GI Medications & NCLEX Pharmacology — Antacids, PPIs, H. pylori Regimens, IBD/IBS Drugs, and NCLEX Nursing Priorities | Chapter 46: Saunders NCLEX-PN Review

GI Medications & NCLEX Pharmacology — Antacids, PPIs, H. pylori Regimens, IBD/IBS Drugs, and NCLEX Nursing Priorities | Chapter 46: Saunders NCLEX-PN Review

Chapter 46 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides a detailed breakdown of gastrointestinal (GI) medications by drug class, mechanism of action, side effects, contraindications, and nursing interventions. It includes NCLEX-style questions that help reinforce safe medication administration, critical thinking, and patient teaching for GI pharmacology.

Watch the video above for a concise pharmacology review, then read the expanded notes below to solidify your understanding.

Book cover

Antacids & Gastric Protection

  • Antacids: Aluminum, magnesium, calcium, and sodium-based — know side effects (constipation vs. diarrhea), dosing, and interactions
  • Sucralfate: Protective barrier for ulcers — give on empty stomach, separate from other meds
  • Misoprostol: Prevents NSAID-induced ulcers — contraindicated in pregnancy

Acid-Reducing Agents

  • H2-receptor antagonists: Cimetidine, ranitidine, famotidine — watch for CNS effects in elderly, avoid smoking, give before meals/bedtime
  • Proton Pump Inhibitors (PPIs): Omeprazole, pantoprazole — GERD, ulcer healing, given before meals; monitor for long-term osteoporosis risk

H. pylori Treatment Regimens

  • Triple therapy — PPI + clarithromycin + amoxicillin or metronidazole
  • Quadruple therapy — PPI + bismuth subsalicylate + tetracycline + metronidazole

Motility & Bile Acid Medications

  • Prokinetics: Metoclopramide — increases GI motility, risk of extrapyramidal symptoms
  • Bile acid sequestrants: Cholestyramine, colesevelam — for bile salt diarrhea, mix with fluids, watch for constipation

Liver & Pancreatic Support

  • Lactulose: Reduces ammonia levels in hepatic encephalopathy, promotes bowel movements
  • Pancrelipase: Enzyme replacement — take with meals/snacks, avoid mixing with hot foods, monitor for improved fat absorption

Inflammatory Bowel Disease (IBD) & Irritable Bowel Syndrome (IBS) Medications

  • IBD: Sulfasalazine, mesalamine, corticosteroids, immunosuppressants, biologics
  • IBS-C: Lubiprostone, linaclotide
  • IBS-D: Alosetron — restricted use due to ischemic colitis risk

Antiemetics

  • Ondansetron — serotonin antagonist, minimal sedation
  • Promethazine — antihistamine, sedation risk
  • Metoclopramide — dopamine antagonist, watch for EPS
  • Cannabinoids — appetite stimulation, N/V prevention in chemo

Laxatives & Antidiarrheals

  • Laxatives: Bulk-forming (psyllium), osmotic (magnesium hydroxide), stimulant (senna), stool softeners (docusate)
  • Antidiarrheals: Loperamide, diphenoxylate-atropine, bismuth subsalicylate — monitor for dehydration, avoid in infectious diarrhea

NCLEX Nursing Priorities

  • Give meds at correct timing in relation to meals
  • Teach patients about side effects and when to report adverse reactions
  • Monitor hydration, electrolyte status, and bowel patterns
  • Prevent injury in patients at risk for CNS side effects

Conclusion

Mastery of GI pharmacology ensures safe, effective care for patients with digestive system disorders and increases success on the NCLEX-PN. This chapter integrates drug actions with clinical application for confident nursing practice.

Subscribe to Last Minute Lecture for more NCLEX-focused textbook breakdowns and pharmacology study aids.

View the full Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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