Drugs acting on the GI system include:
- Antiemetics which prevent nausea and vomiting like ondansetron and metoclopramide.
- Laxatives and purgatives like lactulose, bisacodyl, and docusate which are used to treat constipation.
- Antacids such as aluminum hydroxide, magnesium hydroxide, and calcium carbonate which neutralize stomach acid.
- Cholinergic drugs which increase GI motility and secretions. Anticholinergic drugs block acetylcholine and decrease motility and secretions.
Slides are prepared as per INC Syllabus Unit V Drugs used on Respiratory systems and it is most benefited for 2nd yr B sc Nursing students and faculty of the subject.
Pharmacology of commonly used antisep, disinfect, insecticideMr. Dipti sorte
Slides are prepared as per INC Syllabus Unit III Antiseptics & Disinfectants and it is most benefited for B sc Nursing students and faculty of the subject
Slides are prepared as per INC Syllabus Unit V Drugs used on Respiratory systems and it is most benefited for 2nd yr B sc Nursing students and faculty of the subject.
Pharmacology of commonly used antisep, disinfect, insecticideMr. Dipti sorte
Slides are prepared as per INC Syllabus Unit III Antiseptics & Disinfectants and it is most benefited for B sc Nursing students and faculty of the subject
Slides are prepared as per INC Syllabus Unit IX Drugs used in nervous system and it is most benefited for B sc Nursing students and faculty of the subject
short and simple study on the topic of laxative and purgatives which is very usefull for the student , teachers, as well as health cares peoples. this study is done by the student with the help of teachers
Omeprazole, sold under the brand names Prilosec and Losec, among others, is a medication used in the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger–Ellison syndrome.It is also used to prevent upper gastrointestinal bleeding in people who are at high risk. Omeprazole is a proton-pump inhibitor (PPI) and its effectiveness is similar to other PPIs. It can be taken by mouth or by injection into a vein.
Common side effects include nausea, vomiting, headaches, abdominal pain, and increased intestinal gas.[1][9] Serious side effects may include Clostridium difficile colitis, an increased risk of pneumonia, an increased risk of bone fractures, and the potential of masking stomach cancer.[1] It is unclear if it is safe for use in pregnancy.[1] It works by blocking the release of stomach acid.[1]
The gastrointestinal tract is an organ system within humans and other animals which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces. The mouth, esophagus, stomach and intestines are part of the gastrointestinal tract
Drugs using for GI system(pharmacology)varsha surkar
INC Syllabus • Antiemetics • Emetics • Purgatives • Antacids • Cholinergic • Anticholinergics • Fluid and Electrolyte therapy • Antidiarrheals • Histamines Composition, Action, Dosage, Route, Indications, Contraindications, Drug Interactions, Side effects, Adverse effects, Toxicity & Role of nurse Proton pump inhibitors
3. Antiemetics •Antiemetics are the Drugs which prevent or control the Vomiting/Nausea.
4. Antiemetics • Antiemetic are the drugs which prevent or control the vomiting/nausea. Classification Ondansetron 5HT3 AntagonistsGranisetron Dolasetron Domperidone Prokinetics / Dopamine AntagonistsOlanzapine Metoclopramide Cyclizine Antihistamines Diphenhydramine Meclozine Promethazine Hydroxyzine Hyoscine & Dicyclomine Anticholinergics
5. Mechanism of action • 5HT3 Antagonists: They block serotonin receptors in CNS and Gastrointestinal tract So they can be used to treat post operative and cytotoxic (Chemotherapy) drugs nausea/ vomiting. • Prokinetics (Dopamine Antagonists): They block the dopamine neurotransmitter also they promote gastrointestinal motility & quicken gastric emptying. • Antihistamines: They block the histamine neurotransmitter and they act by an effect on vomiting center and by producing sedation. • Anticholinergics: An Anticholinergic agents block the neurotransmitter Acetyl choline in central and peripheral nervous system.
