Nausea/Vomiting

Question 1

this class is indicated for treatment and prevention of postoperative N/V or chemotherapy induced N/V. However, it is used much more frequently than these instances

Answer 1

5-HT3 Antagonists

Question 2

ADRs include HA, dizziness, diarrhea, abdominal pain

Answer 2

5-HT3 Antagonists

Question 3

This class can antagonize D2 and (at high enough doses) 5-HT3 receptors. Also promote gastric emptying and peristalsis of SI

Answer 3

Dopamine Antagonist

Question 4

Contraindications include GI hemorrhage, obstruction, or perforation, pheochromocytoma, seizure. Use cautiously in children and depression

Answer 4

Dopamine antagonist

Question 5

ADRs include extrapyramidial effects, restlessness, anxiety, drowsiness, fatigue, hallucinations, HTN, HPOTN, AV block, bradycardia, agranulocytosis

Answer 5

Dopamine antagonist

Question 6

This class blocks H1 and is an antagonist of D2 receptors in the CTZ

Answer 6

Antihistamines

Question 7

ADRs include dry mouth, dizziness, Parkinsonian symptoms, neuroleptic malignant syndrome, blood dyscrasias

Answer 7

Antihistamines

Question 8

Caution in patients with BPH, urinary retention, glaucoma

Answer 8

Antihistamines

Question 9

Side effects include drowsiness, sedation, increased appetite

Answer 9

Dronabinol (Cannabinoids)

Question 10

Medications that cause constipation

Answer 10

OPIATES
Ca and Al antacids
Calcium channel blockers
Clonidine
Anticholinergics

Question 11

These drugs increase the volume of non-absorbable solid residue with water and stimulate peristaltic activity increasing the rate of colonic transit

Answer 11

Bulk forming laxatives

Question 12

adequate fluid intake is very important with these agents

Answer 12

Bulk forming laxatives

Question 13

1st line for bedridden or geriatric pt with chronic constipation. Good in pregnancy

Answer 13

Bulk forming laxatives

Question 14

ADRs include flatulence, abdominal distention, GI obstruction

Answer 14

Bulk forming laxatives

Question 15

This class binds drugs and reduces absorption, so give it separate from other meds

Answer 15

Bulk forming laxatives

Question 16

This class can be used to relieve symptoms of mild diarrhea, IBS, and lower cholesterol

Answer 16

bulk forming laxatives

Question 17

this laxative class is first line for pregnant women (along with bulk forming)

Answer 17

Emollient (docusate sodium)

Question 18

this drug is used to avoid straining and can be used after MI, rectal surgery, or opiates

Answer 18

docusate sodium

Question 19

Contraindicated in patients with fecal impaction or signs and symptoms of appendicitis

Answer 19

docusate sodium

Question 20

this laxative class is not recommended for chronic use (mainly for prevention) after MI or rectal surgery

Answer 20

lubricants (mineral oil)

Question 21

this lax class coats stool and inhibits colonic absorption of water

Answer 21

lubricants (mineral oil)

Question 22

this lax class should be avoided in elderly patients dt aspiration risk and decrease absorption of fat soluble vitamins

Answer 22

lubricants (mineral oil)

Question 23

this lax drug is not considered a first line agent. It may result in flatulence, cramps, and electrolyte imbalances and is commonly used in patients with hepatic encephalopathy

Answer 23

Lactulose

Question 24

this lax creates an osmotic gradient and can cause hyperglycemia

Answer 24

sorbitol

Question 25

this lax class increases the water content of bowel through osmosis. Used post-surgery. Not for use in pts with impaired renal function (Mg and Na accumulation), CHF, HTN

Answer 25

saline cathartics

Question 26

this lax is metabolized to ricinoleic acid and stimulates secretory pathways. Not for routine use. Can cause decrease in glucose absorption

Answer 26

castor oil

Question 27

this lax has osmotic action in the rectum. It is very safe and can be used in children intermittently

Answer 27

glycerin suppository

Question 28

this lax is an osmotic that can be used chronically. It is relatively safe and can be used in children

Answer 28

polyethylene glycol (mirilax)

Question 29

this lax is used for colonic cleansing before diagnostic procedures. Not for chronic use or for patients with intestinal obstruction

Answer 29

polyethylene glycol (PEG, GoLYTELY)

