GI Flashcards
1
Q
What are the three gastric gland cell types?
A
- Parietal
- Chief
- Mucoid
2
Q
What cells are the primary site of action for many acid-controller drugs?
A
Parietal cells
3
Q
What do parietal cells secrete?
A
HCl
4
Q
What do chief cells secrete?
A
Pepsinogen
5
Q
What does pepsin break down?
A
Proteins
6
Q
What does mucous protect against?
A
Self-digestion by HCl
7
Q
What is the pH of the stomach?
A
1-4
8
Q
What are three stimuli for HCl secretion?
A
- Excessive amounts of alcohol
- Large, fatty meals
- Emotional stress
9
Q
Acid-related GI disorders are due to an imbalance of what?
A
The three gastric gland secretions
10
Q
What is the most common kind of acid-related GI disorder?
A
Hyperacidity
11
Q
What are three lay terms for hyperacidity?
A
- Sour stomach
- Acid stomach
- Heart burn
12
Q
What is peptic ulcer disease (PUD)?
A
- Lesion in stomach (gastric)
- Lesion in small intestine (duodenal)
13
Q
What are six predisposing factors of PUD?
A
- Heavy ETOH use
- Smoking
- Heavy caffeine use
- Chronic use of ASA (aspirin) and other NSAIDs
- Chronic use of systemic corticosteroids (injection or pill… NOT inhaler)
- Excessive psychological stress
14
Q
What are two primary etiologies for PUD?
A
- Chronic NSAID use
- Heliobacter pylori infection
15
Q
What is a rare condition of hypersecretion of HCl due to gastrinoma?
A
Zollinger-Ellison Syndrome
16
Q
In Zollinger-Ellison Syndrome, what does the tumor secrete and what does this cause?
A
Tumor secretes gastrin
Hypersecretion of HCl
17
Q
In what age group do duodenal ulcers frequently occur?
A
30-50
18
Q
How does a duodenual ulcer manifest?
A
Hematemesis or melena
19
Q
In a duodenal ulcer, what can the pain be relieved by?
A
Eating
20
Q
Gastric ulcers are more common in what age group?
A
Over 60
21
Q
What do gastric ulcers present with?
A
- Anorexia
- Weight loss
- Vomiting
- Epigastric pain that may/may not be relieved by eating
22
Q
What are two forms of inflammatory bowel disease (IBD)?
A
- Crohn’s Disease
- Ulcerative Colitis
23
Q
Where can inflammation occur in Crohn’s Disease?
A
Anywhere along the alimentary canal
24
Q
What is the most common site of inflammation in Crohn’s Disease?
A
Terminal Ileum
25
What are the characteristics of the lesions in Crohn's Disease?
They are "skip lesions"
26
True or False:
Extraintestinal mainfestations are very common in Crohn's Disease.
False
(Extraintestinal manifestations less common)
27
Where does inflammation and ulceration take place in Ulcerative Colitis (UC)?
Large intestine
28
True or False:
Extraintestinal manifestations are very common in Ulcerative Colitis (UC)
True
29
In UC, where does pyoderma gangrenosum usually occur?
Cutaneous ulcerations usually in legs
30
What is erythema nodosum?
Inflammation, scarring, and destruction of bile ducts
31
What are ten extraintestinal manifestations that occur in IBD (mostly UC)?
1. Sacroiliitis
2. Osteoporosis
3. Peripheral arthritis
4. Uveitis
5. Scleritis
6. Episcleritis
7. Nephrolitiasis
8. Thromboembolic events
9. Pyoderma gangrenosum
10. Primary sclerosing cholangitis
32
What is gastroesophageal reflux disease (GERD)?
HCl from stomach splashes up into esophagus
↓ ↓
Results in severe heartburn and other chest symptoms
33
What is GERD caused by?
Ineffective lower esophageal sphincter
34
What are some complications that arise from GERD?
* Esophageal ulcers
* Barrett's esophagitis
* Esophageal strictures
35
What happens to the squamous epithelium in the distal esophagus when a person has Barrett's esophagitis?
Converts to columnar epithelium
(Not normally found here → Pre-malignant)
36
How do esophageal strictures cause disphagia?
Esophageal lining damaged from HCl
↓ ↓
Develops scar tissue
↓ ↓
Esophageal lining becomes still and scar tissue builds up
↓ ↓
Esophageal narrowing around scar tissue
37
What are three goals for pharmacotherapy of PUD and GERD?
