Module 8-10 Drugs Flashcards
Ondansetron
antiemetic; serotonin recepter antagonist; first approved for chemotherapy induced n/v; and for radiotherapy, anesthesia, pregnancy, etc; more effective when used with dexamethasone
Side Effects/Adverse Effects of Ondansetron
headache, diarrhea, dizziness, prolonged, QT interval, risk of torsades de pointes
Glucocorticoids
in terms of aniemetics; include methylprednisolone and dexamethasoe; MOA not known; used to suppress CINV but not approved by FDA for this;
Metoclopramide
antiemetic; brand Reglan; blocks dopamine receptors in CTZ; postoperative n/v, anticancer drug, opioids, toxins, radiation therapy
Scopolamine
used for motion sickness; muscarinic antagonist;
Side effects of Scopolamine
DRY MOUTH, blurred vision, drowsiness
Antihistamines
in terms of motion sickness; include dimenhydrinate, meclizine, cyclizine; anticholinergic; SE: sedation (H1), dry mouth, blurred vision, urinary retention, constipation
Opioids
nonspecific antidiarrheal agent; MOST effective antidiarrheal agent; activate opioid receptors in GI: reduce intestinal mobility, slow transit, allow more fluid to be absorbed
Diphenoxylate
opioid but formulated with atropine to discourage abuse, antidiarrheal; opioid only used for diarrhea; high doses can elicit typical morphine like subjective responses
Loperamide
opioid; structural analong of meperdine; used to treat diarrhea and to reduce the volume of discharge from ileostomies; little or no potential for abuse
Contraindications to Laxative Use
abd pain, nausea, cramps or other symptoms of appendicitis, regional enteritis, diverticulitis or ulcerative colitis, acute surgical abdomen, fecal impaction or bowel obstruction, habitual use, caution in pregnancy and lactation
Group I Laxative
act rapidly; within 2-6 hours; give stool watery consistency; useful for preparing bowel for diagnostic procedures or surgery
Group II Laxatives
intermediate latency; 6-12 hours; produce a semifluid stool; most frequently abused by the general public
Group III Laxative
act slowly; 1-3 days; produce a soft formed stool; uses include treating chronic constipation and preventing straining
Psyllium
same as metamucil; bulk forming laxative; function simiraly to dietary fiber (swell with water that forms a gel and increases fecal mass); preferred temp treatment of constipation; AE- esophageal obstruction
Docusate Sodium
surfactant laxative; produce soft stool several days after tx; lowers surface tension which facilitates PENTRATION of water in feces
Bisacodyl
stimulant laxative; two effects- stimualte intestinal motility; increase amounts of water and electrolytes in intestinal lumen; widely used and abused; legitametly used for opioid induced constipation and for constipation from slow intestinal transit
Milk of Magnesia
osmotic laxative; laxative salts; draw water in intestinal lumen, fecal mass softens and swells, wall stretches and peristalsis is stimulated; low does- results in 6-12 hrs; high dose 2-6 hrs; AE- dehydartion, acute renal failure, sodium retention
Lubiprostone
selective chloride channel activator; promotes secretion of chlroide rich fluid into the intestive and enhances motility in the small intestine and colon; result is spontaenous evacuation of semi soft stool usually within 24 hrs
Mineral Oil
laxative action is produced by lubrication; especially useful when administered by enema to treat fecal impaction AE- lipid pneumonia, anal leakage, and deposition of mineral oil in the liver
Glycerin Suppository
osmotic agent that softens and lubricates hardened impacted feces; may also stimulate rectal contraction; evacuation occurs about 30 mins after insertion; useful for reestablishing normal bowel function after termination of chronic laxative use
Sodium Phosphate Products
osmotic laxatives that draw water in intestinal lumen, which softens and swells fecal mass which streathces intestinal wall to stimulate peristalsis
Sodium Phosphate Products AE
nausea, bloating, abd discomfort, risk of dehydration, electrolyte disturbance, and kidney damage; hyperphosphatemia **
Furosemide
loop; for edema, hepatic impairment, renal disease HTN, emergent need for rapid fluid excretion; AE/SE- dehydration, hyponatremia, hypochloremia, hypotension, OTOTOXICITY, HYPOKALEMIA, hyperglycemia; avoid admin late in day to prevent nocturia, monitor bg, avoid use with other ototoxic drugs (aminoglycosides)
Hydrochlorothiazide
thiazide; similar effect to loop; max diuresis is lower than loop, not effective when urin flow is scant; first choice for essential HTN, AE/SE- dehydration, hyponatremia, hypokalemia, hypochloremia, hyperglycemia,
Mannitol
osmotic; promotes diuresis by creating osmotic force within lumen of the nephron; MUST BE GIVEN PARENTERLLY, uses- prophylaxis of renal failure, reduction of intracranial and intraocilar pressure; SE/AE- HF, pulmonary edema, fluid electrolyte imbalnce, rebound increased ICP (intracranial pressure) (change in LOC, pupils, HA, n/v)
Spironolactone
potassium sparing aldoesterone antagonists; modest increase in urine production, decrease in potassium excretion; used mainly for HTN and edema; effects may take up to 12-48 hours after admin; AE/SE- hyperkalemia, drowsiness, metabolic acidosis,
alosetron
anti IBS; women specifically;
GI toxicities can cause complicated constipation, lead to perforatrion and ischemis colitis; approdved for WOMEN only;
Contraindications: constipations, GI obstruct, IBD, hepatic impair
Sulfasalazine
antirheumatic; used for IBD, mild to moderate ulceritive colitis;
Maintain urine output of 1200-1500, may cause orange discoloration of urine
do not give if have urinary or bowel obstruction
Budesonide
glucocorticoid; mild to moderate crohns dz that involves the ileum and ascending colon
Do not give with grapefruit
Lubiprostone
laxative; used for chronic idiopathic constupation or IBS-C in females older than 18; spontaneous evacuation of stool wn 24 hrs