6. Drug example and doses S. No. Drugs Doses 1 Hyoscine 200-600mg (SC) 2 Diclomine 40mg 6hourly 3 Cyclizine 50mg 4-6 hour 4 Meclizine 25mg/day. 5 Metoclopramide 10mg 6 Domperidone 10-20 mg 4-6hours 7 Ondansetron 8-16mg
7. Indications / Uses •5HT3 antagonists are used in management of nausea vomiting associated with chemotherapy. •Antihistamine such as diphen hydramine is used for motion sickness and morning sickness. •Metoclopramide is used for gastric emptying in patient’s receiving tube feeding. •Anticholinergic such as hyoscine, Dicyclomine are useful in travel sickness.
8. Contraindication / Precautions •Diphenhydramine is contraindicated in hypertensive patients. •Metoclopramide is contraindicated in suspected gastrointestinal problem. •Use cautiously and reduced dose in renal impairment conditions.
9. Adverse effects •Hypotension. •Constipation. •Dryness of mouth. •Blurred vision. •Pain in IM injection site. •Drowsiness. •Rectal irritation. •Photo sensitivity reaction.
10. Drug interactions •Use antihistamine, other CNS depressants including opioids and sedative – hypnotic drugs causes additive CNS depression. •Metoclopramide affects GI motility and alter GI absorption of other drugs such as salicylates, levodopa, diazepam, lithium, tetracycline.
11. Nursing Responsibilities •Assess the patient for nausea/vomiting and fluid and electrolyte imbalances. •Decrease metoclopramide dose 50% of usual recommended dose if creatinine clearance is less than 40ml/min. •Instruct the patient not to consume alcohol when taking an antiemetic drugs. •Advise the patient to take oral antiemetics 1hour.
Slides are prepared as per INC Syllabus Unit IX Drugs used in nervous system and it is most benefited for B sc Nursing students and faculty of the subject
short and simple study on the topic of laxative and purgatives which is very usefull for the student , teachers, as well as health cares peoples. this study is done by the student with the help of teachers
Omeprazole, sold under the brand names Prilosec and Losec, among others, is a medication used in the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger–Ellison syndrome.It is also used to prevent upper gastrointestinal bleeding in people who are at high risk. Omeprazole is a proton-pump inhibitor (PPI) and its effectiveness is similar to other PPIs. It can be taken by mouth or by injection into a vein.
Common side effects include nausea, vomiting, headaches, abdominal pain, and increased intestinal gas.[1][9] Serious side effects may include Clostridium difficile colitis, an increased risk of pneumonia, an increased risk of bone fractures, and the potential of masking stomach cancer.[1] It is unclear if it is safe for use in pregnancy.[1] It works by blocking the release of stomach acid.[1]
The gastrointestinal tract is an organ system within humans and other animals which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces. The mouth, esophagus, stomach and intestines are part of the gastrointestinal tract
Drugs using for GI system(pharmacology)varsha surkar
INC Syllabus • Antiemetics • Emetics • Purgatives • Antacids • Cholinergic • Anticholinergics • Fluid and Electrolyte therapy • Antidiarrheals • Histamines Composition, Action, Dosage, Route, Indications, Contraindications, Drug Interactions, Side effects, Adverse effects, Toxicity & Role of nurse Proton pump inhibitors
3. Antiemetics •Antiemetics are the Drugs which prevent or control the Vomiting/Nausea.
4. Antiemetics • Antiemetic are the drugs which prevent or control the vomiting/nausea. Classification Ondansetron 5HT3 AntagonistsGranisetron Dolasetron Domperidone Prokinetics / Dopamine AntagonistsOlanzapine Metoclopramide Cyclizine Antihistamines Diphenhydramine Meclozine Promethazine Hydroxyzine Hyoscine & Dicyclomine Anticholinergics
5. Mechanism of action • 5HT3 Antagonists: They block serotonin receptors in CNS and Gastrointestinal tract So they can be used to treat post operative and cytotoxic (Chemotherapy) drugs nausea/ vomiting. • Prokinetics (Dopamine Antagonists): They block the dopamine neurotransmitter also they promote gastrointestinal motility & quicken gastric emptying. • Antihistamines: They block the histamine neurotransmitter and they act by an effect on vomiting center and by producing sedation. • Anticholinergics: An Anticholinergic agents block the neurotransmitter Acetyl choline in central and peripheral nervous system.
