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Pharmacology for Advanced Practice Nurses > GI deck 3 > Flashcards

GI deck 3 Flashcards

1
Q

Antiemetics may be used to provide

A

Symptom relief for nausea and vomiting

Prevention of fluid and electrolyte disturbances

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2
Q

Drug class of antiemetics

A 
Antihistamines
Phenothiazines
Sedative hypnotics
Anticholinergics
Cannabinoids
5-HT3 receptor antagonists
Substance P/neurokinin 1 (NK1) receptor antagonist
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3
Q

Antihistamines MOA

A

have strong anticholinergic effects as well as histamine1-blocking effects

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4
Q

phenothiazines MOA

A

block dopamine receptors in the chemoreceptor trigger zone

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5
Q

Cannabinoids MOA

A

work in the central nervous system (CNS) to prevent nausea and vomiting associated with cancer chemotherapy

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6
Q

5-HT3 MOA

A

receptor antagonists: block serotonin on vagal nerve terminals and in the chemoreceptor trigger zone

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7
Q

Anticholinergic example

A

scopolamine

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8
Q

antihistamine precautions

A

have anticholinergic properties

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9
Q

Phenothiazines

Produce and are contraindicated in

A

Produce extrapyramidal symptoms (EPS)

Contraindicated in Parkinson’s disease

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10
Q

Dronabinol use with caution in

A

in patients with seizure disorders

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11
Q

5-HT3 receptor antagonists: may mask

A

progressive ileus

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12
Q

Antihistamine ADR

A

Drowsiness

Anticholinergic effects of dry mouth, blurred vision, and urinary retention

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13
Q

Phenothiazines ADR

A

Drowsiness

EPS, such as dystonia, akathisia, and tardive dyskinesia

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14
Q

Most commonly used antiemetics

A

antihistamines and phenothiazines

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15
Q

Promethazine: fatal ____

A

respiratory depression in children younger than 2 years of age

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16
Q

Scopolamine ADR

A

Dry mouth

Withdrawal symptoms

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17
Q

Cannabinoid dronabinol ADR

A

dronabinol
Euphoria, depression, dizziness, paranoid thoughts, somnolence, and abnormal thoughts

Cardiac effects: palpitations, tachycardia, and hypotension
Seizure and seizure-like activity have been reported

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18
Q

Scopolamine is commonly delivered in the form of a

A

patch - used behind the ear for motion sickness. 24 hours before nausea inducing events. Sometimes pre surgery as well.

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19
Q

5-HT3 receptor antagonists

ADR

A

Constipation, headache, fatigue, dizziness, and diarrhea

Rare cases of tachycardia, bradycardia, hypotension, and heart rate-corrected QT interval prolongation

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20
Q

Dronabinol is only used for

A

chemotherapy-associated nausea and vomiting, and for appetite stimulation.

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21
Q

5-HT3 Example and what you should be aware of

A

Zofran

prolonged QT interval

22
Q

Antiemetics addive ___ and ___

A

Additive CNS depression when combined with CNS depressants

Additive anticholinergic effects

23
Q

Phenothiazines and lithium: may

A

Phenothiazines and lithium: may increase EPS

Phenothiazines and lithium: may mask lithium toxicity

24
Q

Motion sickness drug used

A

Antihistamines

Dimenhydrinate and meclizine

25
Q

Vomiting caused by gastroparesis drug uese

A

Prokinetic drugs

26
Q

Aprepitant used in conjunction

A

with other antiemetic to prevent N&V associated with chemo

27
Q

Antiemtics monitoring short term

A

use requires minimal monitoring

28
Q

Antiemetics monitoring long term

A

use of promethazine requires complete blood count to monitor for bone marrow depression and blood dyscrasias (week 4 and week 10 of therapy).

29
Q

Anitemetics should be taken

A

1 to 2 hours before departure to treat motion sickness

30
Q

Dronabinol (Marinol): may cause

A

euphoria and behavior changes

31
Q

Antiemetics lifestyle changes

A

Hydration

Electrolyte replacement solutions

32
Q

H2RAs: reversible competitive

A

blockers of histamine at histamine2 receptors
Highly selective
Reduce gastric acid secretion by 35% to 50%

33
Q

H2RA is a great choice

A

for addressing acid related problems. It works by blocking histamine which controls the potency of gastric acid secretion.

good for chronic acid problems. They are not acid neutralizing

34
Q

Commonly H2RA

A

Ranitdine

Famotidine

35
Q

Ranitidine is

A

5 to 12 times more potent than cimetidine

36
Q

Famotidine is

A

30 to 60 times more potent than cimetidine

37
Q

H2RA precautions and contraindications

A

Cautious use in renal impairment

38
Q

Hepatocellular injury may occur with

A

nizatidine

39
Q

Occasional reversible hepatitis or hepatocellular disorders have occurred with

A

rantidine

40
Q

H2RA pregnancy category

A

B

41
Q

Ranitidine and famotidine use is approved in

A

children

42
Q

H2RA ADR

A

Antiandrogenic reactions
Gynecomastia and impotence
Cimetadine the worst offender

CNS adverse reactions

Agranulocytosis, granulocytopenia, thrombocytopenia, and aplastic anemia

43
Q

H2RA monitoring

A

liver function with high-dose or long-term use

44
Q

H2RA clinical use and dosing and no empiric treatment of

A

Gastroesophageal reflux disease (GERD)
Twice daily dosing
No empiric treatment of infants with GERD with H2RAs

45
Q

are H2RA used in peptic ulcer disease

A

no

46
Q

h2ra decreased dosing for

A

renal dysfunction

47
Q

h2ra patient education

A

Take with meals.

Separate antacids by 30 minutes to 1 hour.

48
Q

H2RA may cause

A

H2RAs may cause drowsiness or dizziness.

Cimetadine may cause gynecomastia and impotence in men

49
Q

Smoking decreases absorption of

A

H2RA

50
Q

ETOH can increase

A

gastric irritation

Pharmacology for Advanced Practice Nurses (50 decks)

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