Question 30

this lax stimulates the nerve plexus of the colon. Should not be taken with antacids, milk, or milk products

Answer 30

bisacodyl

Question 31

this lax can cause intestinal cramps, fluid and electrolyte imbalance, and pink colored urine and feces

Answer 31

bisacodyl

Question 32

Long term use of these lax could cause damage to nerve plexi, resulting in intestinal function deterioration and atonic colon

Answer 32

bisacodyl, senna

Question 33

this lax causes increased peristalsis. It can cause yellow-brown to red colored urine and large doses can cause nephritis

Answer 33

senna

Question 34

this lax is a cl channel activator. it can cause nausea and diarrhea and is contraindicated in intestinal obs and pregnancy

Answer 34

lubiprostone

Question 35

this lax is a peripheral antagonist of mu. It does not cross the BBB. Good for opiate-caused constipation

Answer 35

methylnaltrexone

Question 36

what is a good lax to give diabetics

Answer 36

Metamucil (sugar free)

Question 37

what types of lax to use in pregs? not to use?

Answer 37

use: bulk formers or emollients | do not use: mineral oil, caster oil, osmotics

Question 38

what lax should I avoid in olds

Answer 38

saline (CHANGE IN ELECTROLYTES)

Question 39

what lax should I avoid in kids

Answer 39

stimulants, excessive enemas

Question 40

Diarrhea: when should I NOT use antimotility agents?

Answer 40

dysentery or c diff

Question 41

these two drugs can cause premature emptying colon

Answer 41

metoclopramide | erythromycin

Question 42

what drugs cause diarrhea

Answer 42

``` lax antacids (w mg) antineoplastics colchicine NSAIDs orlistat Abx: clin or BS ACEi digoxin xholinergics esomeprazole famotidine ```

Question 43

this drugs slow intestinal transit, prolong contact and absorption, and increase gut capacity. At risk for addiction, and can worsen diarrhea

Answer 43

antimotility

Question 44

this antimotil agent should not be given to someone with c diff or enterotoxin producing bacteria

Answer 44

lomotil

Question 45

this antimotil agent acts directly on intestinal muscles to inhibit peristalsis and prolongs transit time

Answer 45

loperamide

Question 46

don't use in pts with a high fever, acute UC, antibiotic associated colitis, or children under 2

Answer 46

loperamide

Question 47

these absorb nutrients, toxins, drugs, and digestive juices

Answer 47

adsorbents

Question 48

this adsorbent absorbs bile salts and c diff toxin

Answer 48

cholestryamine

Question 49

this drug has anti-secretory, inflammatory, and bacterial effects

Answer 49

pepto bismol

Question 50

do not use in kids, can cause Reyes syndrome

Answer 50

pepto bismol

Question 51

this drug can cause blackened stools and tongue, salicylism, and gout attacks

Answer 51

pepto bismol

Question 52

this drug interacts with anticoagulants and tetracycline (may interfere with radiologic studies)

Answer 52

pepto bismol

Question 53

this drug blocks the release of serotonin, reducing motility and increasing water absorption from the gut

Answer 53

octreotide

Question 54

used to control symptoms in pts with metastatic vasoactive intestinal peptide-secreting tumor associated with diarrhea

Answer 54

octreotide

Question 55

this drug blocks vagal tone and prolongs gut transit time. Contraindicated in glaucoma, prostatic hypertrophy

Answer 55

atropine

Question 56

this drug prevents diarrhea, indicated for use post-antibiotic. Restores normal flora and intestinal function

Answer 56

lactobacillus

Question 57

useful only in lactose intolerance

Answer 57

lactase enzymes

Question 58

used as an adjunct to oral rehydration salts (ORS)

Answer 58

zinc

Question 59

traveler's diarrhea prophylaxis

Answer 59

bismuth subsalicylate, antibiotics (not responsible)

Question 60

traveler's diarrhea treatment

Answer 60

rehydration | cipro or azithromycin

Question 61

C diff treatment

Answer 61

metronidazole | vancomycin (PO)

Question 62

treat constipation predominant IBS

Answer 62

increase fiber and fluid bulk forming lax consider antispasmodics add serotonin-4 agonist-TEGASEROD $$

Question 63

treat diarrhea predominant IBS

Answer 63

lactose/caffeine free diet loperamide serotonin antagonist ALOSETRON