6. Drug example and doses S. No. Drugs Doses 1 Hyoscine 200-600mg (SC) 2 Diclomine 40mg 6hourly 3 Cyclizine 50mg 4-6 hour 4 Meclizine 25mg/day. 5 Metoclopramide 10mg 6 Domperidone 10-20 mg 4-6hours 7 Ondansetron 8-16mg
7. Indications / Uses •5HT3 antagonists are used in management of nausea vomiting associated with chemotherapy. •Antihistamine such as diphen hydramine is used for motion sickness and morning sickness. •Metoclopramide is used for gastric emptying in patient’s receiving tube feeding. •Anticholinergic such as hyoscine, Dicyclomine are useful in travel sickness.
8. Contraindication / Precautions •Diphenhydramine is contraindicated in hypertensive patients. •Metoclopramide is contraindicated in suspected gastrointestinal problem. •Use cautiously and reduced dose in renal impairment conditions.
9. Adverse effects •Hypotension. •Constipation. •Dryness of mouth. •Blurred vision. •Pain in IM injection site. •Drowsiness. •Rectal irritation. •Photo sensitivity reaction.
10. Drug interactions •Use antihistamine, other CNS depressants including opioids and sedative – hypnotic drugs causes additive CNS depression. •Metoclopramide affects GI motility and alter GI absorption of other drugs such as salicylates, levodopa, diazepam, lithium, tetracycline.
11. Nursing Responsibilities •Assess the patient for nausea/vomiting and fluid and electrolyte imbalances. •Decrease metoclopramide dose 50% of usual recommended dose if creatinine clearance is less than 40ml/min. •Instruct the patient not to consume alcohol when taking an antiemetic drugs. •Advise the patient to take oral antiemetics 1hour.
laxatives and purgatives. Pharma pptx by Mr. Praveen JaiswalPraveenJaiswal44
This presentation contains information about the commonly used laxative and purgative drugs. This presentation can be used to teach nursing and allied health students.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
4. Antiemetics
• Antiemetic are the drugs which prevent or control the
vomiting/nausea.
Classification
Ondansetron
5HT3 AntagonistsGranisetron
Dolasetron
Domperidone
Prokinetics / Dopamine AntagonistsOlanzapine
Metoclopramide
Cyclizine
Antihistamines
Diphenhydramine
Meclozine
Promethazine
Hydroxyzine
Hyoscine & Dicyclomine Anticholinergics
5. Mechanism of action
• 5HT3 Antagonists: They block serotonin receptors in CNS and
Gastrointestinal tract So they can be used to treat post operative and
cytotoxic (Chemotherapy) drugs nausea/ vomiting.
• Prokinetics (Dopamine Antagonists): They block the dopamine
neurotransmitter also they promote gastrointestinal motility &
quicken gastric emptying.
• Antihistamines: They block the histamine neurotransmitter and
they act by an effect on vomiting center and by producing sedation.
• Anticholinergics: An Anticholinergic agents block the
neurotransmitter Acetyl choline in central and peripheral nervous
system.
6. Drug example and doses
S.
No.
Drugs Doses
1 Hyoscine 200-600mg (SC)
2 Diclomine 40mg 6hourly
3 Cyclizine 50mg 4-6 hour
4 Meclizine 25mg/day.
5 Metoclopramide 10mg
6 Domperidone 10-20 mg 4-6hours
7 Ondansetron 8-16mg
7. Indications / Uses
•5HT3 antagonists are used in management of
nausea vomiting associated with chemotherapy.
•Antihistamine such as diphen hydramine is used
for motion sickness and morning sickness.
