G.I. drugs with ADRs

Question 1

ondansetron/palonosetron class and ADRs

Answer 1

Serotonin 5-HT3 receptor antagonists
-most effective drug for suppressing Nausea and vomiting
-ADRs: risk for prolonged QT interval

Question 2

Promethazine drug class and ADR

Answer 2

dopamine antagonist used for post op N/V
ADRs: sedation leading to serious respiratory depression
-no use in children or elderly!!
-tissue necrosis with IV route be careful

Question 3

Droperidol and Haloperiol

Answer 3

these are the dopamine antagonist Butyrophenos
used for post op N/V
ADRs: extra pyramidal effects, respiratory depression, prolonged QT, hypotension, sedation, anticholinergic effects

Question 4

Metoclopramide (Reglan) class and adrs, and contraindication

Answer 4

dopamine antagonist and a prokinetic agent
-used in post op N/V, diabetic gastroparesis, GERD
-contraindicated in GI bleed, obstruction, and perforation
ADRS: well tolerated but can cause some sedation, diarrhea and Extra pyramidal symptoms in high doses

Question 5

Lorazepam //class, moa, adrs

Answer 5

it is a Benzodiazepine that enhances GABA, which causes sedation, suppression of N/V, amnesia,
-frequently used in combination with other antiemetics

Question 6

aprepitant

Answer 6

neurokinin type receptor antagonist used in post op nausea, delayed action
-used with other meds like dexamethasone (glucocorticoid) or ondansetron
adr: fatigue

Question 7

methylprednisolone and dexamethasone

Answer 7

two glucocorticoids used off-label for N/V
effective alone or used with other agents like Aprepitant

Question 8

Dronabinol

Answer 8

cannabinoid used for N/V, appetite stimulant, pain med
ADR: marijuana effects
schedule 3 drug

Question 9

bismuth subsalicylate

Answer 9

suppresses vomiting, used also to treat diarrhea and PUD
-contains aspirin (ringing in ears if too much)
-will make your tongue and stool black

Question 10

dymenhydrinate and diphenhydramine

Answer 10

antihistamines for motion sickness
-need to take prophylactilly
-anticholinergic side effects
contraindicated in patients with glaucoma

Question 11

scopolamine

Answer 11

anticholinergic drug used for motion sickness
-anticholinergic side effects
-contraindicated in patients with glaucoma

Question 12

Diphenoxylate with Atropine

Answer 12

synthetic opioid antidiarrheal

Question 13

methycellulose, psyllium, polycarbophil contraindications

Answer 13

bulk forming laxatives
ADRs: b/c they are not absorbed there are no systemic effects
however with insufficient fluid they can solidify in the GI tract
contraindicated in patients who cannot drink lots of fluids (heart failure)
-clients with hypercalcemia should avoid calcium polycarbophil in fiberCon

Question 14

docusate sodium (colace)

Answer 14

surfactant laxative (stool softeners) that decrease the surface tension of the stool
no adrs to report

Question 15

Bisacodyl, Senna, castor oil

Answer 15

these are stimulant laxative
-caution in these as they are frequently used and abused

Question 16

magnesium hydroxide, sodium phosphate

Answer 16

these are osmotic laxatives that draw water into the lumen, the fecal mass softens and swells
magensium: monitor renal function, contraindicated in kidney disease
sodium: cause fluid retention so contraindicated in pts with heart failure and HTN

Question 17

lactulose

Answer 17

an osmotic laxative that is used for its excretion of ammonia
-used for pts with liver disease and hepatic encephalopathy
adr: flatulence and cramping

Question 18

Alosetron

Answer 18

used for IBS with diarrhea
selectively blockades the 5-HT receptors leading to a change in transit time to increase the firmness of the stool,

Question 19

Orlistat (alli)

Answer 19

decrease absorption of fats , weight loss drug