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Nurs 2514 Drugs > Unit 2 Drugs > Flashcards

Unit 2 Drugs Flashcards

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1
Q

What are the different types of antiemetics?

A
  • Serotonin receptor antagonist
  • Glucocorticoids
  • Dopamine Antagonists
  • Cannabinoids
  • Antihistamines/Anticholinergics
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2
Q

Serotonin Receptor Antagonist

Odansetron Class, MOA, and tradename?

A

Class: Serotonin Receptor antagonist
MOA: Works in the CTZ, blocking receptors = less avaliable serotonin
Trade name: Zofran

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3
Q

Serotonin Receptor Antagonist

Odansetron indication and admin?

A

Indications
- Nausea associated with chemo, radiation, anesthesia, viral gastritis & pregnancy
- Often used with dexamethasone for increased effectiveness
Admin: PO/IV/IM admin

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4
Q

Serotonin Receptor Antagonist

Odansetron adverse effects?

A

Adverse Effects
- Headache
- Constipation
- Diarrhea
- Dizziness
- Urinary Retention
- Muscle pain
- QT prolongnation

QT prolongnation slows HR and inteferes with electrical impulses

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5
Q

Serotonin Receptor Antagonist

Odansetron nursing considerations?

A
  • Monitor EKG
  • Monitor for effectiveness
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6
Q

Glucocorticoid

Dexamethasone MOA, Class and Trade name?

A

MOA: unknown
Class: Glucocoricoid
Trade name:

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7
Q
A
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8
Q

Glucocorticoid

Dexamethasone inidcation and admin?

A

Indication: Nausea associated with chemo
- Can be used aone or combined with other antiemtics (odansetron)
- When used briefly there are no negative side effects
Admin: PO/IV

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9
Q

Dopamine Antagonist

Metoclopramide MOA, class and trade name?

A

MOA: Blocks dopamine and serotonin receptors in the CTZ, enhances upper GI tract response to acetycholine (increased peristalsis)

Class: Dopamine Antagonist

Trade name: Maxeran

Prokinetic drug: speeds gastric emptying + GI motility LOTS OF AE

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10
Q

Dopamine Antagonist

Metoclopramide Indications?

A

Indications: Nausea caused by post op, cancer medications, opioids, toxins radiation

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11
Q

Dopamine Antagonist

Metoclopramide adverse effects and contraindications?

A

Adverse affects:
- In high doses, diarrhea and sedation are common
- With long term use: risk of tardive dyskinesia (repetitive involuntary movement)
Contraindicated for PT with GI obstruction, perforation, or hemorrhage

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12
Q

Dopamine Antagonist

Nursing considerations for metoclopramide?

A
  • GI assessment (verify no obstructions)
  • Assess mental status
  • Look for uncontrolled movement
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13
Q

Cannabinoids

Nabilone MOA and class?

A

MOA: Likely activation of receptors around the vomiting centre
Class: Cannabinoids (synthetic cannabinoid)

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14
Q

Cannabinoids

Nabilone indications?

A
  • Used to suppress chemo induced nausea
  • Second line drugs due to pyschotomimetic effects and potential for abuse
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15
Q

Cannabinoids

Nabilone Nursing considerations and side effects?

A

Nursing considerations: Monitor for drowsiness
Side effects:
CNS: Temporal disintegration, dissociation (avoid in PT with pysch disorders)
CVS: tachycardia and hypotension (avoid in PT with CVS disease)

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16
Q

Antihistamine

Dimenhydrinate MOA, Class and tradename?

A

MOA: Blocks H! receptors in the GI tract and Muscarinic receptors in the vestibular system (anticholinergic)

Class: Antihistamine

Trade name: Gravol

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17
Q

Antihistamine

Dimenthydrinate indication?

A
  • Motion sickness
  • Radiation
  • Post op
  • Drug induced nausea

Anticholinergic: supress rest and diegst, increase fight or flight

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18
Q

Antihistamine

Dimenhydrinate adverse effects?

A
  • Drowsiness (drug crosses BBB), dry mouth, constipation
  • Increased urine retention
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19
Q

Antihistamine

Dimenhydrinate nursing considerations?

A
  • Avoid with other CNS depressents
  • Should not be taken with a hx of glaucoma, chronic lung disease, difficulty urinating
  • GI assessment
  • Assess alertness
  • Vital signs
  • Signs of urinretention
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20
Q

Muscarinic Antagonist

Scopolamine MOA, class and trade name?

A

MOA: Blocks nerve impulses between vestibular apparatus in inner ear and vomiting centre

Class: Muscarinic Antagonist

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21
Q

Muscarinic Antagonist

Scopolamine indication and admin?

A

Indication: Motion sickness - most effective drug for preventing and treating motion sickness

Admin: PO/SC/transdermal dosing

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22
Q

Muscarinic Antagonist

Scopolamine adverse effects and nursing considerations?

