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MC Pharm 2 Exam 3

Fabick Ch 14, 16, 17, 40, & 41

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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