NVDC + Meds

Question 1

What are the 4 classes of antidiarrheal medications?

Answer 1

Adsorbents
AntiCholinergics
Opiates
Probiotics

Question 2

Adsorbents
-for what?
-example?
-MOA?

Answer 2

For mild diarrhea

Bismuth subsalicylate (pepto)

Coat walls of GI tract
Some antimicrobial action

Question 3

Anticholinergics
-for what?
-example?
-MOA?
-effect?

Answer 3

For moderate-severe diarrhea

Atropine

Decrease GI muscle tone and peristalsis

Drying effect

Question 4

Opiates
-for what?
-MOA?
-Affect on water?
-example?

Answer 4

For moderate-severe diarrhea

Decrease bowel motility/transit time and reduce pain by relief of spasms

Increases time for water/lyte reabsorption

Loperamide

Question 5

Probiotics
-for what?
-example?
-MOA?
-Effect?

Answer 5

For antibiotic-induced diarrhea symptoms

Lactobacillus acidophilus

Supply missing bacteria to GI tract

Suppress growth of diarrhea-causing bacteria

Question 6

Adsorbents AEs?

Answer 6

(Bismuth Subsalicylate)
Increased bleeding time
Constipation, dark stools
Tinnitus, confusion

Question 7

Anticholinergic AEs?

Answer 7

(Atropine)
Urinary retention, impotence
HA, dizzy, confusion, anxiety
Blurred vision
Hypotension, bradycardia

Question 8

Opioids AEs?

Answer 8

(Loperamide)
Respiratory depression
CNS depression

Question 9

Bismuth subsalicylate should NOT be given to _____, due to risk of»>

Answer 9

Children
Reye’s syndrome

Question 10

Anticholinergics (atropine) should NOT be given to patients with …

Answer 10

Narrow-angle glaucoma
Bowel Obstruction
Myasthenia gravis
paralytic ileus
toxic megacolon

Question 11

Opiates should not be given with&raquo_space;>

Answer 11

Other CNS depressants

Question 12

Loperamide should not be given with…

Answer 12

Bloody diarrhea

Question 13

What are the 5 classes of laxatives?

Answer 13

Bulk-forming
Emollient
Hyperosmotic
Saline
Stimulant

Question 14

Bulk-forming meds
-for what?
-MOA?
-example?

Answer 14

Laxative for constipation

Fiber increases the bulk of stool, distended bowel initiates reflex bowel activity

Question 15

What should bulk-forming laxatives always be given with?

Answer 15

Water! (fiber needs water)

Question 16

Emollient meds
-for what?
-MOA?
example?

Answer 16

Laxatives for constipation
-stool softeners, lubricants

Promotes more water and fat in stools-lubricates feces and intestinal walls

Docusate Salts

Question 17

Hyperosmotic meds
-for what?
-MOA?
-2 examples?

Answer 17

Laxative for constipation

Increase fecal water content-bowel distention-increased peristalsis and evacuation

Polythylene glycol (miralax)
Lactulose: hepatic encephalopathy prep

Question 18

Saline meds
-for what?
-MOA?
-example?

Answer 18

Laxatives for constipation

Increases osmotic pressure within GI tract, causing more water to enter intestines-results in bowel distention, increases peristalsis, evacuation

Magnesium hydroxide

Question 19

Stimulant meds
-for what?
-MOA?
-example?

Answer 19

Laxatives for constipation

Increases peristalsis via intestinal nerve stimulation

Senna

Question 20

What is a common AE of all laxatives?

Answer 20

Electrolyte disturbances

Question 21

Bulk-forming laxative AEs?

Answer 21

(psyllium)

Impaction
esophageal blockage
fluid overload

Question 22

Emollient laxative AEs?

Answer 22

(docusate salts)

skin rashes
decreased vitamin absorption

Question 23

Hyperosmotic laxative AEs?

Answer 23

(polythylene glycol, lactulose)

abdominal bloating
rectal irritation
diarrhea
Electrolyte disturbance (#1)

Question 24

Saline laxative AEs?

Answer 24

(magnesium hydroxide)

magnesium toxicity- for renal impairment

diarrhea
increased thirst
cramping

Question 25

Stimulant laxative AEs?

Answer 25

(Senna) nutrient malabsorption skin rashes gastric irritation discolored urine rectal irritation

Question 26

Laxatives should NOT be taken if ____ or ___ pain is present

Answer 26

N/V or abdominal pain

Question 27

Long-term laxative use can result in decreased ____ tone and dependency

Answer 27

bowel tone

Question 28

To decrease laxative use, one can increase _____ intake

Answer 28

Fiber

Question 29

Bulk laxatives should be taken with at least _____ of water

Answer 29

8 oz

Question 30

Which laxatives should be avoided for patients with renal faiure?

Answer 30

Magnesium-containing (saline) (magnesium hydroxide)

Question 31

Anticholinergic meds for nausea -MOA? -example? -used for?

Answer 31

Bind to/block ACh receptors in inner ear labyrinth, blocking nauseating stimuli transmission Scopolamine Used for motion sickness, excess secretions, N&V

Question 32

What are some contraindications for scopolamine?

Answer 32

(anticholinergic) Glaucoma- can cause increase in pressure

Question 33

Antihistamine meds for nausea -Class? -MOA? -AE? -Example?

Answer 33

H1 receptor blockers Inhibit ACh by binding to H1 receptors, preventing cholinergic stimulation in vestibular and reticular areas Causes drowsiness Meclizine

Question 34

Antidopaminergic meds for nausea -MOA? -AE? -Also used for? -Example?

Answer 34

Block dopamine receptors in CTZ Drowsiness Psychotic disorders, intractable hiccups Promethazine

Question 35

Prokinetic Drugs -MOA? -Causes? -Also used for? -Example?

Answer 35

Blocks dopamine receptors in CTZ, making CTZ less sensitive to impulses from GI tract Stimulates peristalsis, enhancing stomach emptying Also for GERD and delayed gastric emptying Metoclopramide

Question 36

Long term use of metoclopramide can cause?

Answer 36

Irreversible tardive dyskinesia

Question 37

Serotonin Blockers -MOA? -used for? -interaction? -example?

Answer 37

Blocks serotonin receptors in GI, CTZ, VC Used for N/V in chemp or post-op patients Can cause serotonin syndrome with some antidepressants Ondansetron

Question 38

Giner -used for? -AEs? -interactions?

Answer 38

N/V from chemo, morning sickness, motion sickness Anorexia, N/V, skin reactions Increases absorption of some PO meds Increases bleeding risk w/ anticoagulants