1. Provide relief from symptoms
2. Promote healing of ulcer
3. Prevent future recurrence of disease
38
What is the MOA for antacids?
**Promote gastric mucosal secretion**
Mucus is rich in bicarbonate so it buffers HCl.
39
True or False:
Antacids prevent the over-production of acid.
False
(Antacids DO NOT prevent the overproduction of acid)
40
True or False:
Antacids neutralize the acid once it's present in the stomach.
True
41
Chronic use of antacids may lead to what?
Rebound hyperacidity
| (especially calcium formations)
42
Raising gastric pH from 1.3 to 1.6 (0.3) neutralizes what percentage of the gastric acid?
What percentage would be neutralized by raising it from 1.3 to 2.3 (1.0)?
50%
90%
43
What are five OTC formulations of antacids?
1. Capsules and tablets
2. Powders
3. Chewable tablets
4. Suspensions
5. Effervescent granules and tablets
44
What are four types of antacids?
1. Aluminum salts
2. Magnesium salts
3. Calcium salts
4. Sodium bicarbonate
45
Why are aluminum salts are often used with magnesium?
Counteract constipation
46
What is an example of an aluminum?
Aluminum carbonate (Basaljel)
47
Aluminum causes _________ while magnesium is a \_\_\_\_\_\_\_\_\_\_.
Constipation; laxative
48
Why do you need to use caution when giving magnesium to a patient with renal failure?
Failing kidney cannot excrete extra Mg
↓ ↓
Magnesium accumulation
49
What is an example of magnesium?
Magnesium hydroxide (MOM)
50
What is an example of a combo of magnesium and aluminum?
Maalox and Mylanta
51
What is the most common form of calcium?
Carbonate
52
What might calcium cause?
Constipation
53
Calcium might contribute to the development of what?
Kidney stones
54
What are two examples of calcium salts?
* Tums
* Rolaids
55
Sodium bicarb is more commonly known as what?
Baking soda
56
What are three sodium content cautions?
* CHF
* Htn
* Renal insufficiency
57
What is a special precaution of sodium bicarb and why?
Alkaseltzer
Because it has sodium bicarb, citric acid, and aspirin
58
Antiflatulents relieve painful symptoms associated with what?
Gas
59
Antiflatulents are often added to what combination products?
Antacid
60
What is the OTC antiflatulent?
Simethicone
61
What is the MOA of simethicone?
Alters elasticity of mucus-coated bubbles
↓ ↓
Bubbles break
62
What are five examples of simethicone?
1. Phazyme
2. Flatulex
3. Mylicon
4. Gas-X
5. Mylanta Gas
63
Aluminum and calcium cause \_\_\_\_\_\_\_\_\_; magnesium causes \_\_\_\_\_\_\_\_; calcium carbonate causes _______ and \_\_\_\_\_\_\_\_\_\_.
Aluminum and calcium cause **CONSTIPATION**; magnesium causes **DIARRHEA**; calcium carbonate causes **GAS** and **BELCHING**.
64
To prevent gas and belching, calcium carbonate is often combined with what?
Simethicone
65
What is chelation?
Chemical binding with other drugs
↓ ↓
Drugs become inactive
↓ ↓
Insoluble complexes
↓ ↓
Reduced absorption of bioactive drug
66
What are three drug interactions of antacid?
1. Chelation
2. Inceased gastric pH
3. Increased urine pH
67
Why does gastric pH rise from taking antacids?
* **Increased** absorption of **basic** drugs
* **Decrease** absorption of **acidic** drugs
68
What are five drug interactions of calcium compounds?
1. Quinolones
2. **Tetracycline**
3. Corticosteroids
4. Calcium channel blockers (CCBs)
5. Phosphate supplements
69
Histamine stimulates ________ cells in the stomach to produce \_\_\_\_\_\_.
Parietal; HCl
70
What do H2 antagonists block? What does this cause?
Histamine at the parietal cell H2 receptors
Decreased production of HCl from stomach
71
True or False:
H2 antagonists are all available OTC.
True
72
True or False:
H2 anagonists are more popular than PPIs.
False
73
What are four H2 antagonists?
1. Cimetidine (Tagamet)
2. Famotidine (Pepcid)
3. Nizatidine (Axid)
4. Ranitidine (Zantac)
74
What is the MOA of H2 anatgonists?