A

Adverse effects
- Dry mouth, blurred vision, drowsiness (common)
- Urinary retention, constipation, disorientation (less common)

Nursing considerations
- GI assessment
- Monitor for signs of urinary retention
- Assess alertness

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23
Q

Types of laxatives?

A
  • Bulk forming
  • Surfactant
  • Stimulant
  • Osmotic
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24
Q

Bulk forming

Psyllium MOA?

A

MOA:
- Similar action to fiber (increased bulk leads to soft formed stool)
- Made from polysaccharides and cellulose derived from grains and plants (non digestible)
- Pulls water into to stool to soften it

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25
# Bulk forming Psyllium class and brand name?
Class: Bulkforming Name: Metamucil
26
# Bulk forming Pysllium indications and administration?
Inidcations: Chronic constipation, prevent straining of stool, IBS Administration: should be given with a full glass of water to avoid obdtruction/impaction **Produces a soft but still formed stool in 1-3 days**
27
# Bulkforming Psyllium adverse effects?
Not absorbed systemically (side effects rare)
28
# Osmotic Laxatives Lactulose MOA and class?
MOA - Poorly absorbed and not digested by enzymed in the GI = N/V Side effects (pulls water in to soften stool) - Binds to ammonia - Turns into lactic acid in the colon which has an osmotic action similar to other osmotics Class: Osmotic laxatives | Produces soft stool in 1-3 Days
29
# Osmotic Laxatives Lactulose adverse effects?
More adverse effects then other laxatives N/V More expensive then other laxatives
30
# Osmotic laxatives: Laxative salts Magnesium hydroxide MOA?
Poorly absorbed salts and osmotic action draw Low dose therapy: Stool in 6-12 hours High dose: Stool in 2-6 | Used as a purgative
31
# Osmotic laxatives: Laxative salts Magneisum hydroxide adverse effects?
- Increased risk for dehydration - Contraindicated for thouse with kidney disease
32
# Osmotic Laxatives: Polyethylene Glycol PEG MOA?
MOA Non absorbable compound, retains water in intestinal lumen Causes feces to swell and soften Indications: Chronic constipation Restoralax
33
# Osmotic Laxatives: Polyethylene Glycol PEG Time of onset?
onset is dose dependent Low: 6-12 High: 2-6 Can be used as purgative
34
# Osmotic Laxatives: Polyethylene Glycol PEG side effects?
- Nausea - Bloating - Cramping - Flatulence - Diarrhea
35
# Stimulant Laxatives Bisacodly MOA and trade name?
MOA - Stimulates intestinal motility & increases the amount of water an delectrolytes within the bowel - Used for opiod induced constipation - Common drug for laxative abuse Trade name: Dulcolax
36
# Stimulant Laxatives Bisacodyl administration/onset?
Avaliable as rectal suppository or by mouth Oral Route: 6-12 hours (given before bed) Rectal route: 15-60 mins
37
# Surfactant laxatives Docusate sodium MOA and trade name?
MOA - Works in the small intestine and colon - Softens the stool by facilitating the penetration of stool (lowers stool surface tension) - Also causes secretion of water and electrolytes into the intestine (doesnt make you poop but makes it easier when you do poop) Trade name: colace
38
# Surfactant laxatives Docusate sodium onset and adverse effects?
Slow onset Produces stool in 1-3 days Adverse effects: mild cramping, diarrhea
39
Non specific antidiarrheals?
Opiod: loperamide Opiod: Diphenoxylate Atropine Bismuth Subsalicylate | NOT USED IF SOMEONE HAS A FEVER
40
Nonspecific antidiarrheals: opioids
- Most effective antidiarrheal agents - Activate opioid receptors in GI to slow intestinal motility (more time for absorption of fluid and electrolytes) - May cause toxic megacolon in patients with IBD
41
# Opiods Diphenoxylate ( + Atropine)
Brand name: Lomotil Opiods used only for diarrhea **Atropine is added to discourage abuse**(causes unpleasent side effects) Only in PO only (Cant abuse IV)
42
# Opiods Diphenoxylate ( + Atropine) adverse effects?
- Dizziness - Drowsiness - light-headedness - N/V
43
# Opioids Loperamide
Brand name: Imodium - Suppresses bowel moltility and bowel secretions - Used to reduce volume of discharge from ileostomies - Large doses do not produce morphine like effects
44
# Other Antidiarrheals Bismuth Subsalicylate
Brand name: Pepto Bismol Coats the walls of the GI tract (reduces secretions) Binds to causatives bacteria or toxin which is then elimated in stool
45
# Other Antidiarrheals Bismuth Subsalicylate adverse effects?
- Increased bleeding time - Constipation - Dark stools (can be mistaken for melena) - hearing loss - Tinnitus - Metallic taste - Blue gums
