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MC Pharm 2 Exam 3
Fabick Ch 14, 16, 17, 40, & 41
| Question | Answer |
|---|---|
| situational | stressful event or environment |
| generalized | excessive unknown cause |
| panic | severe anxiety lots of CNS stimulation "feeling of doom" |
| phobias | excessive fear of something know unrational |
| OCD | thoughts cause behaviors relieve anxiety |
| PTSD | situational anxiety from severe traumatic event |
| limbic system | emotions & memory |
| hypothalamus | unconscious fight or flight |
| reticular formation | neurons in brain stem alert, arousal, drowsiness, sleep |
| reticular activating system | sleep & wakefulness, focus attention, & causes anxiety |
| sedative | soothing, calming, causing drowsy |
| hypnotic | produces sleep, induce loss of concious & pain sensations |
| tranquilizer | calm tranquil feeling |
| antidepressant drugs | do not cure only manages symptoms by affecting levels of norepi & serotonin |
| TCA | tricyclic antidepressant |
| imipramine (Tofranil) | TCA |
| amitriptyline (Elavil) | TCA |
| TCA action | unknown thought to inhibit reuptake of norepi & serotonin at nervous system or peripheral recetors |
| TCA SE for given with anxiety & insomnia | weight GAIN, increased intraocular pressure, anticholinergic, orthostatic hypotension, & sedation |
| SSRI | selective serotonin reuptake inhibitors |
| escitalopram oxalate (Lexapro) | SSRI |
| citalopram (Celexa) | SSRI |
| fluoxetine (Prozac) | SSRI |
| sertaline (Zoloft) | SSRI |
| paroxetime (Paxil) | SSRI |
| SSRI action | inhibits CNS reuptake serotonin |
| SSRI SE | agitation, somnolence, insomnia, dry mouth, dizziness, A/N/V (less than TCA) |
| SNRI | serotonin-norepinephrine reuptake inhibtors |
| mirtazapine (Remeron) | SNRI |
| trazodone (Desyrel) | SNRI |
| venlafaxine (Effexor) | SNRI |
| SNRI SE | VS changes, dry mouth, N/V/A, dizziness, sedation, weight LOSS |
| MAOI | monoamine oxidase inhibitors |
| phenelzine (Nardil) | MAOI |
| isocarboxazid (Marplan) | MAOI |
| tranylcypromine (Parnate) | MAOI |
| MAOI action | blocks or inhibits activity of monoamine oxidase & block the uptake of amines |
| MAOI SE | N/C, dry mouth, orthostatic hypotension |
| MAOI AE | HTN crisis |
| MAOI avoids | tyramine |
| Antidepressant classes | TCA, SSRI, SNRI, MAOI |
| Antianxiety/anxiolytics & insomnia drugs | benzodiazepines, barbiturates, misc sedatives & hypnotics (non-benzos, non-barbits, CNS depressants) |
| most widely prescribed drugs in medicine, relatively low abuse potential, action same for all but the onset & duration vary per drug | benzodiazepines |
| lorazepam (Ativan) | benzodiazepines |
| alprazolam (Xanax) | benzodiazepines |
| chlordiazepoxide (Librium) | benzodiazepines |
| clonazepam (Klonopin) | benzodiazepines |
| diazepam (Valium) | benzodiazepines |
| midazolam (Versed) | benzodiazepines |
| flurazepam (Dalmane) | benzodiazepines |
| temazepam (Restoril) | benzodiazepines |
| triazolam (Halcion) | benzodiazepines |
| alprazolam (Xanax) | panic attacks |
| chlordiazepoxide (Librium) | acute alcohol withdrawl |
| clonazepam (Klonopin) | anticonvulsant, panic attacks, anxiolytic |
| diazepam (Valium) | sedative, hypnotic, anticonvulsant, muscle relaxant, concsious sedation |
| midazolam (Versed) | very short acting more concious sedation, supplement anesthesia |
| flurazepam (Dalmane), temazepam (Restoril), & triazolam (Halcion) | hypnotic & sleep |
| benzodiazepines action: loraxepam (Ativan) | provide muscle relaxation, antianxiety, anticonvulsant, hypnotic, ataxic effects |
| benzodiazepines SE | drowsiness, sedation, lethargy, resp depression, ataxia, dry mouth, N/V/C, H/A, dizziness, blurred vision, slured speech, hallucinations, hypotension, tachycardia, CV collapse, urinary retention/incontinence, paradoxical rage |
