Pharm 6

• Antiemetics prevent nausea and vomiting
• Emetics stimulate vomiting
• Acid Neutralizers (Antacids):

  • Action: Neutralize or reduce the acidity of stomach and duodenal contents by combining with HCl and increasing the pH of the stomach acid (helps treat peptic ulcer disease)
• Acid neutralizers (Antacids) May interfere with the activity of other oral drugs, no oral drug should be administered within 5 to 10 minutes of an antacid.
• Acid-reducing agents reduces the secretion of gastric acid
• Histamine H2 antagonist: Inhibit the action of histamine at H2 receptor cells of the stomach

  meds: Tagamet (Cimetidine)
• Proton Pump Inhibitor:

  • suppress gastric acid secretion by inhibition of hydrogen–potassium adenosine triphosphatase enzyme system of the gastric parietal cells
  • block the final step in the production of gastric acid by the gastric mucosa also called the acid (proton) pump system

  Meds: Omeprazole
• Proton pump inhibitor use:

  H. pylori (treated with proton pump inhibitors and two anti-infectives)

  meds: Metronidazole
• Pepsin inhibitor: binds with protein molecules toform a viscous substance which buffers acid andprotects the mucosal lining (e.g., sucralfate)

  Meds: Sucralfate
• Miscellaneous Acid Reducer:

  • misoprostol = Prostaglandin E analog
• Gastrointestinal Stimulant: increases the motility of the upper GI tract without increasing the production of secretions; results in faster emptying of gastric contents into small intestine

  meds: metoclopramide(prokinetic/dopamine antagonist)
• Antiemetic: 5-hydroxytryptamine type 3 (5HT3)receptor antagonists

  • target and inhibit serotonin receptors in both the CTZ and peripherally acting at the nerve endings in the stomach

  meds: ondansetron
• Antiemetic Use: irritable bowel syndrome

  
  

  Meds: Lotronex
• Aminosalicylates: Aspirin-like compound with anti-inflammatory action

  meds: sulfasalazine
• Antidiarrheals: diphenoxylate

  Action: decrease intestinal peristalsis, which often is increased when the client has diarrhea

  • Notify physician if diarrhea unresolved after 48 hours
• Antidiarrheals: loperamide

  • Action: Act directly on the muscle wall of the bowel to slowmotility
  • Use: to treat chronic diarrhea
• Laxatives:

  • Stool softener (Docusate sodium) promote water retention in the fecal mass and soften the stool.
  • Stimulant Laxative (bisacodyl) increase peristalsis by direct action on the intestine
• Bulk-producing laxatives-adds bulk and water to thecontents of the intestines. Stimulates peristalsis andencourages evacuation of the stool
• Laxative:

  • Hyperosmotic (lactulose) agents: reduction of blood ammonia levels in hepatic encephalopathy
  • Meds: Lubiprostone
• Excessive or prolonged use of laxatives should be avoided due to potential for physical dependence on them for normal bowel movements
• • Give bulk-producing or stool-softening laxatives with full glass of water or juice
  • bulk-producing laxatives are followed by an additional glass of water
• Urinary Anti-infectives

  • anti-infectives used to treat UTIs have a rapid excretion rate and have a high concentration in the urine; interfere with bacterial multiplication in the urine

  Meds: Nitrofurantoin, Phenazopyridine
• Urinary Anti-infective adverse reactions:

  * Diarrhea

  *Stomatitis

  
  

  If signs of pulmonary reaction occur, withhold dose and contact the provider!!!
• For patient receiving a urinary anti-infective drug encourage client to drink at least 2000 mL of fluid daily to dilute urine and decrease pain on voiding
• For Urinary anti-infective:

  *Inform the client that phenazopyridine must be taken after meals and may cause a reddish-orange discoloration of urine and tears

  *May stain clothing or contact lenses
• Topical antibiotics (example: bacitracin ointment)
• Topical Immunomodulators: Contraindicated in patients who are allergic to macrolide (erythromycin) antibiotics
• Topical antifungals: Slow or retard the multiplication of fungi

  Meds: Nystatin, Ketoconazole
• Drugs for Glaucoma

  Prostaglandin Agonists: act to lower IOP by increasing the outflow ofaqueous humor through the trabecular meshwork

  
  

  Meds: Latanoprost
• Drugs used for infection and inflammation:

  Sulfonamides (silver sulfadiazine)
• Antiviral drugs: disables the protein part of the virus

  Meds: Acyclovir
• Only instill solutions labeled “ophthalmic” in the eye
• Client Receiving an Ophthalmic Preparation

  • Apply ophthalmic drops into the middle of the lower conjunctival sac; not directly on eyeball
  • Apply ophthalmic ointment to the eyelids or drop into lower conjunctival sac
  • After instillation of eye solution, apply pressure on inner canthus
  • When two different eye drop medications are prescribed; allow for 5 minutes in between administration
• Aminopenicillins: Amoxicillin susp
• Aminoglycodise: Gentamicin
• Fluoroquinolones: Interferes with the synthesis of bacterial enzymes, which prevents making of bacterial

  Meds: Ciprofloxacin
• Phenazopyridine: Exerts a topical analgesic effect on the lining of the urinary tract
• Trimethoprim and sulfamethoxazole: Bacteriostatic that treats urinary tract infections
• Lubiprostone Capsules (Amitiza): Chronic idiopathic constipation