Top 50 Meds

Question 1

4 medications for constipation used in the hospital

Answer 1

Docusate (Colace)
Senna
Bisocodyl
Lactulose

Question 2

Dosage and MOA - Docusate Sodium (Colace)

Answer 2

Dosage - 100mg PO BID

MOA - stool softener (facilitates mix of stool fat and water)

Question 3

Dosage and MOA - Senna

Answer 3

Dosage - 8.6mg PO BID

MOA - (soap) - increases peristalsis

Question 4

Dosage and MOA - Bisocodyl

Answer 4

Dosage - 10-15mg rectal daily constipation
Dosage - 20mg x 1 - bowel prep
MOA - increases peristalsis

Question 5

Colace common side effects (and scariest)

Answer 5

Common:

• throat irritation
• rash
• electrolyte issues
• tastes bitter
• dirrhea/cramping

Serious:
- none known

Question 6

Senna side effects

Answer 6

Common:

• nausea/distention/cramping/flatulence/diarrhea
• urine discoloration

Scary/rare: laxative abuse/cathartic colon

Question 7

Bisacodyl side effects

Answer 7

common:
- nausea/cramping/vomiting/dirrhea
- rectal burning sensation

serious:
- electrolyte imbalance (long term use)
- cathartic colon (long term use)

Question 8

Dosage, uses and MOA - lactulose

Answer 8

Dosage
constipation - 15-30mg PO prn
portal systemic encephalopathy - 30-45mL PO TID-QID (goal is to titrate to 2-3 soft stools per day)

MOA - osmotic laxative (increases stool water content. Increases stool acidity and traps NH4 ions)

Question 9

Benadryl (Diphenhydramine) Uses, dosages, MOA

Answer 9

Uses:

• Allergy/Ithciness sx’s - 25mg PO prn (max 12 tabs/day)
• Insomnia (short term only!) - 1-2 tabs 30 min before bed
• motion sickness (prevention)

MOA:

• central and peripheral histamine (H1) receptor blockers
• inhibits medullary cough center (antitussive)
• anticholinergic (antiemetic, sedative, antidyskinetic)

Question 10

Caution if considering benadryl use for the following paitnets:

Answer 10

• elderly
• kids <6
• IOP increased or glaucoma
• Hypertensive
• Hyperthyroid
• asthma/COPD
• GI obstruction
• high temperature environment

Question 11

Benadryl adverse effects

Answer 11

common:
- tired
- dizzy/impaired coordination
- headache
- anticholinergic stuff: dry mucous membranes, dysuria, urinary retention, blurry vision, diplopia, palpitations, tachycardia, sweating

Serious:

• anaphylaxis
• hemolytic anemia
• thrombocytopenia/agranulocytosis/pancytopenia
• arrhythmia
• seizure
• toxic psychosis

Question 12

Zofran uses, doses, MOA

Answer 12

Ondensatron

Uses: 
Nausea in various scenarios: 
- n/v, gastritis related - 8mg PO q8h prn (4mg if IV)
- chemo/radiation - IV or PO
- post-op - 4mg IV/IM x 1

MOA:
- selectively blocks serotonin 5-HT3 receptors

Question 13

Zofran adverse effects

Answer 13

common:
- headache/fatigue
- diarrhea/constipation
- fever
- urinary retention
- itchy/irritation

serious reactions:

• SJS/TEN
• QT prolongation/Torsades (dont’ use if long QT!)
• caution if bradycardia, recent MI, CHF or electrolyte issues)
• caution if hepatic impairment
• Serotonin syndrome
• transient blindness

Question 14

morphine dosage:

Answer 14

• 2mg IV prn for pain

Question 15

Dilaudid dosage

Answer 15

• 1mg IV prn for pain

Question 16

Norco dosage

Answer 16

• 5-10mg PO for pain

Question 17

Labetalol dosage, uses, MOA

Answer 17

Uses Inpatient:

• HTN + HR >90 in hospital — 10mg IV
• HTN emergency - 40-80mg IV q10min prn (max = 300 mg/total)

Outpatient:
- 100-400mg PO BID

MOA:
selective blocker of A1, B1, B2 receptors.

Question 18

Hydralazine dosage, uses, MOA

Answer 18

Uses

- CHF with