| Which drug class is used for smalles dose over shortest time? | benzodiazepines |
| What time frame should benzodiazepines & barbituates be given? | 2 weeks or less |
| flumazenil (Romazicon) | antidote for CNS depression for benzodiazepines |
| barbituates action | stimulate metabolic enzymes in the liver. nonselective depression of CNS. may induce anesthesia,decrease excitatory neurotransmitter effects, decrease corticostimuli, wakefulness & alertness, & motor cortex of the brain |
| phenobarbital (Luminal) | barbituates |
| pentobarbital (Nembutol) | barbituates |
| secobarbital (Seconal) | barbituates |
| "barb" | barbituates |
| long acting barbituates | phenobarbital (Luminal) |
| short acting barbituates | secobarbital (Seconal) |
| shorter acting barbituates | pentobarbital (Nembutol) |
| barbituates SE | ataxia, drowsiness, confusion, lethargy, dizziness, N/V/C, H/A, hangover effect, resp depression, dependency & tolerance, disrupts normal sleep pattern |
| barbituates interactions with | alcohol & CNS depressants |
| chloral hydrate (Noctec) | short term hypnotic used for sleep. has hang over effect & loses effect in about 2 weeks. |
| buspirone HCL (BuSpar) | misc sedative & hypnotics nonbenzodiazepine |
| eszopiclone (Lunesta) | misc sedative & hypnotics nonbenzodiazepine |
| zolpidem (Ambien) | misc sedative & hypnotics nonbenzodiazepine |
| hydroxyzine (Atarax, Vistaril) | misc sedative & hypnotics |
| buspirone HCL (BuSpar) SE | H/A, N, dry mouth, blurred vision, decreased ability to concentrate |
| What is the DOC for hx of drug abuse? | buspirone HCL (BuSpar) |
| buspirone HCL (BuSpar) AE | chest pain, palpitation, altered thought process |
| buspirone HCL (BuSpar) | antianxiety, good response 1-2 weeks, less SE, no CNS depression, administered with food |
| eszopiclone (Lunesta) | 1st FDA longterm approved. try to take not every day. not taken after fatty foods or large meal. must be taken right before climbing into bed. |
| zolpidem (Ambien) | similar to Lunesta can come in CR controlled release |
| hydroxyzine (Atarax, Vistaril) | depresses activity in the subcortical areas of the CNS, H 1 blcoker (allergic response), anticholinergic effects |
| Which drug causes vestibular & labrynth function problems? | hydroxyzine (Atarax, Vistaril) |
| hydroxyzine (Atarax, Vistaril) uses | antianxiety, antiemetic, sedative-hypnotic, antihistamines |
| hydroxyzine (Atarax, Vistaril) SE | sedation dry mouth, skin rash, tremors, seizures, elderly have hyperactivity |
| hydroxyzine (Atarax, Vistaril) NI | deep IM |
| overdose symptoms with sedatives or hypnotics | excessive sleepiness, hard to wake, slurred speech, confusion, respiratory depression & increased anxiety |
| kava | active substance in root. used to treat anxiety & insomnia forms include tincture, tea, & capsules |
| kava interacts with | CNS depressants (barbituates, alcohol, benzodiazepines, antiParkinson) |
| valerian | several substance in root used to treat nervouseness, anxiety, & insomnia. action is similar to Valium CNS depressant |
| valerian SE | drowsiness, sedation, paradoxical nervousness/jitters |
| amoxapine (Asendin) | TCA |
| desipramine (Norpramin) | TCA |
| TCA SE given for emotional & mood disorders | sedation, anticholinergic, confusion, distrubed concentration, decreased memory, orthostatic hypotension, diaphoresis, seizures, cardiotoxicity, photosensitivity, hypomania, wt GAIN |
| CI & caution for TCA | CI: taking MAOI caution: cardiac disorders, glaucoma, increased intraocular pressure, urinary retention, hyperthyroidism, seizures, liver or kidney dysfx |
