Santos

Question 1

Ondesetron, Granisetron, Dolesetron, Palonesetron

Answer 1

• block 5-HT3R
• for chemo- or post-op induced vomiting
• AE: SERROTONIN SYNDROME and QT PROLONGATION

Question 2

Aprepitant, Netupitant, Rolapitant

Answer 2

• blocks NK-1R
• for chemo-induced vomiting
• metabolized by CYP3A4 -> Aprepitant decreases INR in ptxs on Warfarin
• QT prolongation if used w/ cisapride

Question 3

Diphenhydramine, Dimenhydrinate, Meclinizine

Answer 3

• blocks H1R
• prevent motion sickness/vertigo and chemo induced vomiting
• 1st 2 have SEDATING properties

Question 4

Hyoscine (Scopalamine)

Answer 4

• blocks M1R
• prevent motion sickness/vertigo
• transdermal patch

Question 5

Metoclopramide

Answer 5

• blocks D2R
• for chemo induced vomiting
• SAFE DURING PREGNANCY

Question 6

Prochlorperazine and Promethazine

Answer 6

• anti-psychotic
• blocks D2R -> antiemetic
• EXTRAPYRAMIDAL symptoms

Question 7

Olanzapine

Answer 7

• anti-psychotic

- blocks D2R -> antiemetic

Question 8

Droperidol

Answer 8

• anti-psychotic
• blocks D2R -> antiemetic
• EXTRAPYRAMIDAL symptoms and QT PROLONGATION

Question 9

Dronabinol

Answer 9

• CB1R agonist
• appetite stimulant in AIDS ptxs
• prevent chemo-induced nausea

Question 10

Pyridoxine (vit. B6) + Doxylamine (H1 receptor blocker)

Answer 10

-treat nausea/vomiting in PREGNANCY

Question 11

Diazepam and Lorazepam

Answer 11

-reduce anticipatory vomiting from anxiety in chemo ptxs

Question 12

when do you NOT want to give anti-diarrheals?

Answer 12

-bloody diarrhea, fever, systemic toxicity

Question 13

Bismuth Subsalicylate (pepto-bismol)

Answer 13

• anti-diarrheal
• treats H. pylori and TRAVELERS DIARRHEA
• AE: REYE’S SYNDROME, hearing loss, dark stools, black tongue

Question 14

Loperamide

Answer 14

• uOpiod receptor agonist -> anti-diarrheal
• does NOT cross blood brain barrier
• used for Travelers diarrhea
• not used in children <2 y/o

Question 15

Diphenoxylate and Difenoxin

Answer 15

• uOpiod receptor agonist -> anti-diarrheal
• CROSSES blood brain barrier
• Schedule V CONTROLLED substance by DEA
• used w/ ATROPINE -> promote constipation and prevent abuse
• AE: TOXIC MEGACOLON

Question 16

Cholestyramine, Colestipol, Colesevelam

Answer 16

• sequester excess bile salts/acid -> prevent diarrhea
• can exacerbate fat malabsorption
• 1st 2 prevent absorption of drugs

Question 17

Octreotide

Answer 17

• SST analogue
• inhibit secretion of 5-HT and GI peptides (VIP) -> treat secretory diarrhea
• for variceal bleeding, dysmotility, acute pancreatitis

Question 18

Calcium polycarbophil and Carboxymethylcellulose

Answer 18

• bulk forming agents

- for chronic diarrhea in IBS

Question 19

Crofelemer

Answer 19

• inhibit cAMP-stimulated CFTR Cl- channels and Ca2+ activated Cl- channels on the luminal enterocyte -> prevent water loss
• treat diarrhea associated with ART therapy in HIV/AIDS ptxs

Question 20

the most important NT in the ENS

Answer 20

5-HT

-released by enterochromaffin cells (ETC) -> + gut reflexes

Question 21

pro kinetic drugs

Answer 21

-treat constipation -> increase COORDINATED GI motility

Question 22

Bethanechol and Carbchol

Answer 22

-+ M3 receptor at myenteric plexus -> increase ACh -> increase motility

Question 23

Neostigmine

Answer 23

-AChE inhibitor -> increase ACh at myenteric plexus -> increase motility

Question 24

Metoclopramide and Domperidone

Answer 24

-D2R blockers -> increase ACh and GI motility

Question 25

Meoclopramide

Answer 25

- both D2R blocker and 5-HT4R agonist -> increase ACh and GI motility - AE: TARDIVE DYSKINESIA

Question 26

Cisapride

Answer 26

- 5-HT4R agonist and weak 5-HT3R antagonist -> increase ACh and GI motility - AE: cardiac -> FATAL ARRYTHMIAS and QT PROLONGATION

Question 27

Tegaserod

Answer 27

- PARTIAL 5-HT4R agonist -> increase ACh and GI motility | - for constipation w/ IBS

Question 28

motilin

Answer 28

-release from M cells and ETC cells -> increase GI motility

Question 29

erythromycin (macrolide)

Answer 29

- bind to GPCR like motilin -> increase GI motility (only gastric and small bowel) - used for diabetic gastroparesis

Question 30

Psyllium, Methylcellulose, Polycarbophil

Answer 30

- bulk-forming laxatives | - colloids absorb water -> distention -> peristalsis

Question 31

Docusate

Answer 31

- ANIONIC stool surfactant/softener | - lower stool surface tension -> promote water and lipid penetration

Question 32

Mineral oil and Glycerin suppository

Answer 32

-other stool surfactant agents

Question 33

Magnesium hydroxide (milk of magnesia) and Magnesium citrate

Answer 33

- osmotic laxatives - for bowel cleansing before procedures or constipation - AE: hypermagnasemia or ABUSED BY BULEMICS

Question 34

Senna***

Answer 34

- stimulant laxative -> + ENS | - prolonged use -> MELANOSIS COLI

Question 35

Bisacodyl

Answer 35

- stimulant laxative | - safe for long term use

Question 36

Castor oil

Answer 36

- stimulant laxative | - AE: unpleasant taste and toxic effects on ENS

Question 37

Lubiprostone

Answer 37

- chloride secretion activator | - + type 2 chloride channels (ClC-2)

Question 38

Linaclotide and Plecanatide

Answer 38

- chloride secretion activators - bind type 2 chloride channels and + guanylate cyclase - NOT USED IN PEDIATRICS

Question 39

Methylnaltrexone and Alvimopan

Answer 39

- opioid receptor antagonists (u-Opioid receptors) | - AE: CV TOXICITY

Question 40

Methylnaltrexone

Answer 40

for opioid induced constipation

Question 41

Alvimopan

Answer 41

for post-op ileus