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Pharm II Test 1 > Constipation, Nausea, Vomiting > Flashcards

Constipation, Nausea, Vomiting Flashcards

1
Q

Dietary Fiber, Psyllium (Metamucil)- Mech of Action

A

increase stool weight, draw water into the stool

stimulate peristalsis

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2
Q

Dietary Fiber, Psyllium (Metamucil)- Absorption, Distribution

A

Effective in 12-24hrs

Max effect in several days

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3
Q

Dietary Fiber, Psyllium (Metamucil)- Adverse Effects/Contraindications

A

Flatulence

Requires increased fluid intake- do not use on patients that cannot drink increased fluid

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4
Q

Bulk Laxatives- Available drugs

A

Dietary Fiber

Psyllium (Metamucil)

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5
Q

Osmotic Laxatives- Available drugs

A

Non-absorbable sugars: lactulose, sorbitol

Sodium & Magnesium salts: magnesium citrate, magnesium hydroxide, sodium phosphate

Polyethylene Glycol: Miralax, Glycolx, Colyte, Golytely

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6
Q

Non-absorbable sugars: lactulose, sorbitol- Mech of Action

A

increase osmotic pressure and acidity of stool, draw water into stool

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7
Q

Non-absorbable sugars: lactulose, sorbitol- Clinical Use

A

constipation

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8
Q

Non-absorbable sugars: lactulose, sorbitol- Adverse effects/contraindications

A

bloating, cramps, flatulance; “sickly sweet” taste

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9
Q

Sodium & Magnesium salts: magnesium citrate, magnesium hydroxide, sodium phosphate- Mech of Action

A

osmotically active particles, Mg stimulates cholecystokinin

increase intraluminal volume, stimulate intestinal activity

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10
Q

Sodium & Magnesium salts: magnesium citrate, magnesium hydroxide, sodium phosphate- Clinical use

A

Magnesium citrate & sodium phosphate- bowel prep

Magnesium hydroxide- Constipation

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11
Q

Sodium & Magnesium salts: magnesium citrate, magnesium hydroxide, sodium phosphate- Adverse effects/Contraindications

A

High doses= rapid bowel evacuation; last resort for constipation

rarely cause ischemic colitis

Contraindicated in bowel obstruction, dehydration, electrolyte abnormalities, renal failure

Sodium phosphate can cause acute phosphate nephropathy

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12
Q

Polyethylene Glycol: Miralax, Glycolx, Colyte, Golytely- Mech of Action

A

osmotically active, retains water in stool

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13
Q

Polyethylene Glycol: Miralax, Glycolx, Colyte, Golytely- Clinical use

A

Miralax & Glycolax- (small dose) constipation

Colyte & Golytely- (large volume) bowel prep

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14
Q

Stimulant Laxatives- Available Drugs

A

Senna

Bisacodyl

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15
Q

Senna- Mech of Action

A

converts to active metabolite in colon, stimulates myenteric plexus

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16
Q

Biscodyl- Mech of Action

A

stimulate sensory nerve endings, parasympathetic stimulation, peristalsis

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17
Q

Senna & Biscodyl- Clinical Use

A

constipation

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18
Q

Senna & Biscodyl- Adverse effects/Contraindications

A

cramping

melanosis coli

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19
Q

Lubricants- Available drugs

A

Detergent Laxatives: Docusate
Glycerin
Mineral oil

20
Q

Detergent Laxatives: Docusate- Mech of Action

A

Suractant, increases penetration of fluid into stool, softens feces

21
Q

Detergent Laxatives: Docusate- Clinical Use

A

prevent formation of hard stool

22
Q

Glycerin- Mech of Action

A

osmotic action

irritant to stimulate rectal contrations

23
Q

Glycerin- Absorption, Distribution

A

suppository or enema

24
Q

Glycerin- Clinical Use

A

fecal impaction

25
Q

Mineral oil- Mech of Action

A

coats fecal matter, softens stools, lubricates

26
Q

Mineral oil- Absorption, distribution

A

large volume enema

27
Q

Mineral oil- Clinical Use

A

fecal impaction

28
Q

Mineral oil- Adverse Effects/Contraindications

A

never administered orally in debilitated patients- severe pneumonia, lipoid pneumonitis

29
Q

Nausea & Vomiting- Available Drugs

A 
metoclopramide
prochlorperazine
promethazine
ondansetron
scopolomine
corticosteroids: prednisone, dexamethasone
benzodiazepenes: lorazepam, diazepam
30
Q

Metoclopramide- Mech of Action

A

Dopamine receptor antagonist.
Blocks pathway 3- chemoreceptors.
Also promoted motility of upper G.I.

31
Q

Metoclopramide- Clinical use

A

Chemotherapy induced nausea, vomiting.

UGI tract dysmotility.

32
Q

Metoclopramide- Adverse Effects/Contraindications

A

Extrapyramidal anti-dopaminergic: dystonia, akathisia, Parkinsonism. Caution in Parkinson’s disease. Acute dystonic reactions- Trismus, torticollis- treat with anticholinergic diphenhydramine.

33
Q

Prochlorperazine- Mech of Action

A

Dopamine receptor antagonist.
Peripheral vagus block.
Blocks pathways 3 and 4.

34
Q

Prochlorperazine- Clinical Use

A

Opioid related nausea and vomiting.

GI disorders, inflammation, infection

35
Q

Prochlorperazine- Adverse Effects/Contraindications

A

Extrapyramidal anti-dopaminergic: dystonia, akathisia, Parkinsonism. Caution in Parkinson’s disease. Acute dystonic reactions- Trismus, torticollis- treat with anticholinergic diphenhydramine.

36
Q

Promethazine- Mech of Action

A

H1 antagonist. Blocks pathway 1.

37
Q

Promethazine- Clinical Use

A

motion sickness

38
Q

Promethazine- Adverse Effects/Contraindications

A

sedation

39
Q

Ondansetron- Mech of Action

A

Serotonin 5-HT3 receptor antagonist. Blocks pathways 3 and 4.

40
Q

Ondansetron- Absorption, Distribution

A

may have central and peripheral activity

41
Q

Ondansetron- Clinical Use

A

chemotherapy or radiation induced nausea, vomiting

42
Q

Ondansetron- Adverse Effects/Contraindications

A

Headache

QT prolongation

43
Q

Scopolamine- Mech of Action

A

Pure anticholinergic.

Block pathway 1.

44
Q

Scopolamine- Clinical Use

A

motion sickness

45
Q

Scopolamine- Adverse Effects/Contraindications

A

confusion, urinary retention, acute narrow angle glaucoma, dry mouth

46
Q

Corticosteroids: prednisone, dexamethasone- Clinical use

A

nausea due to increased intracranial pressure

47
Q

Benzodiazepenes: lorazepam, diazepam- Clinical Use

A

anxiety associated nausea and vomiting; anticipatory nausea/vomiting

Pharm II Test 1 (4 decks)

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