| How are TCAs given for mood & emotional disorders? | 1 daily dose at night |
| onset of MAOI actioin | 7-10 days up to 8 weeks for full therapeutic effect |
| CI & caution for MAOI | pheochromocytoma, CHF, liver or renal disease, cerebrovascular defects, cardiovascular disease, & HTN |
| tyramine foods | sausage, hot dog, bologna, pickled/kipprered hearing, meat extract, liver, avocado, banana, raisins, papaya, canned figs, fava beans, yogurt, soy sauce, beer, wine, yeast, chocolate, Pate, pepperoni, salami |
| MAOI SE for mood & emotional disorders | orthostatic hypotension, tremors, H/A, increased appetite, wt GAIN, HTN crisis |
| report MAOI S&S of HTN crisis | H/A, palpitation, tachycardia, chest pain, daiphoresis, N/V |
| avoid with MAOI | sympathomimetic drugs that increase BP: amphetomines, cocaine, OTC cold, dexamethorphan, Ritalin |
| how long does tappering take for MAOI? | 2-3 weeks |
| DOC for severe depression | SSRI |
| CI & caution for SSRI | liver disease, elderly, during pregnancy, lactating, or with MAOI |
| SSRI SE with mood & emotional disorders | skin rash, dizziness, fatigue, H/A, tremor, decrease sexual functioning, A/N/V, dry mouth, wt LOSS, blood dyscrais, hyperglycemia, photosensitivity, drowsy, insomnia |
| to get full antidepressant effect of SSRI it takes | 4-6 week |
| SSRI administered when? | in the morning |
| St. John's Wort | thought to work like an SSRI to treat depression. has drug & herbal interactions take this or antidepressant drug not boht. |
| SE of St. John's Wort | photosensitivity, & very few others |
| bupropion (Wellbutrin) | SNRI |
| SE of bupropion (Wellbutrin) aka SNRI for depression | H/A, insomnia, HTN |
| lithium carbonate (Eskalith) | mood stabilizer |
| mood stabilizer action | not known, accelerates the destruction of catecholamines, & decreases receptor sensitivity to correct overactive catecholamine systems taht occur in mania |
| mood stabilizer uses | bipolar (typically manic) control & prevent, increases neutrophil counts |
| CI & caution mood stabilizers | CI: 1st trimester & avoided later Cautions: renal disease, cardiovascular disease, dehydration, Na depletion & concurrent therapy with diuretics |
| mood stabilizers SE | thirst, N/D, increased urination, weakness, wt GAIN, resp difficulty, irregular pulse, blood dyscrasias |
| early signs of toxicity for mood stabilizers | D/A, weakness, slurred speech, drowsy |
| later signs of toxicity for mood stabilizers | blurred vision, confusion, convulsion, severe tremors, ataxia, increased urination |
| litium levels | 0.5-1.2 mEq/L |
| monitor for lithium levels when | every 2-3 days initially. 1-3 month maintenance |
| valproic acid (Depakene, Depakote) | mood stabilizer |
| carbamazepine (Tegretol) | mood stabilizer |
| methylphenidate (Ritalin) | CNS stimulants |
| d- & L -amphetamine racemic (Adderall) | CNS stimulants |
| dextroamphetamine (Dexedrine) | CNS stimulants |
| methamphetamine (Desoxyn) | CNS stimulants |
| pemoline (Cylert) | CNS stimulants |
| action of CNS stimulants | reverse symptoms of ADHD especially in alertness & ability to focus |
| SE of CNS stimulants | paradoxical CNS activity, insomnia, nervouseness, A, wt. LOSS |
| NI for CNS stimulants | schedule II control substance, high risk abuse, pregnancy category C, caution hazardous activity, high Cloride meals, tapered dose, monitor wt, teach security of meds |
| NI lithium carbonate (Eskalith) | monitor lithium levels, teach signs of toxicity to report & withhold, |
| schizphrenia | abnormal or disordered thought processes and communication |
| conventional antipsychotics | phenothiazines & phenothiazine like drugs |
| conventional antipsychotics take how long to take effect? | take 6-8 weeks or longer |
