Nausea/Vomiting Flashcards

1
Q

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

A

5-HT3 Antagonists

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2
Q

ADRs include HA, dizziness, diarrhea, abdominal pain

A

5-HT3 Antagonists

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3
Q

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

A

Dopamine Antagonist

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4
Q

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

A

Dopamine antagonist

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5
Q

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

A

Dopamine antagonist

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6
Q

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

A

Antihistamines

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7
Q

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

A

Antihistamines

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8
Q

Caution in patients with BPH, urinary retention, glaucoma

A

Antihistamines

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9
Q

Side effects include drowsiness, sedation, increased appetite

A

Dronabinol (Cannabinoids)

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10
Q

Medications that cause constipation

A
OPIATES
Ca and Al antacids
Calcium channel blockers
Clonidine
Anticholinergics
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11
Q

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

A

Bulk forming laxatives

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12
Q

adequate fluid intake is very important with these agents

A

Bulk forming laxatives

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13
Q

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

A

Bulk forming laxatives

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14
Q

ADRs include flatulence, abdominal distention, GI obstruction

A

Bulk forming laxatives

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15
Q

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

A

Bulk forming laxatives

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16
Q

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

A

bulk forming laxatives

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17
Q

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

A

Emollient (docusate sodium)

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18
Q

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

A

docusate sodium

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19
Q

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

A

docusate sodium

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20
Q

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

A

lubricants (mineral oil)

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21
Q

this lax class coats stool and inhibits colonic absorption of water

A

lubricants (mineral oil)

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22
Q

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

A

lubricants (mineral oil)

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23
Q

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

A

Lactulose

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24
Q

this lax creates an osmotic gradient and can cause hyperglycemia

A

sorbitol

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25
Q

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

A

saline cathartics

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26
Q

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

A

castor oil

27
Q

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

A

glycerin suppository

28
Q

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

A

polyethylene glycol (mirilax)

29
Q

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

A

polyethylene glycol (PEG, GoLYTELY)

30
Q

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

A

bisacodyl

31
Q

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

A

bisacodyl

32
Q

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

A

bisacodyl, senna

33
Q

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

A

senna

34
Q

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

A

lubiprostone

35
Q

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

A

methylnaltrexone

36
Q

what is a good lax to give diabetics

A

Metamucil (sugar free)

37
Q

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

A

use: bulk formers or emollients

do not use: mineral oil, caster oil, osmotics

38
Q

what lax should I avoid in olds

A

saline (CHANGE IN ELECTROLYTES)

39
Q

what lax should I avoid in kids

A

stimulants, excessive enemas

40
Q

Diarrhea: when should I NOT use antimotility agents?

A

dysentery or c diff

41
Q

these two drugs can cause premature emptying colon

A

metoclopramide

erythromycin

42
Q

what drugs cause diarrhea

A
lax
antacids (w mg)
antineoplastics
colchicine
NSAIDs
orlistat
Abx: clin or BS
ACEi
digoxin
xholinergics
esomeprazole
famotidine
43
Q

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

A

antimotility

44
Q

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

A

lomotil

45
Q

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

A

loperamide

46
Q

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

A

loperamide

47
Q

these absorb nutrients, toxins, drugs, and digestive juices

A

adsorbents

48
Q

this adsorbent absorbs bile salts and c diff toxin

A

cholestryamine

49
Q

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

A

pepto bismol

50
Q

do not use in kids, can cause Reyes syndrome

A

pepto bismol

51
Q

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

A

pepto bismol

52
Q

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

A

pepto bismol

53
Q

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

A

octreotide

54
Q

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

A

octreotide

55
Q

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

A

atropine

56
Q

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

A

lactobacillus

57
Q

useful only in lactose intolerance

A

lactase enzymes

58
Q

used as an adjunct to oral rehydration salts (ORS)

A

zinc

59
Q

traveler’s diarrhea prophylaxis

A

bismuth subsalicylate, antibiotics (not responsible)

60
Q

traveler’s diarrhea treatment

A

rehydration

cipro or azithromycin

61
Q

C diff treatment

A

metronidazole

vancomycin (PO)

62
Q

treat constipation predominant IBS

A

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

63
Q

treat diarrhea predominant IBS

A

lactose/caffeine free diet
loperamide
serotonin antagonist ALOSETRON