Histamine stimulates parietal cells to produce HCl
↓ ↓
H2 antagonists block histamine (H2) at the parietal H2 receptors
↓ ↓
Decreased production of HCl from parietal cells in stomach
75
What are six indications for H2 antagonists?
1. Heal active ulcers
2. Maintenance therapy ulcers
3. Reduction of GERD symptoms
4. Heal erosive esophagitis
5. Zollinger-Ellison Syndrome
6. Prevent GI bleed in critical care patients (stress ulcers)
76
True or False:
H2 antagonists are also used in management of severe or refractory allergic conditions.
True
77
What are H2 antagonists used in conjunction with to manage severe or refractory allergic conditions?
* H1 blockers
* Antihistamines
* Corticosteroids
78
True or False:
H2 antagonists have a large number of side effects.
False
(Low side effect profile overall - less than 3%)
79
Cimetadine (Tagamet) might induce what two conditions?
* Impotence
* Gynecomastia
80
What happens when Cimetidine (Tagamet) interacts with the P-450 microsomal oxidase system in the liver?
Inhibits oxidation (metabolism) of many drugs
↓ ↓
Higher risk of increased bioactive drug levels
81
What decreases effectiveness of H2 blockers?
Smoking
82
Why must you use caution with H2 antagonists in elderly patients?
Greater risk of CNS side effects (especially Tagamet)
83
What is the "proton pump"?
When parietal cells release H+ ions (protons) during HCl production
84
True or False:
H2 antagonists and antihistamines inhibot the action of the proton pump.
False
(They **do not** inhibit the proton pump)
85
What is the MOA for proton pump inhibitors (PPIs)?
Irreversibly block H+/K+ ATPase system (proton pump) in parietal cells
↓ ↓
Prevetn the release of H+ ions from parietal cells
↓ ↓
**Blocks ALL gastric acid secretion**
86
What is achlorhydria?
Total inhibition of gastric acid secretion
87
What are the seven currently available PPIs?
**They all end in "-prazole"**
1. Lanso**prazole** (Prevacid)
2. Ome**prazole** (Prilosec)
3. Ome**prazole** + sodium bicarb (Zegerid)
4. Rabe**prazole** (Aciphex)
5. Panto**prazole** (Protonix)
6. Esome**prazole (**Nexium)
7. Dexlanso**prazole** (Dexilant)
88
What are five indications for PPIs?
1. GERD maintenance therapy
2. Erosive esophagitis
3. Short-term treatment of active duodenal and benign gastric ulcers
4. Zollinger-Ellison syndrome
5. Treatment of *H. pylori*-induced ulcers
89
Are H2 antagonists or PPIs better to use for GERD?
PPIs
| (H2 are not as popular as PPIs now.)
90
PPIs have pretty benign side effects. What are they?
1. Headache
2. Diarrhea
3. Abdominal pain
4. Nausea
5. Constipation
6. Bloating
91
PPI's might increase serum levels of _________ and \_\_\_\_\_\_\_\_\_. We must take precautions before prescribing.
Diazepam; Phenytoin
92
A patient is taking Coumadin. Is it OK to prescribe a PPI? If not, why?
No.
May cause increased risk of bleeding.
93
What is Dr. Dill's favorite PPI?
Prevacid
94
What percentage of **duodenal ulcers** are related to *H. pylori*?
What about **gastric ulcers**?
90%
70%
95
True or False:
If *H. pylori* is not treated, the infection could remain active for life.
True
96
Iradication of H. pylori organism leads to two things. What are they?
* Ulcers heal more rapidly
* Results in longer remission
97
What are four antibiotics commonly prescribed as part of *H. pylori* therapy? How many are usually prescribed?
1. Amoxicillin (Amoxil)
2. Clarithromycin (Biaxin)
3. Metroniadazole (Flagyl)
4. Tetracycline
Two or more
98
What are two reasons why we prescribe antibiotics for *H. pylori* therapy?
1. Increase effectiveness of therapy
2. Lower bacterial resistance potential
99
What are bismuth compounds added to *H. pylori t*herapy?
Inhibit bacterial growth
100
What drug would you prescribe for an *H. pylori* ulcer?
Prevpac + Bismuth compound
101
What is contained in one dose of Prevpac?
* Lansoprazole (Prevacid), **30 mg**
* Amoxicillin, **1 gram**
* Clarithromycin (Biaxin), **500 mg**
102
What is the adult Sig of Prevpac?
One dose bid x 14 d
103
How long should antibiotic therapy for *H. pylori* ulcers last?