| chlorpromazine (Thorazine) | phenothiazines |
| mellaril | phenothiazines |
| serintil | phenothiazines |
| prolixin | phenothiazines |
| phenothiazines action | alternation in dopamine effect on CNS by preventing dopamine & serotonin from attaching to their receptors sites in the brain, depresses limbic & cerebral cortex |
| use of phenothiazines | treat psychosis, anxiety, agitation, intractable hiccups, N/V, preoperative seadation, behavioral problems in children, Alzheimer's disease |
| phenothiazines SE | sedation, hypotension, wt GAIN, photosensitivity, dizziness, EPS, N/V/C/D, H/A, dry mouth & eyes, urinary retention, TD, seizures, agranulocytosis, NMS, respiratory depression, circulatory failure, pink or reddish brown urine |
| TD | tardive dyskinesia: tongue & facial spasms |
| phenothiazines interactions | increase CNS depression alcohol, sedative, hypnotics, TCA, st johns wort, & kava |
| phenothiazines NI | monitor VS, protect from light & dilute with fruit juice, avoid med contact with skin, IM deep Z track, 1 daily dose, administer with food/fluids, observe for EPS, ensure family planning, obtain F/U labs, no alcohol or CNS depressants, don't abruptly stop |
| NMS | neuroleptic malignant syndrome can be fata: increased fever, tachycardia, HTN, muscle rigidity, altered mental status, acute renal failure, pallor, daiphoresis, dyrhythmias, varing decreased LOC |
| phenothiazines given when | at bedtime |
| haloperidol (Haldol) | nonphenothiazines |
| chlorprothixene (Taractan) | nonphenothiazines |
| loxapine succinate (Loxitane) | nonphenothiazines |
| thiothixene (Navane) | nonphenothiazines |
| which drug is worse for EPS | haloperidol (Haldol) |
| action of nonphenothiazines | alteration of the effect of dopamine on the CNS, mechanism for antipsychotic effects are unknown, antiemetic |
| uses for nonphenothiazines | treat acute & chronic psychoses, children with severe behavior problems, suppress narcotic withdrawl symptoms, treat schizophrenia that is resistant to other drugs, dementia & agitation in elderly, tourette's |
| SE nonphenothiazines | sedation, EPS, orthostatic hypotension, H/A, photosensitivity, dry mouth & eyes, blurred vision, tachycardia, seizures, urinary retention, TD, laryngospasm, respiratory depression, cardiac dysrhythmias, NMS |
| nonphenothiazines interaction increased sedation | alcohol & CNS depressants |
| nonphenothiazines interactiosn with decreased effects | phenobarbital, carbamazepine, & caffiene |
| nonphenothiazines interactions increased toxicity | anticholinergics, CNS depressants, & lithium |
| clozapin (Clozaril) | atypical antipsychotic agents/neuroleptics |
| aripiprazole (Abilify) | DSS |
| DSS | mild SE often added to other drugs |
| olanzapine (Zyprexa) | atypical antipsychotic agents/neuroleptics |
| quetiapine (Seroquel) | atypical antipsychotic agents/neuroleptics |
| resperidone (Resperdal) | atypical antipsychotic agents/neuroleptics |
| atypical antipsychotic agents/neuroleptics use | treatment of resistant schizoprenia or when others cause too many SE. start dose slowly. |
| atypical antipsychotic agents/neuroleptics SE | less b/c of no dopamine N/VC, hypersalivation, hypotension, H/A, wt. gain, severe agranulocytosis, NMS, & drowsy |
| When are atypical antipsychotic agents/neuroleptics taken? | daily at bedtime |
| What should you monitor atypical antipsychotic agents/neuroleptics for? | flu-like symptoms through WBC testing |
| Which drug is weekly WBC drawn? | Clozaril |
| parietal secrete | HCL acid & intrinsic factor |
| chief cells secrete | enzymes for digestion |
| bismuth subsalicylate (Pepto-Bismol) | bismuth salts |
| Tritec | combo with bismuth in it |
