part 1

  • Antacids neutralize stomach acid to relieve heartburn and indigestion.
    • Monitor for electrolyte imbalances and space out from other medications.
    • Formulations are aluminum-based (cause constipation), magnesium-based (cause loose stools, diarrhea), or calcium-based
  • Histamine 2 Receptor Antagonists (end in -dine) block histamine production in the stomach lining to promote ulcer healing and reduce acid-related irritation.
    • Can cause diarrhea or constipation.
    • Avoid smoking, alcohol, and NSAIDs.
  • Proton Pump Inhibitors (PPIs, end in -zole) decrease acid production by proton pumps in the stomach lining.
    • Long-term use can lead to mineral deficiencies (calcium, magnesium) and increased risk of C. Diff infections.
    • Take 30 minutes before meals; do not crush or chew tablets.
  • H. Pylori Treatment:
    • First-line: Triple therapy (PPI + amoxicillin + clarithromycin).
    • Second-line: Quadruple therapy (tetracycline + metronidazole + PPI + bismuth subsalicylate).
  • Stool Softeners (e.g., docusate sodium) increase water absorption in the stool.
    • Appropriate for mild constipation or prevention.
    • Take with a full glass of water.
  • Laxatives stimulate or irritate the bowel.
    • Bulk-Forming (e.g., psyllium): absorb water to soften stool and increase bulk.
      • Mix with a full glass of water and drink immediately.
    • Stimulant (e.g., bisacodyl, senna): increase bowel motility.
      • Suppositories are effective for stool in the lower rectum.
    • Osmotic (e.g., MiraLAX): draw water into the bowel.
      • Mix with a full glass of water and drink immediately.
    • Monitor for dehydration and electrolyte imbalances.
  • Small Bowel Obstruction symptoms include cramping abdominal pain, nausea/vomiting, bloating/distension, and absence of stool or gas.
    • Do not administer laxatives.
  • Mucosal Protectants (e.g., sucralfate) form a protective barrier in the stomach.
    • Take on an empty stomach; avoid taking with antacids.
  • Antidiarrheals decrease bowel motility or thicken stool.
    • Examples: loperamide, diphenoxylate/atropine.
    • Avoid alcohol and use if diarrhea is caused by an infection.
  • Probiotics restore normal gut flora.
    • Monitor for bloating or gas.
    • Follow product instructions; some require refrigeration.
  • Hepatic Encephalopathy is treated with Lactulose which decreases ammonia levels by drawing ammonia from the blood into the colon and causing diarrhea, facilitating ammonia excretion.
    • Goal: 3 loose stools per day.
    • Monitor for extreme diarrhea or no improvement in confusion; ensure adequate hydration.