7-14 days
104
How does Sucralfate (Carafate) work?
Attracted to and binds to base of ulcers
↓ ↓
Forms protective barrier
105
What does Sucralfate (Carafate) protect the damaged areas of ulcers from?
Harmful effects of pepsin
106
True or False:
Sucralfate (Carafate) allows excessive absorption from the gut.
False
| (**Minimal** absorption from the gut)
107
Since Sucralfate (Carafate) allows only minimal absorption from the gut, what could this impair?
Absorption of other drugs (**especially tetracycline**)
108
What does Sucralfate (Carafate) bind to?
Phosphate
109
Sucrlafate is also used in CFR (chronic renal failure) to _______ phosphate levels.
Lower
110
What are the three indications for Sucralfate (Carafate)?
1. Stress ulcers (damage to GI mucosa associated with critical illness)
2. Erosive esophagitis
3. Adjunct PUD
111
What are three side effects of Sucralfate (Carafate)?
1. nausea
2. dry mouth
3. constipation
112
What is a prostaglandin?
Group of lipid compounds derived from fatty acids
113
What does Misoprostol (Cytotec) act like? What is this called?
A prostaglandin
Cytoprotective
114
True or False:
Prostaglandins have a very short half-life.
True
115
Prostaglandins have what two types of effects?
* Paracrine (local)
* Autocrine (same cell)
116
What are seven functions of prostaglandins?
1. Vasoconstriction / dilation of smooth muscle
2. Aggregration or disaggregation of platelets
3. Sensitize spinal nuerons to pain
4. **Regulate inflammatory mediation**
5. Regulate calcium movement
6. Control hormone regulation
7. Control cell growth
117
Misoprostol (Cytotec) is a synthetic __________ analogue.
Prostaglandin
118
Misoprostol (Cytotec) protects gastric mucosa from injury by enhancing what?
**Local** production of mucus
119
What does Misoprostol (Cytotec) promote in local cells?
Regeneration
120
What happens when there is enhanced mucosal blood flow? What drug causes this?
Enhanced mucosal integrity
**Misoprostol (Cytotec)**
121
What are *said* to inhibit prostaglandins?
NSAIDs
(Get it? What are "said"... just a little joke to lighten the tension!!)
122
Misoprostol (Cytotec) inhibits activation of what?
Proton pump
123
What is / are the indiciation(s) for Misoprostol (Cytotec)?
1. **Prevention of NSAID-induced gastric ulcer**
2. Used in conjunction with RU486 for early pregnancy termination
3. Cervical ripening at / near term pregnancy
4. Severe refractory (nothing works) constipation
124
Does Misoprostol (Cytotec) have a therapeutic effect in duodenal ulcers?
Only with high doses
↓ ↓
This will likely cause abdominal cramps, diarrhea
125
What is the BLACK BOX WARNING for Misoprostol (Cytotec)?
Abortification
126
What are the indications for Metoclompromide (Reglan)?
* GERD (nobody uses it for this anymore...)
* Diabetic gastroparesis (hypomotility)
* **Prevention of N/V in chemotherapy**
* **Prevention of N/V in post-op patients**
127
What are the two anticholinergics for PUD?
* Glycopyrrolate (Robinul)
* Propantheline
128
Are anticholinergics for PUD primary or adjunct treatment?
Adjunct treatment
129
What is the MOA of anticholinergics for PUD?
Cholinergic blockers (anticholinergics) at muscarinic receptors
↓ ↓
Inhibit autonomic receptors for gastric acid secretion (via vagus nerve)
130
Diarrhea could be what of three things?
* Abnormal frequent passage of loose stool
* Abnormal passage of stools with increased
* frequency
* fluidity
* weight
* Abnormal passage of stools with increased stool / water excretion
131
What is acute diarrhea?
Sudden onset in a previously healthy person
132
How long does acute diarrhea last for?
3 days to 2 weeks
133
True or False:
Acute diarrhea is self-limiting.
True
134
True or False:
Acute diarrhea sometimes causes sequelae.
False
135
How long does chronic diarrhea last for?
Over 3 to 4 weeks
136
What is chronic diarrhea?
Recurring passage of diarrheal stool
137
Chronic diarrhea may include what four symptoms?
* Fever
* Anorexia
* Nausea and vomiting
* Weight loss
138
What are six causes of acute diarrhea?
1. Bacterial
2. Viral
3. Protozoal
4. Drug-induced
5. Hyperthryoidism
6. Nutritional
139
What are four causes of chronic diarrhea?