| What drugs causes a black colored stool? | bismuth salts & charcoal |
| bismuth salts action | provides protective coating & prevents H. pylori from sticking. suppress & prevents the growth too. |
| How long should you be on bismuth salts? | 8 weeks at most d/t neurologic problems |
| amoxicillins | antibacterial |
| clarithromycin (Biaxin) | antibacterial |
| metronidazole (Flagyl) | antibacterial |
| tetracyclines | antibacterial |
| How are antibiotics given for PUD? | 2 different ones to decrease risk of drug resistance |
| ranitidine (Zantac) | histamine 2 receptor antagonist aka blockers |
| famotidine (Pepcid) | histamine 2 receptor antagonist aka blockers |
| nizatidine (Axid) | histamine 2 receptor antagonist aka blockers |
| cimetidine (Tagamet) | histamine 2 receptor antagonist aka blockers |
| omeprazole (Prilosec) | proton pump inhibitors |
| which histamine 2 receptor antagonist aka blockers is worst for interactions? | Tagamet |
| lansoprazole (Prevacid) | proton pump inhibitors |
| esomeprazole (Nexium) | proton pump inhibitors |
| pantoprazole (Protonix) | proton pump inhibitors |
| -tidine drugs | histamine 2 receptor antagonist aka blockers |
| -prazole drugs | proton pump inhibitors |
| action of histamine 2 receptor antagonist aka blockers | blocks H2 receptors, reduces volume of gastric acid & H+ concentration. combines with androgen receptors to promote healing. decreases acid decreasing risk for pneumonitis in GERD. |
| Which drug class is used as a prophylaxis against stress ulcers? | histamine 2 receptor antagonist aka blockers |
| SE of histamine 2 receptor antagonist aka blockers | gynecomastia, reduced libido, impotence, blood dyscasias, C/D, H/A, fatigue |
| histamine 2 receptor antagonist aka blockers are given how long apart fron antacids? | 1-2 hrs |
| drugs that increase levels of cimetidine (Tagamet) | oral anticoagulants, phenytoin, theophylline, lidocaine |
| how is cimetidine (Tagamet) taken? | BID |
| Proton pump inhibitors action | becomes active form in the parietal cells of the stomach causing irreversible inhibition of the enzyme that generates gastric acid by 97% on 1st does |
| Length of time Proton pump inhibitors can be given | 4-8 weeks d/t carginogenesis to stomach |
| What is the DOC for PUD? | Proton pump inhibitors |
| SE of Proton pump inhibitors | H/A, N/V/D/C, rash, dizziness, URI, cough |
| when does Proton pump inhibitors start working? | within 2 hours |
| NI to remember for Proton pump inhibitors | never crush or chew, take before meals 30 mins prior, avoid things in diet that makes it worse, stop smoking |
| how often is lansoprazole (Prevacid) taken? | BID |
| how often is esomeprazole (Nexium) & pantoprazole (Protonix) taken? | once daily dosing |
| types of antacids | aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium bicarbonate, & combo |
| antacids duration is | 2 hours |
| aluminum hydroxide | slow acting but long duration. contains high amount of sodium. also binds with pepsin. |
| what has a high affinity for phosphate? | aluminum |
| SE of aluminum hydroxide | C |
| amphojel | aluminum hydroxide |
| alternaGEL | aluminum hydroxide |
| magnesium hydroxide | rapid acting long duration. used also as a laxative. |
| MOM | magnesium hydroxide |
| CI & cautiously for magnesium hydroxide | CI: undiagnosed abdominal pain & renal failure caution: cardiac or edema pt |
| when should magnesium and aluminum antacids be given? | 1 & 3 hrs pc & hs |
| what drug class should you not take more than 2 weeks without dr. direcctions? | antacids |
| SE of amgnesium hydroxide | D |
| simethicone | antiflatulant |
| mylanta | antacid & antiflatulant aka simethicon |
| Gas-X | antiflatulant |
