Week 7 Pharm (Same as Week 5)

Question 1

What does Metoclopramide do?

Answer 1

D2-receptor antagonist; treats nausea

Question 2

What are the side effects of Metoclopramide?

Answer 2

CNS effects, tardive dyskinesia, extrapyramidal effects, elevated prolactin

Question 3

What does Trimethobenzamide do?

Answer 3

unknown, likely involves the chemoreceptor trigger zone; treats nausea

Question 4

What are the side effects of Trimethobenzamide?

Answer 4

Anticholinergic effects: Dry mouth, constipation, urinary retention, blurred vision/dilated pupils, confusion and cognitive impairment, increased heart rate, reduced sweating.

Question 5

What do 5-HT3 receptor antagonists do (Ondansetron)?

Answer 5

block peripheral 5-HT3 receptors and 5-HT3 receptors in the vomiting center; treat nausea

Question 6

What are side effects of Ondansetron (5-HT3 receptor antagonists)?

Answer 6

headache, constipation, dizziness, ECG changes, serotonin syndrome

Question 7

What do Neurokinin receptor antagonists do (Aprepitant and Fosaprepitant)?

Answer 7

block NK1 receptors in the chemoreceptor trigger zone; treat nausea

Question 8

What are the side effects of Neurokinin receptor antagonists (Aprepitant and Fosaprepitant)?

Answer 8

fatigue, dizziness, diarrhea

Question 9

What do antipsychotics do (prochlorperazine and promethazine)?

Answer 9

inhibit dopamine and muscarinic receptors; treat nausea

Question 10

What are the side effects of antipsychotics (prochlorperazine and promethazine)?

Answer 10

Anticholinergic effects: Dry mouth, constipation, urinary retention, blurred vision/dilated pupils, confusion and cognitive impairment, increased heart rate, reduced sweating.

CNS Depression, hypotension, arrhythmias

Question 11

What do bulk-forming laxatives like Psyllium do?

Answer 11

absorb water, forming a gel that distends the colon and promotes peristalsis; treats constipation

Question 12

What are the side effects of bulk-forming laxatives like Psyllium?

Answer 12

abdominal pain, bloating, esophageal obstruction (avoid by taking with 8 oz of fluid), GI obstruction with large doses

Question 13

What do stool softeners like Docusate do?

Answer 13

reduce surface tension of stool, allowing water and lipids to penetrate and soften; treats constipation

Question 14

What are the side effects of stool softeners like Docusate?

Answer 14

abdominal pain, throat irritation (liquid formulation)

Question 15

What do Osmotic laxatives do (Polyethylene glycol [Miralax], Lactulose, Magnesium hydroxide [Milk of Magnesia], Magnesium citrate, and sodium phosphates?

Answer 15

nonabsorbable, cause osmotic retention of fluid in the colon, causing distension and increased peristalsis; treats constipation

Question 16

What are the side effects of Osmotic laxatives (Polyethylene glycol [Miralax], Lactulose, Magnesium hydroxide [Milk of Magnesia], Magnesium citrate, and sodium phosphates?

Answer 16

abdominal pain, nausea, diarrhea, dehydration, flatulence, polyethylene glycol and glycerin are generally considered non-toxic, high doses of nonabsorbable salts may cause electrolyte disturbances

Question 17

What do stimulant laxatives like Bisacodyl (Dulcolax) and Senna (Ex-Lax) do?

Answer 17

stimulate the enteric nervous system, increase the rate of colonic motility, alter water and electrolyte secretion; treats constipation

Question 18

What are the side effects of stimulant laxatives like Bisacodyl (Dulcolax) and Senna (Ex-Lax)?

Answer 18

abdominal pain, nausea, diarrhea, GI toxicity

Question 19

What do Lubricant laxatives like Mineral oil do?

Answer 19

oil lubricates fecal material, preventing water resorption from the stool; treats constipation

Question 20

What are the side effects of Lubricant laxatives like Mineral oil?

Answer 20

abdominal pain, nausea, vomiting, diarrhea, intestinal obstruction, lipid pneumonitis if aspiration occurs

Question 21

What do opioid receptor antagonists like Methylnaltrexone and Naloxegol do?

Answer 21

block intestinal mucosal opioid receptors; treats constipation

Question 22

What are the side effects of opioid receptor antagonists like Methylnaltrexone and Naloxegol?

Answer 22

abdominal pain, nausea, diarrhea, GI perforation, opioid withdrawal, tremor, hypotension, tachycardia, dizziness, agitation, insomnia, fatigue

Question 23

What do opioid agonists like Loperamide and Diphenoxylate/atropine do?

Answer 23

bind to opioid receptors in the intestines, inhibiting peristalsis and increasing transit time; treat diarrhea

Question 24

What does Lactulose treat

Answer 24

constipation; prevention and treatment of hepatic encephalopathy

Question 25

What are the side effects of opioid agonists like Loperamide and Diphenoxylate/atropine?

