NV constipation diarrhea Flashcards
scopolamine
anticholinergics
N/V
cyclizine dimenhydrinate diphenhydramine hydroxyzine meclizine doxylamine
Antihistamines (N/V)
chlorpromazine
prochlorperazine
promethazine
phenothiazines (N/V)
Droperidol
Haloperidol
Butyrophenones (N/V)
Metoclorpramide
trimethobenzamide
benzamides (N/V)
Dexamethasone
Methylprednisone
Corticosteroids (N/V)
Dronabinol
Nabilone
Cannabinoids (N/V)
Lorazepam
Alprazolam
Benzodiazepines (N/V)
Dolasetron
Granisetron
Ondansetron
Palonesetron
Serotonin Antagonists (N/V)
Aprepitant
Netupitant
Neurokinin-1 antagonists (N/V)
Calcium polycarbophil
psyllium
methylcellulose
Absorbents & Bulk Agents (diarrhea)
Loperamide
Diphenoxylate + atropine
Antiperistaltic Agents (diarrhea)
Bismuth subsalicylate
Octreotide
Antisecretory Agents (diarrhea)
Ciprofloxacin
Lexofloxacin
Azithromycin
Rifaximin
Anti-infectives (diarrhea)
Dicylomine
hyoscyamine
clidinium+chlordiazepoxide
peppermint oil
Anti-spasmodics (diarrhea)
Psyllium
Polycarbophil
Methylcellulose
Bulk Producers (constipation)
Lactulose
Sortbitol
Glycerin
Polyethyline glycol 3350
Hyperosmotics (constipation)
Mineral oil
lubricant (constipation)
Bisacodyl
Senna
Castor Oil
Stimulant laxatives (constipation)
Docusate
Emollients (constipation)
Magnesium citrate
magnesium sulfate
other sodium/phosphate
Saline Agents (constipation)
Lupiprostone
Linaclotide
Intestinal Secretagogues (constipation)
Methylnaltrexone
BromideNaloxegol
Peripherally Acting Mu-opioid antagonists (constipation)
This area of the vomiting center has 3 types of receptors: 5HT3, neurokinin-1, dopamine D2
Chemoreceptor Trigger zone (CTZ)
Is the CTZ inside or outside the BBB?
outside
What is the cerebral cortex affected by?
sensory: sight/smell/emotion
Which area of the vomiting center are best targeted to treat motion system?
Vestibular system (anticholinergics and antihistamines)
Best treatment for mild n/v in pregnancy?
Pyridoxine (B6) or Doxylamine
best treatment for severe n/v in pregnancy?
promethazine
treatment for hyperemesis gravidarum
methylprednisolone
DO NOT GIVE FOR nausea/vomiting in pregnancy…and why
Ondansetron - cleft palate/heart defects
In which class of drugs will you have a risk of EPS?
phenothiazines, butyrophenones, benzamides
Droperidol and haloperidol act on which receptors, treating N/V
Dopamine antagonists
which of the serotonin antagonists if most effective at preventing delayed nausea related to chemo (longest 1/2 life)
Palonsentron
Aprepitant (Neurokinin-1) has MANY interactions due to being what substrate?
CYP3A4
which anti n/v med to take the night before surgery?
scopolamine
which n/v med to take before anesthesia?
palonsetron or dexamethasone
n/v meds recommended after surgery?
Droperidol or serotonin antagonists
most of the anti-constipation meds take 1-3 days. For faster relief, which hyperosmotic do you choose?
Polyethyline glycol (PEG) 3350
what to be cautious of when prescribing mineral oil for constipation
aspiration risk! avoid in elderly
contraindication of castor oil (stimulant laxative)?
PREGNANCY - causes uterine contractions and rupture
Which n/v med is used as PROPHYLAXIS for constipation, and takes up to 72 hours for effect?
emollients (Docusate)
The saline agents need to be avoided in which type of patient?
RENAL failure, CHF, elderly
When to prescribe Mu-opioid receptor antagonists
RESERVE for special situations - give to patients taking opioids to prevent the decrease in GI motility that they cause
do you want to use antiperistaltic agents for infectious diarrhea?
NO! don’t want to keep the organism inside longer.
MOA absorbents/bulk agents
absorb water into intestines, forming gel
antiinfectives used to treat infectious diarrhea
Cipro
levofloxacin
azithromycin
rifamixin