antacid

Contraindications of sodium bicarbonate

Ketoconazole, abnormal kidney function, HF, vomiting, and meta/resp alkalosis.

MOA of sodium bicarbonate

Restores buffering capacity of the body and neutralizes excess acid.

Side effects of sodium bicarbonate

Edema, gastric distension, and pain

Nursing interventions for sodium bicarbonate

• Obtain blood pH

• CBC

These medications treat peptic ulcers

Sodium bicarbonate, omeprazole, and famotidine

Omeprazole is a _

Proton pump inhibitor (PPI)

Contraindications of omeprazole

St. John’s Wort, vitamin B12, low calcium or potassium, low sodium diet, and alkalosis

MOA of omeprazole

Inhibits proton pump activity by binding to hydrogen-potassium, located at the surface of gastric cells, to suppress gastric acid secretion.

Side effects of omeprazole

Asthenia, cough, and acid regurgitation

Adverse effects of omeprazole

Abdominal pain, constipation, and headache

Nursing interventions for omeprazole

• Monitor for S/S of osteoporosis

• Monitor for S/S of acute interstitial nephritis

• CBC

famotidine is a _

H2 receptor antagonist

Contraindications of famotidine

Bloody stools or vomit, kidney impairment, and B12 deficiency

MOA of famotidine

Competitively inhibits action of histamine on H2-receptor sites of parietal cells, decreasing gastric acid secretion.

Adverse effects of famotidine

Headache, dizziness, and constipation

Nursing interventions for famotidine

CBC

Monitor B12 level

Montior for abdominal pain

Monitor I/O (Bloody stool or vomit)