Pharm: SIMPLIFIED GI meds

same as the simplified cardiac, meant to assist with retaining med classes etc.

Glucocorticoid example

Dexamethasone

Glucocorticoid Dexamethasone therapeutic use

Often combined with other antiemetics for chemotherapy‑induced nausea.

Glucocorticoid Dexamethasone memory trick

Dex helps the rest

Substance P/neurokinin1 antagonist example

Aprepitant

Substance P / NK1 Antagonist use

prevent postoperative nausea, vomiting, and chemotherapy nausea.

Substance P / NK1 memory trick for Aprepitant

A-prevent-it

Serotonin Antagonist example

Ondansetron and Granisetron

Serotonin Antagonist therapeutic use

First‑line for most nausea (post‑op, chemo, general)

Serotonin Antagonist Ondansetron (setron=serotonin blocker)

turns off the serotonin

Dopamine Antagonist examples

Prochlorperazine, metoclopramide, promethazine

Dopamine Antagonist therapeutic uses

blockade of dopamine receptors in the CTZ to prevent general nausea and migraines

Dopamine Antagonist memory trick

Don’t vomit

Cannabinoids example

Dronabinol

Cannabinoids therapeutic uses

appetite stimulation and chemo nausea

Cannabinoids Dronabinol memory trick

drawn to a bowl

Anticholinergics example

scopolamine

Anticholinergics therapeutic use

motion sickness in the form of a patch (or IV/PO)

Anticholinergics scopolamine memory trick

Scopo lifts you from motion sickness

Antihistamines examples

Dimenhydrinate and Hydroxyzine

Antihistamines therapeutic use

prevent motion sickness by blocking VC in brain

Antihistamines memory trick for DimeNHYDRINATE

dry and drowsy

Benzodiazepine example

Lorazepam

Benzodiazepine therapeutic use

suppress CINV by causing sedation, anterograde amnesia, and emesis suppression

Benzodiazepine LORAzepam

Lowers anxiety and lowers nausea

ondansetron contraindications and precautions

avoid in long QT syndrome (heart rhythm disorder)

Dopamine Antagonist caution in children and older adults

increase EPS risk

Dopamine Antagonist avoid/caution in

urinary retention, obstruction, asthma, narrow‑angle glaucoma

Dopamine Antagonist promethazine contraindicated in

children under 2 d/t severe resp depression risk

Anticholinergics and Antihistamines have the same cautions as

dopamine blockers

Aprepitant contraindicated with

pimozide and breastfeeding

Aprepitant caution in

children, severe liver/kidney disease

Glucocorticoids avoid with

active, untreated infection

long term use during lactation

Lorazepam avoid in

CNS depression, angle‑closure glaucoma, severe hypotension, uncontrolled severe pain.

can cause fetal harm in 3rd trimester and affects breastfeeding in infants

CNS depressants (opioid and alcohol)

↑ sedation with most antiemetics

Antihypertensives can

↑ hypotension

Anticholinergic meds can

↑ anticholinergic effects

Aprepitant can decrease effectiveness of

warfarin and ethinyl estradiol

Aprepitant can increase

levels of glucocorticoids

Nurses should match antiemetic

to cause (chemo, motion, anxiety, GI)

Preventative dosing works

better than treating active nausea

CINV should be given

before chemotherapy

Combining 3 antiemetics is

more effective than one

Aprepitant post op admin

give 1 dose within 3 hr of anesthesia

Aprepitant CINV admin

give 1 hr before chemo, then daily for 2 more days

Ondansetron: IV

1 hr before chemo

Ondansetron: PO

1 hr before anesthesia

Ondansetron: radiation PO admin

3x/day

Prochlorperazine monitor

orthostatic BP, pulse, respiratory rate, ECG

Watch for Q- and T- wave changes

Dronabinol Appetite admin

give before lunch & supper

Dronabinol emesis admin

Q4H PRN

Scopolamine motion sickness admin

apply patch behind ear 4 hr before travel or take tablet 1 hr before

Lorazepam should be given

with food to reduce GI upset

Bulk-Forming Laxative example

Psyllium, Methylcellulose

Bulk-Forming MOA

Absorb water → swell → form soft, bulky stool → stimulate peristalsis

Bulk forming therapeutic uses

temporary treatment of constipation

control stool (ileostomy or colostomy)