1. Tumors
2. Diabetes
3. Addison's
4. IBS
140
What are four antidiarrheals?
1. Adsorbents
2. Anticholinergics
3. Intestinal Flora Modifiers
4. Opiates
141
What is the MOA for adsorbents?
**Prevents absorption**
Coats walls of GI tract
↓ ↓
Binds to bacteria or toxin
↓ ↓
Eliminated through the stool
142
What are two examples of adsorbnents?
Bismuth subsalicylate **OTC**
Cholestyramine **Rx**
143
What kind of diarrhea is cholestyramine used for?
*C. diff* diarrhea
144
What is the MOA for anticholinergics?
Decrease intestinal muscle tone and peristalsis of GI tract
↓ ↓
Slows movement of fecal matter through the GI tract
145
What are two examples of anticholinergics?
* Donnatal
* phenobarbital
* hyoscyamine
* atropine
* scopolamine
* Motofen **(Sched IV)**
* difenoxin
* atropine
146
What are intestinal flora modifiers?
Bacterial cultures of Lactobacillus organisms
147
What are two things that intestinal flora modifiers do?
* Supply missing bacteria to the GI tract
* Suppress growth of diarrhea-causing bacteria
148
What are two examples of intestinal flora modifiers?
* Lactobacillus acidophilus (Probiotic)
* Yogurt w/ live active cultures
149
What is the B.R.A.T.Y diet?
* Bananas
* Rice
* Applesauce
* Toast / crackers
* Yogurt w/ live active cultures
150
What is the MOA for opiates?
* Decrease bowel motility and relieve rectal spasms
* Increases transit time (slows) through the bowel
151
Opiates increase transit time through the bowel. What does this allow?
More time for water and electrolytes to be absorbed
152
What are examples of opiates?
* Diphenoxalate / Atropine (Lomotil) **Sched V**
* Loperamide (Imodium) **Rx/OTC**
153
Adsorbents may ________ absorption of many agents.
(Increase or decrease?)
Decrease
154
Antacids may ________ anticholinergic / antidiarrheal effect.
(Increase or decrease?)
Decrease
155
What are the two trade names of Bismuth Subsalicylate (OTC)?
* Pepto Bismol
* Kaopectate
156
What is Bismuth Subsalicylate contraindicated in?
What is there a risk of if you give this drug?
Children under age of 16 or teenages with chicken pox
Reye's syndrome associated with ASA
157
What is constipation?
Abnormally infrequent and / or difficult passage of tool
↓ ↓
Disorder of movement through the colon and / or rectum
158
What are two metabolic / endocrine disorders that cause constipation?
* Diabetes
* Hypothyroidism
159
What are five neurogenic disorders of constipation?
* Autonomic neuropathy
* Multiple sclerosis
* Spinal cord lesions
* Parkinson's disease
* CVA
160
What are nine drug causes of constipation?
1. Anticholinergics
2. Iron supplements
3. Opiates
4. Aluminum antacids
5. Calcium antacids
6. Antispasmodics
7. Antidepressants
8. Diuretics
9. Anticonvulsants
161
What are six lifestyle causes of constipation?
1. Poor bowel habits
2. Inadequate fluid intake
3. Low-residue (roughage) diet
4. Stress and / or anxiety
5. Excessive consumption of dairy products
6. Physical inactivity
162
What are five kinds laxatives?
1. Bulk-forming
2. Emollient
3. Hyperosmotic
4. Saline
5. Stimulant
163
What is the MOA of bulk-forming laxatives?
**High fiber**
Absorbs water to increase bulk
↓ ↓
Distends bowel to initiate reflex bowel activity
164
What are three examples of bulk-forming laxatives?
* Psyllium (Metamucil) **OTC**
* Methylcellulose (Citrucel) **OTC**
* Calcium Polycarbophil (FiberCon) **OTC**
165
What is the MOA for emollients?
Stool softener
Not absorbed through GI tract (stay in lumen)
↓ ↓
Adds water / fat to stool
↓ ↓
Lubricate the fecal material and intestinal walls
166
What is an example of a stool softener?
Docusate salts (Colace) **OTC**
167
What is an example of a lubricant?
Mineral oil **OTC**
168
What is the MOA of hyperosmotics?