Answer 25

constipation, ileus, dizziness, drowsiness Loperamide: drowsiness, N/V, abdominal pain, headache, miosis, bradycardia, respiratory depression, arrhythmias Diphenoxylate/atropine: anticholinergic effects + opioid effects

Question 26

What do bile acid sequestrates (Cholestyramine) do?

Answer 26

bind excess fecal bile acids; treats diarrhea and dyslipidemia

Question 27

What are the side effects of bile acid sequestrates (Cholestyramine)?

Answer 27

constipation, bloating, flatulence, GI obstruction

Question 28

What does Bismuth subsalicylate do?

Answer 28

stimulates absorption of fluid and electrolytes across the intestinal wall, inhibits inflammation and hypermotility; treats diarrhea, dyspepsia, and H. Pylori infection

Question 29

What are the side effects of Bismuth subsalicylate?

Answer 29

black stool and tongue, salicylate toxicity

Question 30

What does Lubiprostone do?

Answer 30

stimulates chloride channels in the small intestine, treats IBS with constipation, chronic idiopathic constipation, and opioid-induced constipation

Question 31

What are the side effects of Lubiprostone?

Answer 31

nausea, abdominal pain, diarrhea, headache, chest tightness

Question 32

What does Linaclotide do?

Answer 32

activates guanylyl cyclase-C, increasing cGMP and chloride-rich secretion; treats IBS with constipation

Question 33

What are the side effects of Linaclotide?

Answer 33

diarrhea, abdominal pain, headache

Question 34

What does Eluxadoline do?

Answer 34

mixed opioid agonist and antagonist; treats IBS with diarrhea

Question 35

What are the side effects of Eluxadoline?

Answer 35

constipation, nausea, abdominal pain

Question 36

What does Rifaximin do?

Answer 36

antibiotic, anti-inflammatory effects; treats IBS with diarrhea

Question 37

What are the side effects of Rifaximin?

Answer 37

dizziness, fatigue, nausea

Question 38

What do aminosalicylates like Mesalamine and Sulfasalazine do?

Answer 38

modulate inflammatory mediators, interfere with cytokine production, scavenge free radicals, inhibit natural killer cells, mucosal lymphocytes, and macrophages; treats IBD

Question 39

What are the side effects of aminosalicylates like Mesalamine and Sulfasalazine?

Answer 39

well-tolerated except for sulfasalazine; similar to salicylate toxicity

Question 40

What does Azathioprine do?

Answer 40

inhibit DNA and RNA synthesis; treats IBD, Crohn Disease, Ulcerative Colitis, Dermatomyositis/polymyositis, Chronic immune thrombocytopenia, lupus nephritis, rheumatoid arthritis, and renal transplantation

Question 41

What are the side effects of Azathioprine?

Answer 41

N/V, diarrhea, leukopenia, lymphoma, fever, bone marrow suppression, hepatotoxicity

Question 42

What does Methotrexate do?

Answer 42

inhibits dihydrofolate reductase, producing anti-inflammatory effects; treats IBD, Crohn disease, dermatomyositis/polymyositis, ectopic pregnancy, psoriasis, rheumatoid arthritis, systemic lupus erythematous, and various malignancies

Question 43

What are the side effects of Methotrexate?

Answer 43

nausea, diarrhea, increased liver enzymes, headache, severe skin reactions; risk of GI ADRs reduced with folate supplementation, pancytopenia, N/V, diarrhea, hepatotoxicity, pulmonary damage

Question 44

What do TNF antagonists like Infliximab and Adalimumab do?

Answer 44

monoclonal antibodies bind to TNF, preventing it from binding to its receptors and causing inflammatory effects; treats IBD; Infliximab treats Crohn disease, Ulcerative colitis, ankylosing spondylitis, plaque or pustular psoriasis, psoriatic arthritis, and rheumatic arthritis

Question 45

What are the side effects of TNF antagonists like Infliximab and Adalimumab?

Answer 45

opportunistic infection, infusion reactions (infliximab), antibody development

Question 46

What does Vedolizumab do?

Answer 46

integrin receptor antagonist; treats IBD

Question 47

What are the side effects of Vedolizumab?

Answer 47

headache, arthralgias, infusion reactions, infection (especially nasopharyngeal), hepatotoxicity, antibody development

Question 48

What does Ustekinumab do?

Answer 48

IL-12 and IL-23 inhibitor; treat IBD, Crohn disease, ulcerative colitis, plaque psoriasis, psoriatic arthritis

Question 49

What are the side effects of Ustekinumab?

Answer 49

reactivation of latent infections, non-melanoma skin cancer, neurotoxicity, antibody development