Exam 3 Flashcards
What are the two major centers in the medulla oblongata that control vomiting ?
Chemoreceptor Trigger Zone
Vomiting Center
What are some over the counter remedies for nausea?
diphenhydramine, dramamine, meclizine, pepto-bismol
What are common prescription antinausea meds?
Antihistamines (OTC)
Anticholinergics
Dopamine antagonists
Benzodiazepines
Serotonin antagonists
Glucocorticoids
Cannabinoids
Miscellaneous
Scopalamine patches are used for what?
Postoperative nausea relief for 72 hours
What are the 5 side effects of anticholinergenics?
Can’t see - pupil dilation
Can’t pee - urinary retention
Can’t spit - dries secretions
Can’t shit - Constipation
Tachycardia
Pupil dilation is why we can’t give to people with glaucoma
How do Dopamine Antagonists work?
Block dopamine 2 receptors in the Chemoreceptor Trigger Zone
Two uses of Dopamine Antagonists are ________________ and __________________. Smaller doses are used for which purpose?
Antipsychotics (chemical restraint) and antinausea
Smaller doses are used for antinausea purposes
Side effects of Dopamine Antagonists are:
Hypotension, sedation, extra pyramidal syndrome, CNS effects, dry mouth, constipation, urinary retention.
What are the side effects of Butyrophenones?
Why does this make sense?
EPS occur with extended use, Hypotension- monitor BP
This makes sense because butyrophenones are dopamine antagonists.
What are side effects of metocloparimide?
Who should not take it?
What makes sense and what is surprising about these considerations?
High doses cause sedation and diarrhea
Do not give with GI obstruction, hemorrhage, or perforation (This makes sense, because it causes diarrhea, which harms these folks)
EPS more prevalent in children
Sedation and EPS makes sense because it’s a dopamine antagonist, but the diarrhea is unexpected. Surprise! Diarrhea!
In addition to their uses for sedation, Benzodiazapines can be used as an ___________________ med.
antinausea
Why are serotonin receptor antagonists superior to dopamine antagonists ?
The are extremely effective, do not cause extra pyramidal syndrome or other side effects of the dopamine antagonists.
What are side effects of serotonin antagonists?
head ache, diarrhea, dizziness, and fatigue
5-HT3 receptor antagonists can cause QTc prolongation if administered concomitantly with other QTc-prolonging medications or in patients with a history of congenital long-QT syndrome.
What use are glucocorticoids for cancer patients and postoperative patients?
They are steroids, and good antinausea meds that are effective for n/v associated with cancer treatment and postoperatively.
They are used only for a short while, thus side effects decreased.
What are side effects of cannabinoids?
Who should use them, and for what?
Who shouldn’t use them?
Side Effects - Mood changes, euphoria, drowsy, dizzy, head ache, hypertension, ortho hypotension, dry mouth, confusion
Any one who needs an appetite, pain relief, has cancer
but does not have psychological problems, or heart problems.
Diarrhea and vomiting lead to electrolyte imbalance, especially which electrolyte?
Potassium
Your ass puts the lytes in the pot
How long should you use antidiarrheals?
When should you not use them?
Two days max
If the diarrhea presents with fever
The three types of antidiarrheals Prof Holly mentioned are:
The fourth type is:
Opiates/opiate related
Somostatin Analogues
Adsorbents
Also, bulk forming agents
What are nonpharmaacologic interventions for constipation?
High fiber diet
Increased water intake
Exercise
When should you not use laxatives or cathartics?
Do not use if intestinal obstruction, appendicitis, ulcerative colitis, diverticulitis
What is the difference between a laxative and a cathartic?
Laxatives ease the passage of fully formed fecal matter from the rectum; while cathartics have a stronger effect, and cause the evacuation of the entire colon, usually in the form of watery, unformed stool.
What are the four types of laxatives?
Osmotics
Stimulants
Bulk forming
Emollients
What are the 7 types of drugs used to treat ulcers?
Tranquilizers- decrease vagal activity
Anticholinergics- decrease acetylcholine by blocking cholinergic receptors
Antacids- take 1-3 hours after meals neutralize gastric acid decrease absorption of everything promote ulcer healing – Mg - diarrhea or Al – causes constipation Magnesium Aluminum Oxide has both
Antihistimine blockers- block h2 receptors
Proton pump inhibitors- inhibit gastric acid secretion
Sucralfate- mucosal protectant
Prostaglandin E1 analogue misoprostol- inhibits gastric acid secretion and protects the mucosa
What are nonpharmacologic interventions for ulcers?
Cessation of tobacco and alcohol.
Weight loss
Avoid hot, spicy, greasy foods.
NSAIDs/ Glucocorticoids should be taken with food or decrease dose.
Raise head of bed.
Avoid eating before bedtime.
Wear loose fitting clothes.
