Exam 1 N/V/D/Constipation

Question 1

What class of anti-emetics also promotes gastric emptying and small intestine peristalsis aka prokinetic effects?

Answer 1

Dopamine antagonists

Question 2

What are the contraindications for dopamine antagonists?

Answer 2

1. GI- hemorrhage, obstruction, or perforation
2. Seizure
3. Use very cautiously in children

Question 3

What are the ADRs for dopamine antagonists?

Answer 3

1. Extrapyramidal effects
2. Restlessness, anxiety, drowsiness, fatigue, hallucinations
3. CV—HTN, HPOTN, AV block, bradycardia
4. Agranulocytosis

Question 4

What are the ADRs for antihistamines?

Answer 4

1. Parkinsonian symptoms (dyskinesia, dystonias, akathisia)

2. Neuroleptic malignant syndrome

Question 5

What is the best way to control constipation?

Answer 5

Drink plenty of fluids and eat a high fiber diet

Question 6

What are bulk-forming laxatives used for as first line treatment?

Answer 6

Considered 1st line tx for bed-ridden or geriatric pts with chronic constipation. Also good in pregnancy

Question 7

What is an important drug interaction to consider with bulk-forming laxatives?

Answer 7

Binds to drugs & reduces absorption—separate from other medication administration.

Question 8

What are three other uses for bulk-forming laxatives other than for constipation relief?

Answer 8

1. Relieving sx of mild diarrhea
2. Relieving sx of IBS
3. Lowers cholesterol

Question 9

What are the first line tx for constipation for pregnant women?

Answer 9

Bulk-forming laxatives and emollients

Question 10

Should lubricants for constipation relief be used chronically?

Answer 10

NO

Question 11

Why are lubricants for constipation relief bad to use?

Answer 11

1. Avoid in elderly
2. Aspiration risk
3. Decrease absorption of fat-soluble vitamins (DEAK)

Question 12

What is used for patients with constipation and hepatic encephalopathy?

Answer 12

Lactulose

Question 13

What is the MOA of saline cathartics?

Answer 13

Mg++ or Na+ salts are poorly absorbed; they increase the water content of the bowel through osmosis.

Question 14

What is the main use of polyethylene glycol in the form of PEG/GoLYTELY?

Answer 14

colonic cleansing before diagnostic procedures

Question 15

Is PEG/GoLYTELY for chronic use? Can it be used in pts with intestinal obstruction?

Answer 15

No and No

Question 16

Stimulant laxatives should not be take within ____ hour(s) of ingestion of _________?

Answer 16

1 hour, antacids, milk, or milk products

Question 17

What are the ADRs for stimulant laxatives?

Answer 17

1. Can cause fluid and electrolyte inbalance.

2. Pink colored urine and feces

Question 18

What is an ADR for the chronic use of stimulant laxatives?

Answer 18

It could cause damage to the nerve plexi, resulting in deterioration of intestinal function, and atonic colon

Question 19

What are the ADRs for anthraquinone laxatives?

Answer 19

1. Yellow-brown to red colored urine

2. Large doses can produce nephritis

Question 20

What are the contraindications for anthraquinone laxatives?

Answer 20

1. Pregnancy

2. Acute intestinal inflammation

Question 21

What are the contraindications for lubiprostone?

Answer 21

1. Pregnancy

2. Intestinal inflammation

Question 22

What is the best way to prevent diarrhea?

Answer 22

Wash your hands!