•Metoclopramide is used for gastric emptying in
patient’s receiving tube feeding.
•Anticholinergic such as hyoscine, Dicyclomine
are useful in travel sickness.
8. Contraindication / Precautions
•Diphenhydramine is contraindicated in
hypertensive patients.
•Metoclopramide is contraindicated in
suspected gastrointestinal problem.
•Use cautiously and reduced dose in renal
impairment conditions.
10. Drug interactions
•Use antihistamine, other CNS depressants
including opioids and sedative – hypnotic
drugs causes additive CNS depression.
•Metoclopramide affects GI motility and
alter GI absorption of other drugs such as
salicylates, levodopa, diazepam, lithium,
tetracycline.
11. Nursing Responsibilities
•Assess the patient for nausea/vomiting and fluid and
electrolyte imbalances.
•Decrease metoclopramide dose 50% of usual
recommended dose if creatinine clearance is less than
40ml/min.
•Instruct the patient not to consume alcohol when taking an
antiemetic drugs.
•Advise the patient to take oral antiemetics 1hour before
exposures to conditions causing motion sickness or before
travelling.
13. Mechanism of action
•They stimulate the chemoreceptor
trigger zone and gastric mucosa to
induce vomiting.
14. Drug example and doses
S.
No.
Drugs Doses
1 Apomorphine 5mg IM
2 Copper sulfate Given in water every 5 min. until emesis occur.
3 Sodium chloride
(NaCl)
2 table spoon of NaCl in glass of warm water
4 Ipecac syrup 15-30ml (followed by 200ml of water.
15. Indications / Uses
•To induce vomiting.
•To treat poisoning.
•Treatment of overdose of drug.
19. Nursing Responsibilities
•Assess the consciousness level of patient before
administering drug.
•Follow administration of Ipecac syrup with one or two
passes of tepid water or other clear liquid.
•Obtain a history, to find out caustic substances to
determine possible antidotes.
•We should know that lavage is necessary if second dose
not produce vomiting Ipecac may be cardiotoxic if
absorbed.
20. Laxatives/Purgatives
•These drugs are combinedly knows as
purgatives, which includes laxatives and
cathartics these drugs are used to
overcome the constipation and proper
evacuation of bowels.
21. Mechanism of action
•Osmotic laxatives (Magnesium hydroxide) draw water into
the intestine to increase the mass of stool, stretching
musculature which results in peristalsis.
•Stimulant laxatives result in stimulation of intestinal
peristalsis.
•Lubricant laxatives increase water retention in the stool,
prevent water absorption from the stool, and lubricate as
well as soften intestinal contents.
•Stool softener allow more fluid are fat to penetrate the
faeces, producing a softer fecal mass.
22. Drug example and doses
S.
No.
Drugs Doses
1 Bilk forming laxatives (Methyl
Cellulose)
2 tablets 1000mg orally with 8oz of
liquid up to 6times a day.
2 Lubricant laxatives include mineral oil
(Kondremal, Fleet mineral oil enema.
-
3 Hyperosmotic laxatives include
lactulose.
10mg BD
4 Stimulant laxatives (Bisacodyl, Castor
oil)
5-10 mg sodium Pico sulfate 15-20 ml
5 Stool softener (Docusate Calcium,
Docusate potassium)
240mg 50-400mg orallyb1to 4 equally
divided dose each day.
23. Indications / Uses
•To treat or prevent constipation.
•To prepare the bowel for radiologic or endoscopic
procedures.
•Short term treatment of constipation caused high dose of
opioid use.
•Osmotic laxatives are used to rapid evacuation of the bowel
after ingestion of poison or following anti-helminthic
therapy to rid of the body from dead parasites.
•Methyl cellulose and psyllium are used to many chronic
diarrhea.
25. Adverse effects
• GI irritation.
• Rectal burning sensation.
• Osmotic laxatives may causes dehydration.
• Long term use and abuse of laxatives may cause permanent
loss of colonic motility. Laxative dependence and electrolyte
imbalances.
