Nausea/Vomiting Flashcards Preview

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Flashcards in Nausea/Vomiting Deck (63):
1

this class is indicated for treatment and prevention of postoperative N/V or chemotherapy induced N/V. However, it is used much more frequently than these instances

5-HT3 Antagonists

2

ADRs include HA, dizziness, diarrhea, abdominal pain

5-HT3 Antagonists

3

This class can antagonize D2 and (at high enough doses) 5-HT3 receptors. Also promote gastric emptying and peristalsis of SI

Dopamine Antagonist

4

Contraindications include GI hemorrhage, obstruction, or perforation, pheochromocytoma, seizure. Use cautiously in children and depression

Dopamine antagonist

5

ADRs include extrapyramidial effects, restlessness, anxiety, drowsiness, fatigue, hallucinations, HTN, HPOTN, AV block, bradycardia, agranulocytosis

Dopamine antagonist

6

This class blocks H1 and is an antagonist of D2 receptors in the CTZ

Antihistamines

7

ADRs include dry mouth, dizziness, Parkinsonian symptoms, neuroleptic malignant syndrome, blood dyscrasias

Antihistamines

8

Caution in patients with BPH, urinary retention, glaucoma

Antihistamines

9

Side effects include drowsiness, sedation, increased appetite

Dronabinol (Cannabinoids)

10

Medications that cause constipation

OPIATES
Ca and Al antacids
Calcium channel blockers
Clonidine
Anticholinergics

11

These drugs increase the volume of non-absorbable solid residue with water and stimulate peristaltic activity increasing the rate of colonic transit

Bulk forming laxatives

12

adequate fluid intake is very important with these agents

Bulk forming laxatives

13

1st line for bedridden or geriatric pt with chronic constipation. Good in pregnancy

Bulk forming laxatives

14

ADRs include flatulence, abdominal distention, GI obstruction

Bulk forming laxatives

15

This class binds drugs and reduces absorption, so give it separate from other meds

Bulk forming laxatives

16

This class can be used to relieve symptoms of mild diarrhea, IBS, and lower cholesterol

bulk forming laxatives

17

this laxative class is first line for pregnant women (along with bulk forming)

Emollient (docusate sodium)

18

this drug is used to avoid straining and can be used after MI, rectal surgery, or opiates

docusate sodium

19

Contraindicated in patients with fecal impaction or signs and symptoms of appendicitis

docusate sodium

20

this laxative class is not recommended for chronic use (mainly for prevention) after MI or rectal surgery

lubricants (mineral oil)

21

this lax class coats stool and inhibits colonic absorption of water

lubricants (mineral oil)

22

this lax class should be avoided in elderly patients dt aspiration risk and decrease absorption of fat soluble vitamins

lubricants (mineral oil)

23

this lax drug is not considered a first line agent. It may result in flatulence, cramps, and electrolyte imbalances and is commonly used in patients with hepatic encephalopathy

Lactulose

24

this lax creates an osmotic gradient and can cause hyperglycemia

sorbitol

25

this lax class increases the water content of bowel through osmosis. Used post-surgery. Not for use in pts with impaired renal function (Mg and Na accumulation), CHF, HTN

saline cathartics

26

this lax is metabolized to ricinoleic acid and stimulates secretory pathways. Not for routine use. Can cause decrease in glucose absorption

castor oil

27

this lax has osmotic action in the rectum. It is very safe and can be used in children intermittently

glycerin suppository

28

this lax is an osmotic that can be used chronically. It is relatively safe and can be used in children

polyethylene glycol (mirilax)

29

this lax is used for colonic cleansing before diagnostic procedures. Not for chronic use or for patients with intestinal obstruction

polyethylene glycol (PEG, GoLYTELY)

30

this lax stimulates the nerve plexus of the colon. Should not be taken with antacids, milk, or milk products

bisacodyl

31

this lax can cause intestinal cramps, fluid and electrolyte imbalance, and pink colored urine and feces

bisacodyl

32

Long term use of these lax could cause damage to nerve plexi, resulting in intestinal function deterioration and atonic colon

bisacodyl, senna

33

this lax causes increased peristalsis. It can cause yellow-brown to red colored urine and large doses can cause nephritis

senna

34

this lax is a cl channel activator. it can cause nausea and diarrhea and is contraindicated in intestinal obs and pregnancy

lubiprostone

35

this lax is a peripheral antagonist of mu. It does not cross the BBB. Good for opiate-caused constipation

methylnaltrexone

36

what is a good lax to give diabetics

Metamucil (sugar free)

37

what types of lax to use in pregs? not to use?

use: bulk formers or emollients
do not use: mineral oil, caster oil, osmotics

38

what lax should I avoid in olds

saline (CHANGE IN ELECTROLYTES)

39

what lax should I avoid in kids

stimulants, excessive enemas

40

Diarrhea: when should I NOT use antimotility agents?

dysentery or c diff

41

these two drugs can cause premature emptying colon

metoclopramide
erythromycin

42

what drugs cause diarrhea

lax
antacids (w mg)
antineoplastics
colchicine
NSAIDs
orlistat
Abx: clin or BS
ACEi
digoxin
xholinergics
esomeprazole
famotidine

43

this drugs slow intestinal transit, prolong contact and absorption, and increase gut capacity. At risk for addiction, and can worsen diarrhea

antimotility

44

this antimotil agent should not be given to someone with c diff or enterotoxin producing bacteria

lomotil

45

this antimotil agent acts directly on intestinal muscles to inhibit peristalsis and prolongs transit time

loperamide

46

don't use in pts with a high fever, acute UC, antibiotic associated colitis, or children under 2

loperamide

47

these absorb nutrients, toxins, drugs, and digestive juices

adsorbents

48

this adsorbent absorbs bile salts and c diff toxin

cholestryamine

49

this drug has anti-secretory, inflammatory, and bacterial effects

pepto bismol

50

do not use in kids, can cause Reyes syndrome

pepto bismol

51

this drug can cause blackened stools and tongue, salicylism, and gout attacks

pepto bismol

52

this drug interacts with anticoagulants and tetracycline (may interfere with radiologic studies)

pepto bismol

53

this drug blocks the release of serotonin, reducing motility and increasing water absorption from the gut

octreotide

54

used to control symptoms in pts with metastatic vasoactive intestinal peptide-secreting tumor associated with diarrhea

octreotide

55

this drug blocks vagal tone and prolongs gut transit time. Contraindicated in glaucoma, prostatic hypertrophy

atropine

56

this drug prevents diarrhea, indicated for use post-antibiotic. Restores normal flora and intestinal function

lactobacillus

57

useful only in lactose intolerance

lactase enzymes

58

used as an adjunct to oral rehydration salts (ORS)

zinc

59

traveler's diarrhea prophylaxis

bismuth subsalicylate, antibiotics (not responsible)

60

traveler's diarrhea treatment

rehydration
cipro or azithromycin

61

C diff treatment

metronidazole
vancomycin (PO)

62

treat constipation predominant IBS

increase fiber and fluid
bulk forming lax
consider antispasmodics
add serotonin-4 agonist-TEGASEROD $$

63

treat diarrhea predominant IBS

lactose/caffeine free diet
loperamide
serotonin antagonist ALOSETRON