Bulk forming memory trick

Fiber = form + flow

they form bulk so stool can flow

Stool softening/surfactant example

docusate sodium

stool softening MOA

Lower stool surface tension → allow water & fat to enter stool → soften it.

stool softening therapeutic use

treat constipation by softening fecal impaction

stool softening docusate memory trick

Do-go-soft

stimulant examples

Bisacodyl, senna

Stimulant MOA

Directly stimulate intestinal nerves → increase peristalsis

stimulant therapeutic use

short-term opioid-induced constipation

stimulant memory trick

start the squeeze

osmotic examples

magnesium hydroxide, lactulose

osmotic therapeutic use

low dose: prevent painful elimination

high dose: prep for surgery or colonoscopy

osmotic magnesium hydroxide memory trick

mag makes everything move

with pregnancy and lactation these meds should be used with caution

docusate sodium, lactulose, and magnesium hydroxide

Laxatives are contraindicated in clients who have

fecal impaction, bowel obstruction, and acute surgical abdomen to prevent perforation

nausea, cramping, abdominal pain

all laxatives besides bulk-forming are contraindicated in clients who have

ulcerative colitis and diverticulitis

Adsorbents example

Bismuth subsalicylate

Adsorbents MOA

Coats GI tract walls

Binds bacteria/toxins

Eliminates them in stool

Adsorbents bismuth memory trick

Band-Aid for the bowel

Anti-Motility example

Loperamide, diphenoxylate, codeine, paregoric (tincture of opium)

Anti-Motility MOA

Slows peristalsis

Reduces smooth muscle tone

Decreases rhythmic contractions

Anti-Motility memory trick

Anti-movement

Probiotics MOA

Replenish normal flora (Lactobacillus)

Restore balance

Reduce growth of diarrhea‑causing bacteria

Probiotics memory trick

Pro-balance

H. pylori antibiotics MOA

Kill H. pylori, the bacteria responsible for many gastric and duodenal ulcers

H. pylori antibiotics complications/adverse effects

nausea

diarrhea

H. pylori antibiotics precautions “kill the bug, protect the gut”

Antibiotics kill good bacteria too → consider probiotics to restore gut flora.

Monitor for worsening GI symptoms.

H. pylori antibiotics administration

2–3 antibiotics at the same time for 2 weeks

Metronidazole is best taken with food

Administration varies by antibiotic

H. pylori antibiotic education

complete the entire course of antibiotics

avoid irritants (smoking, alcohol, NSAIDs)

Histamine‑2 Receptor Antagonists (H2 Blockers) examples

cimetidine and famotidine

H2 blockers MOA

Block H2 receptors on parietal cells → decrease gastric acid secretion and lower hydrogen ion concentration.

H2 blockers contraindications

Kidney/Liver impairment

H2 blocker precautions

pregnancy/lactation

older adults

clients at high risk for pneumonia

H2 blocker admin

Mostly PO

Famotidine can be IV for acute situations

H2 blocker education

Avoid smoking, alcohol, NSAIDs, irritating foods

Report GI bleeding (black stools, coffee‑ground emesis)

Continue therapy until ulcer heals

H2 blockers memory trick

halt the hydrogen

Proton Pump Inhibitors (PPI) example

omeprazole

PPI MOA

Irreversibly block the proton pump (H⁺/K⁺‑ATPase) in parietal cells → most powerful acid suppression available.

PPI key complications/ADR

Headache, diarrhea, nausea

Long‑term use: risk of fractures, pneumonia, C. diff, hypomagnesemia

PPI contraindications

misoprostol (pregnancy/lactation)

pantoprazole (lactation)

taking rilpivirine

PPI education

do not crush, chew, break, or sprinkle contents of sustained release

pantoprazole can be IV

PPI admin

1/day b4 eating

PPI memory trick

Pump off, proton off

Antacids example

aluminum hydroxide

Antacids MOA

Neutralize existing stomach acid

Do not prevent acid production—just buffer what’s already there

Antacids admin

up to 7/day

1 hr and 3 hr after meals