GI and Diuretics

Luffy ate so much he having heart burn

Calcium Carbonate

Drug Class: antacid

CONTRAINDICATIONS: hypercalcemia, kidney disease/kidney stones

Mechanism of action = neutralizes gastric acid, increasing gastric pH

Therapeutic uses = heartburn, acid indigestion, symptom relief in GERD and PUD

Nursing considerations =

  1. Separate from other meds by 1-2 hrs and do not exceed max daily dose

  2. Chew tablets completely and follow with water

Patient teaching =

  • smoking cessation

  • avoid alcohol and caffeine

  • avoid spicy and fatty

  • REPORT symptoms lasting >2 weeks

Adverse effects =

  • hypercalcemia, rebound hyperacidity when discontinued

  • constipation


Aluminum hydroxide and Magnesium hydroxide

Drug Class: antacid

CONTRAINDICATIONS: kidney disease and Mg2+ - restricted diets

Mechanism of action = neutralizes gastric acid, increasing gastric pH. Aluminum (constipating) balances magnesium (laxative).

Therapeutic uses = heartburn, acid indigestion, sour stomach

Nursing considerations =

  1. Separate from other meds by 1-2 hrs

  2. Shake suspension well

  3. Give after meals and bedtime as directed

Patient teaching =

  • educate client to take with full glass of water

  • report persistent symptoms of black tarry stools

Adverse effects =

  • diarrhea (magnesium hydroxide)

  • constipation (aluminum hydroxide)

  • hypermagnesemia in renal impairment


Luffy swollen he needs his histamines

Famotidine

Drug class: H-2 receptor antagonist

CONTRAINDICATIONS: use caution and adjust dose in renal impairment

Mechanism of action = blocks histamine (H2) receptors on parietal cells → reducing gastric secretion

Therapeutic uses = GERD, PUD, and prevention and treatment of heartburn

Nursing considerations =

  1. Give famotidine 15-60 min before meals *monitor older adults for confusion*

Patient teachings =

  • avoid smoking, alcohol, and NSAIDs

  • report increased pain or GI bleed immediately

    • coffee ground emesis, black stools

Adverse effects =

  • headache, dizziness, constipation, diarrhea

  • confusion (older adults, renal impairment)

Luffy shrunk bc no more stomach acid being made

Pantoprazole (Protonix) & Omeprazole (Prilosec) (-prazole)
Drug class: proton pump inhibitors (PPI)

Mechanism of action = blocks proton pump (H+/K+ ATPase) which is the final step of gastric acid secretion → in turn decreases stomach acid production

Therapeutic uses = GERD, erosive esophagitis, PUD, H.pylori as a combination medication

Nursing considerations =

  1. Do not crush or chew - granules may go into apple juice and apple sauce

  2. Give before meals

  3. Monitor Mg2+ and bone health long term

DO NOT STOP ABRUPTLY (REBOUOND ACID); AVOID ALCOHOL/NSAIDS

Patient teachings =

  • report increased pain or coffee ground emesis

Adverse effects =

  • headache, abdominal pain, diarrhea, constipation

  • anaphylaxis, skin reactions

  • acute renal dysfunction, lupus; long term bone, hypomagnesemia, B12 deficiency

Big bouncy shield Luffy protecting ulcer sites

Sucralfate

Drug class: mucosal protectant

CONTRAINDICATIONS: use caution with renal failure and diabetes

Mechanism of action = forms a protective barrier over the ulcer site, shielding it from acid and pepsin

Therapeutic uses = duodenal ulcers (treatment and maintenance)

Nursing considerations =

  1. Separate from antacids by 30 minutes

  2. Give on an empty stomach 1-2 hrs before meals

MONITOR FOR CONSTIPATION AND ALUMINUM TOXICITY

Patient teachings =

  • educate client to increase fluids and fiber to finish the full course even if the pain improves

Adverse effects =

  • constipation, aluminum toxicity in renal failure

  • hyperglycemia in clients with diabetes


Gas leaving chiikawas booty and relieves his bloating.

Simethicone

Drug Class: anti-flatulent

CONTRAINDICATION: hypersensitivity

Mechanism of action = breaks up gas bubbles in the GI tract to relieve bloating

Therapeutic uses = gas, bloating, flatulence, post-op gas pain

Nursing considerations =

  1. Give after meals and at bedtime

  2. Chew the tablets thoroughly

  3. Encourage ambulation to relieve gas

Patient education =

  • educate client to reduce swallowed air

  • avoid straws

  • avoid straws and carbonated drinks

Adverse effects =

  • occasional nausea, constipation, diarrhea, and headache

  • rare allergic reaction


bismuth subsalicylate binding to bacteria lolchiikawa has dark stool and a dark tongue from bismuth subsalicylate

Bismuth Subsalicylate

Drug class: antidiarrheal - absorbent

CONTRAINDICATIONS: REYE’S SYNDROME IN CHILDREN RECOVERING IN CHICKENPOX, ULCERS, BLEEDING CONDITIONS, BLOODY OR BLACK STOOLS

Mechanism of action = binds to bacteria and toxins in the intestine; also has antisecretory effects

Therapeutic uses = traveler’s diarrhea, indigestion, upset stomach

Nursing considerations =

  1. Avoid with other salicylates (ASA)

  2. Educate client that dark tongue/stool is EXPECTED

Adverse effects =

  • black/darkened tongue and stool

  • salicylate toxicity (tinnitus)

  • avoid in pregnancy, especially in 3rd trimester and breastfeeding