N&V, GI bowels Flashcards
Dimenhydrinate for chemotherapy
Given 30 mins before exposure
DOC for n&v pregnancy
Diclectin (Pyridoxine 10mg + doxylamine)
Opioid induced n&v OINV DOC
and other drugs
Metoclopramide
Perchlorperazine, Diphen, Dimen, Ondansetron, Haloperidol
Post chemo n&v PCNV tx
RX Meclo, Dronabinol, Perchlor
Low emitogenic and Delayed n&v: start w Dexamethasone for moderate, acute emito: 5HT3 ant. Ondan+Dexa High: dexa+ondan+aprepitant Anticipatory n&v: BZP Lorazepam
Tx for motion sickness
Dimenhydrinate effective for most pts,
Diphenhydramine is the alternative.
Take at least 60mins before, 2nd dose after 6h
Scopolamine transdermal patch use.
Place behind ears, 1 patch q72h, can be removed and reused within 72h but should rotate app site
Scopolamine SEs
Constipation dry mouth blurred vision skin rash disorientation delirium
not used in children
Drug used for drug induced diarrhea, not to be used for less than 2 days
Attapulgite (Kaopectate)
Used in chronic diarrhea, for travelers and H pylori management. CIs and SEs
Bismuth subsalicylate BSS
CIs anticoagulants, salicylates, probenecid methotrexate
SEs BLACK STOOL and TONGUE, tinnitus
Other RX tx for diarrhea
Cholestyramine- bile acid induced
Codeine- who do not respond to nonRX meds
Clonidine-for diarrhea assoc w opioid withdrawal and diabetic neuropathy
Diphenoxylate- less effective than loperamide
Octreotide- chemo induced and AIDs assoc
Drug induced diarrhea
Antibiotics chemotx drugs, antiinflamm- NSAIDs, Colchicine Antiarryth- Quinidine AntiHTN- BB, ACEis Antacids- Mg, Ranitidine, Omep Others Misoprostol, Theophylline
What causes travelers diarrhea
E coli, Shigella sp and Compylobacter jejuni
DOC for travelers diarrhea
Ciprofloxacin 500mg BID f3d
Alternative Azith, Cefixime
cotrimox limited use
Drug that induces constipation
anticholinergic: antidepressants antipsychotics antiparkinsons- Levodopa
Cation agents: Al antacids sucralfate CaCO3 and Ca Bi Fe supp
drugs Verapamil, Clonidine Diuretics Cholestyramine NSAIDs opiates vinca alkaloids, sympathomimetics agents and ganglion blockers
osmotic saline stimulant laxatives MOA
osmotic and saline laxatives- retains water and allow the stool to pass easier through the bowel
stimulant lax- inc. secretions of water and ions into the lumen and stimulate the bowel wall to contract
Osmotic laxative DOC for hepatic encephalopathies and why
Lactulose, DOC due to absorbing ammonia
Glycerine- softens stool, lubricates bowel by inc. water retention
Saline lax examples
Saline: MgOH Milk of Mg, MgSO4 Epsom salt, NaPO4 fleet enemas, Enemas
Stimulant: Senna, Bisacodyl, Cascara sagrada, Castor oil
DOC for opioids induced constipation
Senna- faster onset action
Kind of laxative that increases anticoagulant effect of due to dec. absorption of vit. K (all fat-soluble vit ADEK)
Emollients/Lubricant: mineral oil
Best laxatives for infants children adults pregnant Cancer pt and Elderly
infants: gly, lactulose, sorbitol
children: MgOH, min oil, lac, sorb
pregnant: bulk forming, stool softener, osmotic, Mg lax
Cancer pt stim. lax with enemas
Elderly: Lac, gly
Avoid wc laxatives for infants, pregnant, cancer pt and in longterm opioid pts
infants: enemas, min oil and stim. lax
pregnant: stim lax, min and castor oil
cancer pt: bulk lax
long term opioid pts: stim and saline lax
Acts by preventing bubbling of liquids in stomach, does not absorb from GIT. No sig. SEs And alternative tx for anti flatulence
Simethicone
peppermint, garlic, ginger
Abnormally swollen veins in rectum and anus, caused by too much pressure in the rectum forcing the blood to stretch and bugle walls of veins, rupturing them.
Hemorrhoids (Pile)
DOC for pinworms
SEs and CIs
Pyrantel pamoate
SEs n&v dizziness HE, anorexia
CI pregnant and with liver disease
*liq should be shaken well before use
