The mechanism of action of diphenoxylate (Lotomil) is:
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Solution
A decrease in peristalsis in the intestinal wall
Diphenoxylate acts on the smooth muscle of the intestinal tract to inhibit GI motility and excessive propulsion of the GI tract (peristalsis).
Side effects of loperamide (Imodium) include all of the following except?
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Solution
Diarrhea
Side effects associated with loperamide include CNS fatigue and dizziness, epigastric pain, abdominal cramps, nausea, dry mouth, vomiting, and anorexia. Diarrhea is an indication, not a side effect.
Bismuth subsalicylate (Pepto-Bismol), as an absorbent, has which of the following mechanisms of action?
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Solution
Binding to diarrhea-causing bacteria for excretion
Absorbent antidiarrheal medications bind to diarrhea-causing bacteria to form a nonabsorbable complex, which is then excreted in the stool.
To avoid fecal impaction, psyllium (Metamucil) should be administered with at least how many ounces of fluid?
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Solution
3. 8
Bulk-forming laxatives must be given with at least 8 ounces of liquid plus additional liquid each day to prevent intestinal obstruction.
Sucralfate (Carafate) achieves a therapeutic effect by:
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Solution
Forming a protective barrier around gastric mucosa
Sucralfate has a local effect only on the gastric mucosa. It forms a paste-like substance in the stomach, which adheres to the gastric lining, protecting against adverse effects related to gastric acid. It also stimulates healing of any ulcerated areas of the gastric mucosa.
When administering sucralfate (Carafate) to a patient with a nasogastric tube, it is important to:
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Solution
Allow the tablet to dissolve in water before administering
It is important to give sucralfate on an empty stomach so that it may dissolve and form a protective barrier over the gastric mucosa. The tablet form will not dissolve in water when crushed; it must be left whole and allowed to dissolve. Crushing the medication so that it will not dissolve could lead to clogging of the nasogastric tube and decreased effectiveness of the drug.
A patient unable to tolerate oral medications may be prescribed which of the following proton pump inhibitors to be administered intravenously?
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Solution
pantoprazole (Protonix)
Pantoprazole is the only proton pump inhibitor that is available for intravenous administration. The other medications in this category may only be administered orally.
Proton pump inhibitors:
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Solution
Achlorhydria
Because the proton pump inhibitors stop the final step of acid secretion, they can block up to 90% of acid secretion, leading to achlorhydria (without acid).
Histamine2-receptor antagonists:
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Solution
Compete with histamine for binding sites on the parietal cells
Histamine receptor blocking agents decrease gastric acid by competing with histamine for binding sites on the parietal cells.
Which of the following nursing diagnoses is appropriate for a patient receiving famotidine (Pepcid)?
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Solution
Potential risk for bleeding related to thrombocytopenia.
A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in platelet count and an increased risk of bleeding.