1/2 Ch. 45-46

Question 1

antiemetic serotonin receptor anatagonists:

Answer 1

Odansetron

Question 2

Antiemetic dopamine antagonists:

Answer 2

Promethazine
Metoclopramide

Question 3

Antiemetic antihistamines and anticholinergics

Answer 3

Scopolamine
Dramamine

Question 4

Antiemetic canabinoids

Answer 4

Dronabinol

Question 5

What are antiemetics more effective at?

Answer 5

Preventing than suppressing chemo induced N/V

Question 6

What are 2 non-pharmacologic methods to suppress N/V?

Answer 6

• Crackers and dry toast
• IV fluids if dehydrated

Question 7

What is the first drug approved for chemo-induced N/V?

Answer 7

Serotonin receptor antagonist: Odansetron

Question 8

What does ondansetron NOT do?

Answer 8

Block dopamine receptors: no EPS

Question 9

What drug is considered an antiemetic dopamine antagonist?

Answer 9

Promethazine

Question 10

What side effects do dopamine antagonsts have?

Answer 10

Extrapyramidal symptoms
Anticholinergic effects
Hypotension and sedation

Question 11

What should be monitored/avoided/implemented for clients taking dopamine antagonists like promethazine

Answer 11

Avoid activities that require alertness
Risk slowly from lying to standing to prevent dizziness and falls
Monitor for respiration depression

Question 12

What antiemetic dopamine antagonist increases gastric motility?

Answer 12

metaclopramide

Question 13

What is EPS?

Answer 13

Tardive dyskinesia (resless, face and neck spasms)

Question 14

What is contraindicated in metoclopramide administration?

Answer 14

Bowel perforation, obstruction, or hemorrhage

Question 15

What is scopalomine?

Answer 15

Antihistamine and anticholinergic

Question 16

What is the route for scopalomine?

Answer 16

PO (take 1 hour beforehand)
Patch (apply 4 hours beforehand and change every 3 days)

Question 17

What side effects/adverse reactions are seen with scopolamine?

Answer 17

• Fatigue, dizziness, drowsiness
• Dry mouth and blurred vision
• Urinary retention and constipation

Question 18

What should the nurse implement/monitor in a client taking scopalomine?

Answer 18

• Increase fluids
• Monitor I/O
• Check for bladder distention
• Last bowel movement
• Tell them to suck on hard candy

Question 19

What is contraindicated in patients with glaucoma?

Answer 19

Scopalomine/any anticholinergics

Question 20

What is the name for the cannabinoid antiemetic?

Answer 20

Dronabinol

Question 21

How is dronabinol given?

Answer 21

PO

Question 22

When is dronabinol contraindicated?

Answer 22

In patients with mental health disorders as it can make symptoms worse

Question 23

What is the trade name for antidiarrheals?

Answer 23

Lomotil diphenoxylate with atropine

Question 24

How is Lomotil diphenoxylate with atropine given?

Answer 24

PO

Question 25

Why does lomotil diphenoxylate with atropine prevent abuse?

Answer 25

It has both opiate and atropine characteristics

Question 26

What side effects are associated with lomotil diphenoxylate with atropine?

Answer 26

Constipation and CNS side effects

Question 27

What is the maximum dose/day for lomotil diphenoxylate with atropine?

Answer 27

20 mg or 8 tabs/day

Question 28

What 3 things should you know about imodium?

Answer 28

- Route: PO - Can purchase OTC - No abuse potential

Question 29

What should be monitored in patients taking antidiarrheals

Answer 29

- monitor for dehydration - weight - intake and output - vital signs

Question 30

What should be encouraged in people taking antidiarrheals?

Answer 30

Fluids Avoid water because it lacks needed electrolytes Avoid caffeine (acts as stimulant)

Question 31

What non-pharmacological measures can be taken to relieve constipation:

Answer 31

- Diet - Water - Exercise

Question 32

What does a laxative do?

Answer 32

Production of soft, formed stool over a period of 1 or more days Relatively mild

Question 33

What is catharsis

Answer 33

Prompt, fluid evacuation of the bowel Fast and intense

Question 34

What is the best source of fiber?

Answer 34

Brain Fresh fruits and veggies also high

Question 35

What is a contraindication for laxatives?

Answer 35

Individuals experiencing symptoms of appendicitis, diverticulitis, and ulcerative colitis Fecal impaction or bowel obstruction Caution in pregnancy and lactation

Question 36

What type of laxative is considered bulk-forming

Answer 36

Psyllium

Question 37

What type of laxative is considered a surfactant laxative?

Answer 37

Docusate sodium

Question 38

What types of laxatives are considered stimulant laxatives?

Answer 38

- Disacodyl - Senna

Question 39

What types of laxatives are considered osmotic laxatives?

Answer 39

- Milk of magnesia - Lactulose

Question 40

What is the preferred treatment of constipation in cardiac clients?

Answer 40

Psyllium

Question 41

What adverse effects are associated with psyllium?

Answer 41

Esophageal obstruction This is why its important to give WITH FULL GLASS OF WATER

Question 42

What is psyllium's mechanism of action?

Answer 42

Fiber- bulk forming Aborbs H2O as soon as swallowed

Question 43

What two effects do docusate sodium laxatives have on the bowel?

Answer 43

- Increase amount of water and electrolyes in the intestinal lumen - Monitor for sodium and water retention: edema

Question 44

How are docusate sodium laxatives given?

Answer 44

PO (pill and liquid)

Question 45

What don't docusate sodium laxatives do?

Answer 45

Don't stimulate peristalsis, All these do is soften the stool Okay for heart patients as long as sodium isn't contraindicated

Question 46

When are bisacodyl and senna laxatives given?

Answer 46

At bed time in order to have bowel movement in the morning

Question 47

What is contraindicated in bisacodyl and senna laxative administration and why?

Answer 47

Cannot crush or chew as they are enteric coated

Question 48

What side effect is common with senna?

Answer 48

Turns the urine a reddish-brown color?

Question 49

How are bsiacodyl and senna given?

Answer 49

PO and rectal

Question 50

What are laxative salts?

Answer 50

Poorly absorbed salts that draw water into intestinal lumen – fecal mass softens and swell, wall stretches, and peristalsis is stimulated

Question 51

What does milk of magnesia also function as?

Answer 51

Antacid

Question 52

Who should use caution in taking milk of magnesia?

Answer 52

Clients with hypertension: sodium based

Question 53

What contraindication is associated with milk of magnesia?

Answer 53

Clients without healthy kdineys as this can cause toxicity

Question 54

What complications are associated with milk of magnesium?

Answer 54

Dehydration Skin turgor, daily weight, I/O Hypermagnesemia Renal function Sodium retention Exacerbate HF, HTN, and edema

Question 55

What is hepatic encephalopathy?

Answer 55

A brain dysfuntion caused by liver disease, where the liver's inability to filter toxins from the blood allows them to accululate and affect brain function.

Question 56

What happens to ammonia in hepatic encephalopathy?

Answer 56

Ammonia from the blood is drawn into the colon to be excreted – ammonia can't be absorbed in the gut; therefore, it doesn't affect blood glucose levels

Question 57

What does lactulose do?

Answer 57

Increases bowel movements and decreases ammonia

Question 58

When is lactulose given?

Answer 58

Only for hepatic encephalopathy Only oral liquid (clear, thick)

Question 59

When are cathartics used?

Answer 59

Mainly for bowel prep Immediately have bowel movement Laxative can't preform same task at safe dose

Question 60

What treatment should be implemented for laxative abuse?

Answer 60

Abrupt withdrawl Stool quality is more important than quantity