46
Drugs for PUD?
- H2 receptor antagonist - Proton Pump Inhibitors - Other Antacids - Antibiotics | Many can also be used for management of GERD
47
Goals of drugs for PUD?
1 Alleviate symptoms 2 Promote healing of gastric/duodenal mucosa 3 Prevent complications (hemorrhage, perforation, obstruction) 4 Prevent recurrence
48
Goals of drugs for GERD?
1 Alleviate symptoms 2 Promote healing of esophageal mucosal injury (ulceration or bleeding) 3 Prevent complications (esophageal strictures, Barretts esophagus)
49
# Histamine 2 receptor anatagonist Cimetidine (Tagamet) MOA
- H2 receptors are located in the parietal cells of the stomach (secrete HCL and Intrinsic factor) - Blocking these receptors reduces the volume of gastric juice and decreases concentration of acid ## Footnote Not to be confused with "antihistamines" H1 receptors antagonist that are targeted toward allergy symptoms
50
# Histamine 2 receptor anatagonist Cimetidine (tagamet) Indications
- Require long term therapy to heal gastric and doudenal ulcers (6-12 weeks) - End in **"tidine** - Indications: **PUD, GERD**
51
# Histamine 2 receptor anatagonist Cimetidine (tagamet) adverse effects (uncommon)
CNS - Confusion - Hallucinations - CNS depression (crossess BBB poorly so thi sis rare) Increased risk for pneumonia (loss of acidic buffer = increase in pH which can lead to over growth of good flora)
52
# Histamine 2 receptor anatagonist Cimetidine (Tagamet) Nursing consideration
- Assess for epigastric pain, abd pain or signs of GI bleeding (hematemesis, frank blood or occult blood in stool) - Assess for signs of confusion (especially older adults) - Administer antacids an hour apart from other medications - Monitor for signs of pneumonia
53
# Proton Pump inhibitors Omeprazole (losec) MOA?
- causes irrevsersible inhibition of H+, K+ ATPase, the enzyme that generates gastric acid - A single dose inhibits acid production by 97% in 2 hrs - Effect is irreversible (no new acid until new enzymes is made which may take days to weeks) - Drug is acid-labile so capsules contain enteric coated granules that dissolve in duodenum | **Indicated for for PUD and GERD**
54
# Proton pump inhibitors Omeprazole (losec) adverse effects
Minor - Headache - Diarrhea - N/V Severe - Pneumonia - Fractures - Rebound acid hypersecretion (DYSPEPSIA) - Hypomagnesemia
55
# Proton pump inhibitors Omeprazole (losec) nursing considerations
- Administer doses before meals (take first thing in morning) - Monitor serum Mg. with prolonged use - Monitor for signs of pneumonia - monitor for fractures
56
# Other antiulcer drugs Sucralfate MOA?
- Protects against ulcers by creating a mucosal barrier against acid pepsin - Undergoes chemical reaction in acidic environment of stomach to form a sticky gel - Adheres to ulcer for 6 hours - Eliminated in the feces - Oral admin only **Indication: GERD, duodenal ulcers**
57
# Other antiulcer drugs Sucralfate adverse and nursing considerations?
Adverse effects - Constipation (rare) - No systemic side effects because not absorbed Nursing considerations - PO route only - Should not be taken within 30 minutes of antacids - Can alter absorption of many other meds: should be taken 2hrs apart
58
# Other Antiulcer Drugs Misoprostol MOA?
Replaces endogenous prostaglandin - Suppresses secretion of gastric acid - promotes secretion of bicarb/mucus - Increases mucsosal blood flow
59
# Other Antiulcer drugs Misoprostol indications?
Limited to prevented NSAID induced gastroduodenal ulcers Often seen as a combination drug with NSAIDS
60
# Antiulcer drugs Misoprostol adverse effects and nursing considerations?
Adverse Effects Minimal Diarrhea Can cause irregular periods Nursing Considerations Contraindicated in pregnancy - will cause spontaneous abortion
61
# Other Antiulcer Drugs Antacids MOA?
Alkaline compounds that neutralize stomach acids Raise pH of stomach above 5 (doesnt change HCL secretions) Reduce pepsin activity Stimulate production of porstaglandins Not systemically absorbed (except sodium bicarbonate)
62
# Antiulcer drugs Antacids indications?
GERD, PUD, Gastritis
63
# Antacids Magnesium Hydroxide (milk of magnesia) Adverse effects
- Diarrhea (given with aluminum hydroxide to counteract this effect) - Avoid in pts with undiagnosed abd pain (potential bowel obstruction) - Mg can accumulate in people with renal dysfunction
64

Nurs 2514 Drugs (2 decks)

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