GALEN COLLEGE OF NURSING (NUR 210) PHARMACOLOGY EXAM 4: MEDICATIONS
FOR GASTROINTESTINAL DISORDERS
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PHARMACOLOGY EXAM 4
Units 10 and 11
MEDICATIONS FOR GASTROINTESTINAL DISORDERS
antiemetics, antidiarrheals, laxatives
Pathophysiology Considerations
Vomiting
o A 昀昀 ected by cerebral centers vomiting center, chemoreceptor trigger zone
(CTZ), & vestibular center
o Chemoreceptor trigger adrenergic activation and cholinergic reaction vomiting
center triggered patient vomits dopamine release (only happens with 昀椀 rst
emesis)
o Vomiting with no accompanying nausea may be indicative of brain damage
o BRAT diet bread, apples, rice, toast helps ease vomiting
Diarrhea
o Spoiled foods, bacteria, drug reactions
o Laxative abuse, fecal impaction
o Malabsorption disorders, bowel tumors, IBD
o Stress, anxiety
Constipation
o Bowel obstruction, fecal impaction
o Chronic laxative use eating disorders
o Ignoring use to defecate
o Neurologic disorders
o Lack of exercise
o Insu 昀케 cient consumption of 昀椀 ber or water
Peptic Ulcers
o Erosion of the mucosal lining can be esophageal, gastric, or duodenal
o Can be caused by hypersecretion of HCL or pepsin
o Stomach pH is 2 - 5
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o Risk Factors
o H. pylori infection tested for by a breath test
o Genetics
o Environmental factors
o Drug use
o Stress
o S/S gnawing, aching pain after eating
Gastroesophageal Re 昀氀 ux Disease (GERD)
o In 昀氀 ammation of esophageal mucosa caused by re 昀氀 ux of gastric acid into the esophagus
o Main cause incompetent lower esophageal sphincter (Cardiac sphincter)
o Smoking and alcohol can make it worse
o Interventions
o Sit upright for meals
o Do not eat right before bedtime
o Wear loose-昀椀 tting clothing
o Avoid hot, spicy, greasy foods
o Take any NSAIDs with food
Dopamine Dopamine is a neurotransmitter that has grossly excitatory e 昀昀 ects on
movement and helps facilitate controlled/voluntary movements
• Dopamine often has an opposing or complimentary relationship
with acetylcholine that changes depending on context
• Associated with executive functions: attention, working memory,
problem- solving
• Stimulation of dopamine pathways/centers can cause vomiting and
movement disorders (extrapyramidal symptoms)
Serotonin (5-HT) Serotonin is a neurotransmitter that regulates behavior, mood,
memory, and gastrointestinal homeostasis it is most often excitatory to the CNS
• Inotropic and chronotropic e 昀昀 ects increases intracellular calcium in cardiac
myocytes pharmacological modulation can lead to tachyarrhythmias
• Serotonin increases gastric emptying and gut motility
• Serotonin regulates pancreatic secretions, increases insulin secretion, glucose
uptake in muscle tissue, lipogenesis in fat tissue, and lipid accumulation in the
liver
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