| TUMS or Rolaids | calcium carbonate |
| calcium carbonate | rapid action with long duration. must be chewed very well & can cause acid rebound & gas. |
| What is the reason for decreased compliance for calcium cabonate? | palatability |
| baking soda | sodium bicarbonate |
| sodium bicarbonate | neutralizes acid but isn't useful for PUD b/c release of CO2 & increases intraabdominal pressure. |
| CI & cautions for sodium bicarbonate | pregancy & cardiac pt. |
| what happens if routinely used sodium bicarbonate orally? | systemic alkalosis |
| sucralfate (Carafate) | promotes healing environment for ulcer crater by creating a viscous gel that acts like a bandaid |
| What is the advantages for Carafate? | minimal SE & lacks significant drug interactions |
| How long does Carafate last? | 6 hrs. |
| How long apart is antacids given to Carafate? | 30 mins at least. |
| Carafate decreases absoption of what? | phenytoin (Dilantin), Theophylline, Warfarin, anticoagulants, digoxin, flourquinolone antibiotics |
| misoprostol (Cytotec) actions | helps protect stomach by supressing secretion of gastric acids, increasing production of cytoprotective mucus, & maintains submucosal blood flow |
| which drug is an analogue of prostaglandin E? | cytotec |
| which drug prevents NSAID induced ulcers by serving as a replacement for endogenous prostaglandins? | cytotec |
| SE of cytotec | abdominal pain & D |
| CI of cytotec | pregnancy due to Category X |
| ginger | GI digestive aid & stimulant taht treats N/V, motion sickness, appetite stimulants. |
| psyllium hydrophilic mucilloi (Metamucil) | bulk-forming laxatives |
| bulk-forming laxatives action | powder that is dissolved in liquid that causes bowel to expand because of a mass |
| Metamucil is CI | diabetics due to 50% dextrose |
| bulk-forming laxatives | least harmful laxative |
| when does bulk-forming laxatives work? | 12-24 hrs |
| SE of bulk-forming laxatives | abdominal fullness, flatulence, bulky stools, obstruction of GI tract if not enough water, decrease absorption of some drugs |
| calcium polycarbophil (FiberCon, Fiberall) | bulk-forming laxatives |
| methylcellulose (Citrucel) | bulk-forming laxatives |
| bulk-forming laxatives NI | mix in water & take immediately & follow with another glass of water |
| advantage of Citrucel | more palatable & doesn't gel as fast |
| milk of magnesium | saline laxative |
| magnesium sulfate (Epsom salt) | saline laxative |
| magnesium citrate | saline laxative |
| effervescent sodium phosphate (Fleet Phospho-Soda) | saline laxative |
| saline laxative action | osmotic action pulls fluid into bowel increasing water content |
| LOC for stool specimens, impactions, & poisoning | saline laxative |
| saline laxative SE | D & abd discomfort |
| saline laxative NI | administer with water, fruit juice, or soda due to v if not diluted. |
| saline laxative CI | sodium people - cardiac & with renal disease |
| hyperosmotic laxatives or bowel evacuants | osmotic agent |
| polyethylene glycol (PEG, Miralax) | hyperosmotic laxatives or bowel evacuants |
| electrolytes (GoLYTELY, CoLYTE) | hyperosmotic laxatives or bowel evacuants |
| lactulose syrup (Chronulac) | hyperosmotic laxatives or bowel evacuants |
| action of polyethylene glycol (PEG, Miralax) & electrolytes (GoLYTELY, CoLYTE) | osmotic agent |
| use of polyethylene glycol (PEG, Miralax) & electrolytes (GoLYTELY, CoLYTE) | bowel cleansing before endoscopic or radiological exam or surgery |
| SE polyethylene glycol (PEG, Miralax) & electrolytes (GoLYTELY, CoLYTE) | N/V, bloating, cramps, abd fullness, rectal irritation |
| NI polyethylene glycol (PEG, Miralax) & electrolytes (GoLYTELY, CoLYTE) | dissolved in 1-4 L water, administer 240 ml every 10 min, swallowed rapidly. chilled over ice & very salty. |
