Exam 3

Question 1

What are the two major centers in the medulla oblongata that control vomiting ?

Answer 1

Chemoreceptor Trigger Zone
Vomiting Center

Question 2

What are some over the counter remedies for nausea?

Answer 2

diphenhydramine, dramamine, meclizine, pepto-bismol​

Question 3

What are common prescription antinausea meds?

Answer 3

Antihistamines (OTC)​

Anticholinergics​

Dopamine antagonists​

Benzodiazepines​

Serotonin antagonists​

Glucocorticoids​

Cannabinoids​

Miscellaneous​

Question 4

Scopalamine patches are used for what?

Answer 4

Postoperative nausea relief for 72 hours

Question 5

What are the 5 side effects of anticholinergenics?

Answer 5

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

Question 6

How do Dopamine Antagonists​ work?

Answer 6

Block dopamine 2 receptors in the Chemoreceptor Trigger Zone​

Question 7

Two uses of Dopamine Antagonists​ are ________________ and __________________. Smaller doses are used for which purpose?

Answer 7

Antipsychotics (chemical restraint) and antinausea

Smaller doses are used for antinausea purposes

Question 8

Side effects of Dopamine Antagonists are:

Answer 8

Hypotension, sedation, extra pyramidal syndrome, CNS effects, dry mouth, constipation, urinary retention.

Question 9

What are the side effects of Butyrophenones?
Why does this make sense?

Answer 9

EPS occur with extended use, Hypotension- monitor BP

This makes sense because butyrophenones are dopamine antagonists.​

Question 10

What are side effects of metocloparimide?
Who should not take it?
What makes sense and what is surprising about these considerations?

Answer 10

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!

Question 11

In addition to their uses for sedation, Benzodiazapines can be used as an ___________________ med.

Answer 11

antinausea

Question 12

Why are serotonin receptor antagonists superior to dopamine antagonists ?

Answer 12

The are extremely effective, do not cause extra pyramidal syndrome or other side effects of the dopamine antagonists.

Question 13

What are side effects of serotonin antagonists?

Answer 13

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.

Question 14

What use are glucocorticoids for cancer patients and postoperative patients?

Answer 14

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.​

Question 15

What are side effects of cannabinoids?
Who should use them, and for what?
Who shouldn’t use them?

Answer 15

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.

Question 16

Diarrhea and vomiting lead to electrolyte imbalance, especially which electrolyte?

Answer 16

Potassium

Your ass puts the lytes in the pot

Question 17

How long should you use antidiarrheals?
When should you not use them?

Answer 17

Two days max

If the diarrhea presents with fever

Question 18

The three types of antidiarrheals Prof Holly mentioned are:
The fourth type is:

Answer 18

Opiates/opiate related
Somostatin Analogues
Adsorbents

Also, bulk forming agents

Question 19

What are nonpharmaacologic interventions for constipation?

Answer 19

High fiber diet​

Increased water intake​

Exercise

Question 20

When should you not use laxatives or cathartics?

Answer 20

Do not use if intestinal obstruction, appendicitis, ulcerative colitis, diverticulitis

Question 20

What is the difference between a laxative and a cathartic?

Answer 20

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.

Question 20

What are the four types of laxatives?

Answer 20

Osmotics
Stimulants
Bulk forming
Emollients

Question 20

What are the 7 types of drugs used to treat ulcers?

Answer 20

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​

Question 20

What are nonpharmacologic interventions for ulcers?

Answer 20

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.

Question 20

How do you determine when to take antiulcer drugs?

Answer 20

If decrease absorption take after meals, if decrease acid take before meals (every morning)

Question 21

How do anticholinergenics help heal ulcers?

Answer 21

Take before meals to decrease acid secretion.

Decrease GI motility and secretion​

Delay gastric emptying time (used more for duodenal ulcers)​

Question 22

Antacids come in systemic and nonsystemic forms. Name some of each:

When is the ideal time to take them?

Answer 22

Systemic effect- sodium bicarbonate and calcium carbonate​

Nonsystemic- magnesium and aluminum hydroxide in combination for least side effects. Amphogel, Maalox, Mylanta

Take 13 hrs after meals

Question 23

What are histamine 2 blockers for, and how do they work?

Answer 23

They are for treating acid reflux/ulcers

Prevent gastric reflux into the esophagus, reduce gastric acid secretion and concentration

Question 24

What are side effects of histamine 2 blockers?

Answer 24

headache, dizziness, constipation, skin rash, decreased libido, impotence, gynecomastia

Question 25

What are proton pump inhibitors for and how do they work?

Answer 25

They are for ulcers/ reflux

Proton pump inhibitors suppress gastric acid secretion.

Question 26

What are side effects of proton pump inhibitors?

Answer 26

ha, dizziness, diarrhea, abdominal pain, rash.

Monitor liver enzymes and watch for drug interactions

Question 27

What is sucralfate for, and how does it work?

Answer 27

To protect ulcers and allow them to heal

Nonabsorbable, combines with protein to form protective layer over ulcer. Take one before every meal​

Question 28

What are side effects and considerations for sucralfate?

Answer 28

side effects- constipation​

Decreases absorption of tetracycline, dilantin, fat-soluble vitamins, abx.​

Antacids decrease effects of drug.

Question 29

What are prostaglandin analogues used for?

How do they work?

Answer 29

Antiulcer and abortifacent

Suppress gastric acid secretion and increase cytoprotective mucus in the GI tract. Prevention of NSAID induced gastric ulcers​

Question 30

What are side effects and nursing considerations for prostaglandin analogues?

Answer 30

Side effects- N/V/D, severe abdominal contractions - abdominal pain, constipation, flatulence, menstrual spotting.​

Avoid if pregnant or of child bearing age.