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N201: Test II

Pharmocological

GroupDrugPharm. Act.IndicationsAdminSide EffectsPt. Teaching
Seratonin Antagonists Ondanestron (Zofran) Blocks 5-HT3 serotonin receptor = no nausea Nausea r/t pregnancy, chemo, cancer PO 30-40 mins. before surgery or expected nausea Headache, Dizziness, Diarrhea No driving bc sedation
Prokinetic Metoclopramide (Reglan) Dopamine Blocker, Increase tone of lower esophageal sphincter, Increases peristalsis Nausea, Vomitting, Pt's w/reflux (moves things through) IV or PO, usually 30 mins before meals Sedation, diarrhea, dry mouth, Tardative dyskinesia No alcohol or driving bc of sedation, Monitoe BP & hypotension
Antihistamines Dimenhydrinate (Dramamine) Blocks histamine receptors in the inner ear and CTZ Motion sickness PO, IV, IM, Rectal Sedation, Drowsiness, Dizziness, Dry mouth, constipation, Urinary retention Teach about side effects
Histamine2 Receptor Agents Cimetidine (Tagamet) Famotidine (Pepcid) Ranitidine (Zantac) Block histamine receptors to decrease acid in stomach (doesn't prevent reflux but increases pH) Reflux, Gastic & duodenum ulcers Admin w/or w/o food, don't admin antacids w/in 1 hr. of giving antagonist (effects absorption rate), IV must be given slowly or can cause bradycardia Nausea, vomiting, diarrhea, constipation, Decreased WBC's (long term use), Tagamet: Seizures, Lower labido, Lethargy Antacidseffect absorption rate of Antagonist, Smoking also interferes with absorption
Proton Pump Inhibitors (PPIs) Omeprazole (Prilosec) Lansoprazole (Prevacid) Pantoprazole (Protonix) Esomeprazole (Nexium) Decreases the acids in the stomach Reflux, duodenum & gastic ulcers Empty stomach, usually 1x daily before breakfast Nausea, vomiting, diarrhea, log term use = bone loss Antacids do not oaffect absorption, ^vit D, ^ ca+, ^ excercise
Mucosal Protectants Sucralfate (Carafate) Creates gel to coat stomach (good w/pt's already have ulcer) Pt.'s w/ Ulcers Empty stomach - wait 2hrs before/after meals or other meds - affects absorption Constipation, nausea, diarrhea, dyspepsia Teach pt how to take
Antacids Aluminum hydroxide (Amphojel) Calcium carbonate (Tums) Magnesium hydroxide (Milk of Magnesia) Neutralize gastric acid Ulcers and reflux PO Amphojel & Tums: Constipation Milk of Magnesia: Diarrhea Know what other medications are being taken
Prostaglandin E Analogs Misoprostol (Cytotec) Works to increase pH, protect against ulcer, allow adequate blood flow to the gastric wall Prevents gastric ulcers from long-term NSAID use Take w/meals while taking NSAID Diarrhea, Ab pain, nausea; women uterine cramps, spotting Do not take if pregnant - spontaneous abortion
Laxatives Psyllium (Metamucil) Methylcellulose (Citrucel) Promotes large soft stool by absorbing water into intestines Stimulaes peristalsis Bulk forming PO
Laxatives I Mineral Oil Glycerin Suppository Softens fecal matter and lubricates intestinal tract Lubricant PO, Rectal
Laxatives II Bisacodyl (Dulcolax) Senna (Senokot) Irritates colonic epithelium by stimulating sensory nerve ending and increasing peristalsis; also pulls water into bowel Stimulant PO
Laxatives III Docusate (Colace) Promotes incorporation of water into the stool, resulting in softer fecal mass Fecal Softener PO More of a daily treatment, Could take 1-5 days for it to take effect
Laxatives IV Osmotic agent: Polyethylene glycol and electrolytes (Colyte or Golytely) Rapidly pulls water into colon Give before surgery, clean out intestines/bowels PO Diarrhea
Dopamine Antagonists Porchlorperazine (Compazine), Promethazine (Phenergan), Metoclopramide (Reglan) Blocks Dopamine receptor in CTZ of brain Prevents Nausea PO, IV, Rectal, No IV Push Muscle spasms, tremors, rigidity, hypotension, sedation, dry mouth, urinary retention, constipation Encourage fluids, Make Pt. aware of side effects
Created by: lost little girl