| when does polyethylene glycol (PEG, Miralax) & electrolytes (GoLYTELY, CoLYTE) work? | with in 1 hr & bowel cleansing/emptying up to 4 hrs |
| miralax administration | 17 g in 8 oz water as a laxative |
| lactulose syrup (Chronulac) action | decreases colonic pH & stimulates colon propulsive action |
| use of lactulose syrup (Chronulac) | sever constipation & liver diseases due to ammonia levels |
| which laxative does not effect F/E balance? | lactulose syrup (Chronulac) |
| lactulose syrup (Chronulac) SE | flatulence, intestinal cramps, gas, bleching, d/n |
| lactulose syrup (Chronulac) NI | mix with water, juice or milk decrease sweet taste |
| lactulose syrup (Chronulac) works when? | 20-36 hrs |
| stimulant laxatives action | irritation of bowel to cause a movement |
| castor oil (Emulsoil, Neoloi, Purge) | stimulant laxative |
| phenolphthalein (Ex-Lax, Feen-a-mint, Correctol) | stimulant laxative |
| bisacodyl (Ducolax) | stimulant laxative |
| use of stimulant laxative | prep for barium enema, c, before endoscopic exam |
| SE stimulant laxative | abd cramping, D, hypokalemia, discolor yellow-brown or yellow-pink urine |
| NI stimulant laxative | habit forming limit use |
| castor oil | cause rapid emptying of intestines. several semiliquid stools in 2-6 hrs |
| bisacodyl (Dulcolax) | stimulates peristalsis on contact with colon mucosa used for bowel prep. enteric coated. |
| bisacodyl (Dulcolax) works when? | 6-10 hrs & wont have BM 1-2 days |
| surfactant | emollient, fecal moistening agents, stool softners |
| docusate (Colace, Surfak, Dialose) | emollient, fecal moistening agents, stool softners |
| action of emollient, fecal moistening agents, stool softners | detergent like effect allows water & fats incorporated into stool for evaction |
| emollient, fecal moistening agents, stool softeners uses | rectal impaction, hemorrhoid, chronic c, postop & postpartum c, & painful rectal or anal conditions that need no straining |
| glycerin suppositories | emollient, fecal moistening agents, stool softners |
| glycerin suppositories | hyperosmotic promotes peristalsis by irritating rectal mucosa, melts 1uick at room temp. BM in 15-30 mins. often used for people with decreased sensation like stroke & spinal cord. |
| cascara sagrada | herbal bowel evacuation |
| senna | herbal bowel evacuation |
| cascara sagrada works when | in 8 hrs |
| senna works when | 6-12 hrs |
| mineral oil | lubricant laxative |
| mineral oil | oil not digested & only minimally absorbed. stays in tract & softens the mass & keeps stool soft to prevent straining. |
| use of lubricant laxative | after abdominal or rectal surgery, hemorrhoids, after hernia surgery, or in undesirable straining, chronic c due to inactivity& orthopedic conditions |
| SE lubricant laxative | minimal. seepage from rectum irritates tissue & could delay healing, lipid pneumonia if aspirated, decreased absorption of fat soluble vitamins |
| antidiarrheals | decrease stool water by inhibiting intestinal fluid secretion or by increasing intestinal fluid absorption |
| NI antidiarrheals | no longer than 2-3 days or cause obstruction or c |
| antidiarrheals CI | fever of under age of 3 |
| opiates action | decrease propulsive motility in the bowel, reduce abd pain, & relieve tenesmus |
| tenesmus | rectal spasms |
| SE opiates | CNS depression & sedation, C |
| When are anticholinergics & opium derivatives not used? | invading organisms or pseudomembranous colitis |
| diphenoxylate & atropine sulfate (Lomotil) | opiates |
| Lomotil | inhibit motility by decreasing perstalsis by acting directly on smooth muscle |