• Nutritional deficiencies (with lubricant laxatives).
• Belching (with osmotic laxatives)
• Electrolyte imbalance. (with saline laxatives)
27. Nursing Responsibilities
•Assess for abdominal pain, distention,
nausea/vomiting, bowel sounds.
•Monitor the patient for fluid electrolyte
imbalances.
•Evaluate stools for frequency and
consistency.
•Mix bulk forming laxatives in full glass of
water or juice.
29. Mechanism of action
•They achieve their effects by
neutralizing gastric acid, inhibiting
gastric acid secretion or protect
gastric mucosa.
30. Drug example and doses
S.
No.
Drugs Doses
1 Sodium bi carbonate 1-5 gram orally
2 Magnesium hydroxide 0.5-1gm
3 Aluminum Hydroxide Up to 1gm daily
4 Magnesium carbonate 250-500 mg orally
5 Calcium carbonate Up to 1.5gm daily
35. Nursing Responsibilities
• Give antacids at least one hour after meal and at least one hour a
part from enteric coated tablets.
• Always give combination of aluminum and magnesium hydroxide
because they make a balance (constipation effects of aluminum
with laxative effects of magnesium).
• Give pre-cautiously to kidney and heart patient.
• Check antacids labels for sodium content and to use only low
sodium preparation.
• Teach the patient to avoid gastric irritants such as smoking,
alcohols, caffeine, NSAID’s because they counteract the effect of
drug.
36. Cholinergic - Information for GI system
•Parasympathomimetic or cholinomimetics
•Stimulate parasympathetic nervous system in same manner
as does acetylcholine
•May stimulate cholinergic receptors directly or slow
acetylcholine metabolism at synapses (affect the enzyme
acetylcholinesterase)
•Useful in treating Alzheimer’s Disease, Myasthenia gravis
and to treatment atony of the smooth muscle of the GI
system or urinary system
37. GI effects
•Acetylcholine stimulates cholinergic receptors in
the gut to promote normal secretory and motor
activity
•Cholinergic activity in the gut will increase
peristalsis and facilitates movement of flatus and
feces
•The secretory functions of the salivary and gastric
glands also stimulated.
•Increased tone and contractility in GI smooth
muscle, relaxation of sphincters, increased salivary
gland and GI secretions.
38. Anticholinergics – Information for GI system
• Also called cholinergic blocking agents or parasympatholytics
• Again, focus is on the parasympathetic nervous system
• Parasympathetic system acts as a resting and reparative function
• Functions include digestion, excretion, cardiac decelertion,
anabolism and near vision.
• Most anticholinergic drugs interact with the muscarinic
receptors in the brain, secretory glands, heart, and smooth
muscle
• A few can also affect the nicotinic receptors. Glycopyrrolate
(Robinul) is an example
39. •Mechanism of action: Act by occupying receptor
sites at parasympathetic nerve endings, thereby
leaving fewer receptor sites free to respond to
acetylcholine.
•Distribution of receptors is broad so effects of
anticholinergics will be diffuse.
•Helpful in treating irritable colon or colitis.
•Useful in gastritis, pylorospasm and ulcerative
colitis as they slow motility.
40. Fluid and Electrolyte therapy
•Assignment: Refer to paper notes and
Brief/summarize it and submit..
41. Proton pump inhibitors
•These agents are used in patient
with peptic ulcers (who have
failed to respond H2 blockers)
42. Mechanism of Action
It acts by inhibiting proton pump which is
final common step in gastric acid
secretion. It also have antisecretory
action.
43. Drug example and doses
S.
No.
Drugs Doses
1 Omeprazole 20mg daily
2 Lansoprazole 30 mg OD.
3 Pantoprazole 40mg
4 Rabeprazole 20mg
44. Indications / Uses
•Peptic ulcer.
•Reflux esophagitis.
•Zollinger – elision syndrome.
•Prevent and treat NSAID’s related to
gastric ulcer.