Increase osmolality in lumen of GI tract
↓ ↓
Water attracted due to increase osmotic pressure
↓ ↓
Bowel distension
↓ ↓
Increased peristalsis
↓ ↓
Evacuation
169
What are four hyperosmotic examples?
1. Polyethylene glycol (MiraLax) **Rx**
2. Sorbitol
3. Gylcerin
4. Lactulose (Kristalose) **Rx**
170
What is the MOA for saline laxatives?
Soluble inorganic salts with charged particles (anions / cations)
↓ ↓
Charged particles attract fluid
↓ ↓
Colon distension
↓ ↓
Activates stretch receptors
↓ ↓
Increased colon peristalsis
171
What are three examples of saline laxatives?
1. Magnesium sulfate (Epsom salts) **OTC**
2. Magnesium hydroxide (MOM) **OTC**
3. Magnesium citrate **Rx**
172
What's another name for saline laxatives?
Osmotics
173
What is the MOA for stimulant laxatives?
Increases peristalsis via intestinal nerve stimulation
174
What are five examples of stimulant laxatives?
* Castor oil
* Senna (Senokot)
* Cascara (Herbal)
* Bisacodyl (Dulcolax)
* Docusate sodium + Senna (Peri-Colace)
175
What are three indications for bulk forming laxatives?
1. Acute and chronic constipation
2. Irritable bowel syndrome (IBS)
3. Diverticulosis
176
What are two indications for emollient laxatives?
1. Acute and chronic constipation
2. Fecal impaction
177
What are two indications for hyperosmotic laxatives?
1. Chronic constipation
2. Diagnostic / surgical preps
178
What are three indications for saline laxatives?
1. Occasional constipation
2. Diagnostic / surgical preps
3. Removal of helminths and parasites
179
What are two indications for stimulant laxatives?
1. Acute constipation
2. Diagnostic / surgical preps
180
What is a side effect / precaution for bulk-forming laxatives?
Fluid overload impaction
181
What are two side effects / precautions for emollient laxatives?
* Skin rashes
* Increase absorption of fat-soluble vitamins
182
What are two side effects / precautions for hyperosmotic laxatives?
* Abdominal bloating
* Rectal irritation
183
What are four side effects / precautions for saline laxatives?
1. Magnesium toxicity (with renal insufficiency)
2. Cramping
3. Diarrhea
4. Increased thirsty
184
What are four side effects / precautions for stimulant laxatives?
1. Nutrient malabsorption
2. Skin rashes
3. Gastric irritation
4. Rectal irritation
185
What can all laxatives cause an imbalance in?
Electrolytes
186
What is the MOA for Lubiprostone (Amitiza)?
Chloride channel activator
↓ ↓
GI motility enhancer
187
What are two indications for Lubiprostone (Amitiza)?
1. Chronic idiotpathic constipation
2. Constipation-predominant IBS
188
What are two contraindications for Lubiprostone (Amitiza)?
* Not recommended for children
* Contraindicated in pregnancy
189
What is irritable bowel syndrome (IBS)?
Abdominal pain with altered bowel habits in the absence of an organic explanation
190
What are the three categories of IBS?
1. **IBS-D:** Diarrhea predominant
2. **IBS-C:** Constipation predominant
3. **IBS-M:** Mixed type
191
Why is work-up critical for IBS patients?
Rule out other etiologies
* Not life-threatening
* No single therapy proven effective
* No single established etiology
* No specific diagnostic marker
192
What are three antispasmodics used to treat IBS?
Which two of these three are first line?
* **Dicyclomine HCl (Bentyl)**
* **Hyoscyamine sulfate (Levsin)**
* Donnatal (Combo drug)
(1st line in bold. Use Donnatal very cautiously)
193
What is currently the only laxative approved for IBS in the US?
Lubiprostone (Amitiza)
194
What are four drugs in Donnatal?
1. Phenobarbital
2. Hyoscyamine
3. Atropine
4. Scopolamine
195
What two drugs are in Librax?
1. Chlordiazepoxide HCl (Benzo)
2. Clidinium (Anticholinergic)
196
What are five select antiemetics?
1. Prochlorperazine (Compazine)
2. Promethazine (Phenergan)
3. Metoclopramide (Reglan)
4. Trimethobenzamide (Tigan)
5. Ondansetron (Zofran)
197
What are three indications for Zofran (Ondansetron)?
What is / are the route(s)?
1. Cancer chemotherapy-related N & V
2. Cancer radiation therapy-related N & V
3. Post-op N & V prevention
IV, PO, IM