| SE of Lomotil | drowsiness, dizziness, tachycardia, dry mouth, hyperthermia, abd distress, rash, agitation, bloating, c, paralytic ileus |
| loperamide (Imodium) | opiates |
| camphorated opium tincture (Paregoric) | opiates |
| bismuth subsalicylate (Pepto-Bismol) | adsorbents |
| activated charcoal (Charcoal, CharcoCaps) | adsorbents |
| kaolin & pectin (Kaopectate) | adsorbents |
| cholestyramine (Questran) | adsorbents |
| adsorbents action | coating the walls of GI tract, absorbing the bacteria or toxins causing the d, & passing them out in teh stool. usually taken after each loose BM until controlled. |
| which adsorbents is used for accidental or intentional overdose? | activated charcoal |
| cholestyramine (Questran) info | direct absorbent affinity for acidic materials. not FDA approved use. |
| anticholinergics action | decrease intestinal tone & peristalsis which can lead to C |
| belladonna alkaloids | anticholinergics |
| atropine | anticholinergics |
| hyoscyamine | anticholinergics |
| SE of anticholinergics | classic anticholinergic SE, dry mouth, c, urinary retention, drowsiness |
| anticholinergics use | tx of diarrhea & decrease abd pain & cramps |
| lactobacillus acidophilus | probiotics that restore normal flora in bowel by inhibiting overgrowth of bacteria |
| lactobacillus acidophilus sources | yogurt, milk, tablet, capsules, granules |
| cultural remedies for d | cornstarch in water, rice water after boiled, grated apple that turned brown aka applesauce or juice, & ABC/BRAT diet |
| tx for IBD | 5-ASA, glucocorticoids, immunosuppressants |
| sulfasalazine (Azulfidine) | 5-ASA |
| azathioprine (Imuran) | immunosuppressants |
| methotrexate (MTX) | immunosuppressants |
| infliximab (Remicade) | immunosuppressants a monoclonal antibody |
| psyllium | bulk laxative |
| dicyclomine (Bentyl) | anticholinergic |
| tegaserod (Zelnorm) | 5-HT (serotonin agonist) |
| IBS tx | psyllium, bentyl, zelnorm |
| action of tegaserod (Zelnorm) | binds with serotonin receptors in GI to stimulate peristalsis |
| use of tegaserod (Zelnorm) | IBS & constipation |
| who were IBS drugs made for | women |
| SE of tegaserod (Zelnorm) | leg, abd, & back pain, H/A, N/D |
| NI tegaserod (Zelnorm) | monitor liver & renal fx, monitor cardio status, give prior to meal with full glass of water. can be crushed. |
| T/F CTZ is protected by the blood brain barrier | F |
| antiemetics are used when | the cause is known |
| pt teaching for antiemetics | avoid hazardous activity, no alcohol or CNS depressants, report blood in emesis |
| prochlorperazine (Compazine) | antiemetic |
| promethazine HCL (Phenegran) | antiemetic |
| thiethylperazine maleate (Torecan) | antiemetic |
| action of prochlorperazine (Compazine) | blocks vomiting center in the brain |
| SE of prochlorperazine (Compazine) | orthostatic hypotension, tachycardia, sedation, urinary retention, dry mouth, nose & throat, & EPS |
| Phenegran action | blocks H1 receptors, blocks cholinergic receptors in v center & mediates input from vestibular center |
| SE Phenegran | dizziness, drowsiness, confusion, thickening of bronchial secretions, dry mouth, nose, throat, urinary freq/retention |
| NI for Phenegran | makes narcotics work better, give deep IM, avoid alchohol, CNS depressants & operating machinery |
| Torecan action | not fully understood, dopamine receptor blocker that decreases emesis & wakefulness |
| Torecan | sleepiness, sedation, dry mouth, GI irritation, hyperthermia, tinnitus, blurred vision, H/A, edema, EPS, convulsions, orthostatic hypotension |
| NI for Torecan | take with food or milk to decrease GI irriation caution against hazardous activites |
Created by:
midnight1854
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