47. Drug interactions
•Proton pump inhibitor interfere with
the absorption of drugs
(Ketoconazole, iron and ampicillin)
that depends on gastric PH
absorption.
48. Nursing Responsibilities
•Monitor the patient for diarrhea and
abdominal pain.
•Teach the patient to swallow capsule whole
and not to chew or crush them.
•Teach the patient to avoid gastric irritants,
such as smoking alcohol, aspirin containing
products, caffeine, NSAIDs and food that
causes irritation.
50. Mechanism of action
•Antidiarrheals active opioids
receptor in G.I. tract to decrease
intestinal motility and to increase
the absorption of fluid and sodium
in the intestine.
51. Drug example and doses
S.
No.
Drugs Doses
1 Loperamide 2-4mg
2 Diphenoxylate 5-10mg
3 Octreotide 100-250 mcg TID
4 Polycarbophil ----
5 Bismuth subsalicylate 60 ml 6hourly suspension
52. Indications / Uses
•To treat underlying cause of diarrhea.
•To control the relive symptoms of acute
and chronic diarrhea.
53. Contraindication / Precautions
•Contraindicated in abdominal pain of
unknown pathology.
•There is an increase risk of megacolon in
clients with inflammatory bowel
disorders. This could lead to a serious
complication such as perforation of
bowel.
56. Nursing Responsibilities
• Assess for the abdominal pain and distension, nausea, vomiting,
and bowel sounds.
• Assess the patients skin turgor and monitor fluid and electrolyte
balance for evidence of dehydration resulting from diarrhea.
• Advise patient to avoid drinking plain water because it does not
content necessary electrolytes that have been loss in the stool.
• Advise clients to avoid caffeine. Caffeine exacerbate diarrhea by
increasing GI motility.
• Client with severe case of diarrhea may be hospitalized for
management of diarrhea.
• Know that high dose, long term use of defenoxin or
diphenoxylate may cause dependence.
57. Histamines (Histamine Receptors
Antagonist/H2 blockers)
•They are also called as H2 antagonists.
These agents block the action of
histamine, thus it reduce the amount of
acid released into the stomach. They also
promote ulcer healing.
58. Mechanism of action
•They inhibit gastric acid secretion
by inhibiting the action of histamine
and histamine 2 receptors in gastric
parietal cells.
59. Drug example and doses
S.
No.
Drugs Doses
1 Cimetidine 400mg B.D.
2 Ranitidine 150mg twice daily.
3 Famotidine 20-40 mg.
4 Nizatidine 150 mg twice daily.
63. Drug interactions
•Antacids may inhibit absorption of H2
receptors antagonists.
•Cigarette smoking increases gastric acid
secretions and may decreases the
effectiveness of H2 receptors antagonists.
64. Nursing Responsibilities
•Don’t give an antacid within 1 hour of
administration of H2 receptors antagonists it may
decrease the absorption.
•Teach the patients to avoid gastric irritants, such as
smoking alcohol aspirin containing products,
caffeine, NSAID’s and food that cause G.I. irritation.
•Teach the patient that smoking worsens ulcer
disorders and counteracts the effect of H2 blockers.
65. References
1. Dr. P.K. Panwar, Essentials of pharmacology for nurses, AITBS pub. 2017,
India, Pg no. 38 – 48.
2. Dr. Suresh k sharma, Textbook of pharmacology, pathology & genetics for
nurses, Jaypee pub. 2016 India Pg no 132 – 160.
3. Tara v. Shanbhag, Smita shenoy, Pharmacology preparation manual for
undergraduate, Elsevier pub. 2014. Pg no. 259 – 280.
4. Marilyn Herbert – Ashton, Nancy Clarkson, Pharmacology, Jones & Barllet
pub 2010 India, Pg no 527 – 550.
5. Govind s. mittal, Pharmacology at a glance, Paras medical book pub. 2009
India 35 – 40.
6. Madhuri Inamdar, Pharmacology in nursing, Vora medical pub. 2006 India
1st edition, Pg no 99 – 110.