Medications (separated)

odansetron therapeutic uses

prevents emesis r/t chemotherapy, radiation therapy, postoperative recovery

NV

odansetron complications

HA

diarrhea

dizziness

prolonged QT interval

odansetron contraindications/precautions

caution in pregnancy/breastfeeding

do not administer to those w/ known prolonged QT interval

odansetron interactions

other QT prolonging agents

cimetidine, famotidine therapeutic uses

prevent or treat gastric and duodenal ulcers, GERD, hypersecretory conditions, heartburn, acid indigestion

used in conjunction w/ antibiotics to treat H. pylori ulcers

cimetidine, famotidine complications

blocked androgen receptors

• decreased libido, gynecomastia, impotence

CNS**

• lethargy, hallucinations, confusion, restlessness

GI

• constipation, diarrhea, nausea

cimetidine, famotidine contraindications/precautions

caution during pregnancy/breastfeeding

older adults are more likely to experience CNS effects

kidney impairment? reduce dose

caution in those at risk pneumonia

• COPD

cimetidine, famotidine interactions

P450 enzymes

• warfarin, phenytoin, theophylline, lidocaine

omeprazole therapeutic uses

short-term therapy of gastric and duodenal ulcers, erosive esophagitis, GERD

• 4-8 wk treatment

prevention of stress ulcers for at-risk clients during acute events

omeprazole complications

pneumonia

osteoporosis and fractures

rebound acid hypersecretion

hypomagnesemia

Clostridium difficile-associated diarrhea

omeprazole contraindications/precautions

avoid during pregnancy/breastfeeding

caution in children and those w/ dysphagia or liver dx

caution in those at risk for pneumonia

omeprazole interactions

P450 enzymes

• increase levels of digoxin, methotrexate, diazepam, tacrolimus, antifungals, phenytoin

• decrease levels of antifungals and protease inhibitors

• clopidogrel

sucralfate therapeutic uses

treatment of acute duodenal ulcers and maintenance therapy

sucralfate complications

no systemic complications

constipation

sucralfate interactions

P450

• phenytoin, digoxin, warfarin, ciprofloxacin

antacids

• take 30 min before or after antacids

sucralfate contraindications/precautions

safe in pregnancy and breastfeeding

caution in those w/ CKD and DM

aluminum hydroxide therapeutic uses

PUD

prevention of stress-induced ulcers

GERD

aluminum hydroxide complications

constipation, diarrhea

fluid retention

electrolyte abnormalities

• aluminum: hyperphosphatemia

alkalosis

aluminum hydroxide contraindications/precautions

caution in those w/ GI perforation or obstruction

aluminum hydroxide interactions

decrease the absorption of several medications

• allow >/= 1 hr between antacids and other medications

aluminum compounds bind to warfarin, digoxin, tetracycline

• reduce their effects

alosetron therapeutic uses

females w/ severe IBS-D that has lasted > 6 months and has been resistant to conventional treatment

alosetron complications

constipations

• Can result in GI toxicity: ischemic colitis, bowel obstruction, impaction, perforation

  • Potentially fatal

alosetron contraindications/precautions

contraindications: chronic constipation, hx of bowel obstruction, Crohn dx, UC, impaired intestinal circulation, diverticulitis, hx of toxic megacolon, GI perforation or adhesions, or thrombophlebitis

alosetron interactions

P450 enzymes

• phenobarbital

lubiprostone therapeutic uses

females w/ IBS-C

chronic constipation

lubiprostone complications

diarrhea

nausea

• take this medication w/ food

lubiprostone contraindications/precautions

caution in pregnancy/breastfeeding

contraindications: bowel obstruction

lubiprostone interactions

no significant interactions to report

sulfasalazine therapeutic uses

Crohn disease

mild to moderate acute episodes of UC

sulfasalazine complications

blood disorders

• agranulocytosis

• hemolytic anemia

• macrocytic anemia

nausea, fever, rash, arthralgia

sulfasalazine contraindications/precautions

Caution in pregnancy

• Risk of neural tube defects

Safety not established in breastfeeding

Can cause infertility in males

Contraindications: sensitivity to sulfonamides, salicylates, or thiazide diuretics

Caution in those w/ liver, kidney, blood disorders

sulfasalazine interactions

iron

antibiotics

dephenoxylate plus atropine therapeutic uses

diarrhea

diphenoxylate plus atropine complications

High doses

• Opioid effects: euphoria, CNS depression

• Addition of atropine discourages ingestion of doses higher than those prescribed

  • Anticholinergic effects

diphenoxylate plus atropine contraindications/precautions

Caution in pregnancy/breastfeeding

Increased risk of megacolon w/ IBD

Contraindicated in those w/ severe fluid/electrolyte imbalances

Schedule V agent

diphenoxylate plus atropine interactions

CNS depressants

anticholinergics

psyllium therapeutic uses

Constipation, decrease diarrhea w/ diverticulosis and IBS, control stool for those w/ ileostomy or colostomy

psyllium complications

GI irritation

obstruction

psyllium contraindications/precautions

contraindications: fecal impaction, bowel obstruction, acute surgical abdomen, nausea, cramping, abdominal pain

psyllium interactions

laxatives

docusate sodium therapeutic uses

constipation, softening of fecal impaction

docusate sodium complications

GI irritation

sodium absorption

fluid retention

docusate sodium contraindications/precautions

contraindications: fecal impaction, bowel obstruction, acute surgical abdomen, nausea, cramping, abdominal pain, UC, diverticulitis

docusate sodium interactions

laxatives

bisacodyl therapeutic uses

bowel preparation prior to surgery or endoscopy, short-term treatment of constipation caused by opioid use or slow intestinal transit

bisacodyl complications

GI irritation

rectal burning sensation leading to proctitis

• do not use suppositories on a regular basis

bisacodyl contraindications/precautions

Contraindications: fecal impaction, bowel obstruction, acute surgical abdomen, nausea, cramping, abdominal pain, UC, diverticulitis

bisacodyl interactions

milk and antacids

• destroy the coating

laxatives

magnesium hydroxide therapeutic uses

low dose: prevent painful elimination

high dose: preparation prior to surgery or endoscopy

magnesium hydroxide complications

GI irritation

toxic magnesium levels

dehydration

magnesium hydroxide contraindications/precautions

contraindications: fecal impaction, bowel obstruction, acute surgical abdomen, nausea, cramping, abdominal pain, UC, diverticulitis

magnesium hydroxide interactions

laxatives

magnesium

metoclopramide therapeutic uses

IV: NV

PO: gastroparesis and GERD

metoclopramide complications

tardive dyskinesia

EPS

• administer an antihistamine to minimize EPS

sedation

diarrhea

metoclopramide contraindications/precautions

caution in children and older adults

• increased risk of EPS

contraindications: GI perforation, bowel obstruction, and GI hemorrhage, seizures

metoclopramide interactions

CNS depressants

opioids and anticholinergics

• decrease the effects