patho exam 2

bethanecol (urecholine) antidote

atropine

atropine is a

anticholinergic- antimotility

atropine will

decrease intestinal tone and peristalsis

bethanechol (urecholine)

stimulates intestines and bladder

bethanechol (urecholine) is used for

postsurgical bladder, GI atony, urinary retention and incontinence

bethanechol (urecholine) is a

cholinergic

cholinergic drug effects cardiovascular

bradycardia and hypotension

cholinergic drug effects cardiovascular left untreated can lead to

cardiac arrest

tolterodine is a

anticholinergic- blocks the action of acetylcholine

antispasmodic- relieves/prevents muscle spasms

tolterodine is used for

neurogenic bladder, urinary frequency and incontinence

taking tolterodine may result in

urinary retention

dont use tolterodine with

urinary retention or UTI

when taking tolterodine you may experience

dry mouth and light sensitivity

when taking tolterodine avoid

grapefruit juice and physical exertion- high temps

tamsulosin (flomax) is a

alpha blocker

side effects of alpha blocker

first dose phenomenon(orthostatic hypotension), reflex tachycardia, abnormal ejaculation

reflex tachycardia

HR increases due to decreased BP

tamsulosin (flomax) treats

benign prostatic hyperplasia BPH

tamsulosin is indicated for

male patients

oxybutynin is used for

neurogenic bladder, urinary frequency and incontinence

oxybutynin is a

anticholinergic- blocks the action of acetylcholine

antispasmodic- relieves/prevents muscle spasms

atropine + diphenoxylate is a

antimotility drug- opiate

atropine + diphenoxylate is used to

decrease bowel motlity, reduce rectal spasm pain- allowing more time for fluid absorption

atropine + diphenoxylate SE/AE

neuro changes, respiratory depression, constipation

phenazopyridine is a

urinary analgesic

phenazopyridine treats

symptoms of UTI- pain, burning

phenazopyridine SE/AE

temporary discoloration of teeth and secretions (red-orange), stained soft contacts, dark colored urine/jaundice

phenazopyridine- when taking avoid

alcohol and contacts

methylcellulose is a

bulk forming laxative

methylcellulose

absorbs water to increase stool bulk and initiate bowel activity

methylcellulose SE/AE

esophogeal/intestinal obstruction, rebound diarrhea with excessive use

methylcellulose decreases absorption of

antibiotics, aspirin, nitrofurantoin

methylcellulose- report

difficulty swallowing

antacid recommended for patients with renal failure

aluminum salts- aluminum hydroxide

aluminum salts- aluminum hydroxide combination with

magnesium to counteract constipation

aluminum salts- aluminum hydroxide recommended for patients with renal failure because

aluminum is more easily excreted than other antacid salts

drugs can be chemically enhanced by

antacids

antacids may reduce

effectiveness of interacting drugs by interfering with GI absorption

take interacting drugs 1-2 hours before or after, 2 hours before or after for quinolone antibiotics when taking

antacids

dont use antacids with high sodium if you have

heart failure or hypertension

long term use of antacids can mask

serious conditions

neurokinin blockers

enhance serotonin blockers and glucocorticoids to inhibit acute and delayed chemo induced emesis

metoclopramide (reglan) is a

prokinetic drug

metoclopramide (reglan) is often reserved for

patients with N/V associated with antineoplastic drugs/radiation

give metoclopramide (reglan)

30 min before meals

metoclopramide (reglan)- report

extrapyramidal symptoms and stop drug

extrapyramidal symptoms EPS

movement disorders- tardive dyskinesia, grimacing, rapid eye blinking, lip smacking, tongue protrusion

ondansetron (zofran) is a

serotonin blocker

ondansetron (zofran) treats

N/V pre chemo

do not use in children under 4 and watch closely in those with prolonged QT syndrome (ECG)

ondansetron (zofran)

dronabinol (marinol) is a

tetrahydrocannabinoid (THC)

dronabinol (marinol) treats

N/V pre chemo

antiemetics with alcohol can

cause severe depression

give chemo antiemetics

30-60 min before chemo

antiemetics may cause

severe drowsiness and hypotension

bisacodyl (dulcolax) is a

stimulant laxative

bisacodyl (dulcolax) is used for

acute constipation and bowel prep for diagnostics/surgery

bisacodyl (dulcolax) is offered as

oral tab or suppository

take bisacodyl (dulcolax)

on an empty stomach

with bisacodyl (dulcolax)

stool should occur within 12 hr- oral, less than 60 min- suppository

do not take bisacodyl (dulcolax) with

antacids, milk, or juice (1hr)

retain bisacodyl (dulcolax) suppository for

15-30 min

omeprazole (prilosec) is a

proton pump inhibitor PPI

proton pump inhibitor PPI ending

-PRAZOLE

omeprazole (prilosec) is used short term for

GERD, peptic ulcers, duodenal/benign gastric ulcers, zollinger ellison syndrome, NSAID induced ulcers, stress ulcers, H. pylori ulcers

zollinger ellison syndrome

rare digestive order- overproduction of stomach acid due to tumors

proton pump inhibitors are

generally well tolerated

proton pump inhibitors decrease stomach acid which gives

predisposition to C. Diff

proton pump inhibitors increase risk of developing

pneumonia

proton pump inhibitors may cause

osteoporosis- increased risk of hip, wrist, and spine fractures

food may decrease absorption proton pump inhibitors-

take on empty stomach

some proton pump inhibitors are available for

parental admin

proton pump inhibitors lansoprazole capsules and pantoprazole granules

can be put down 16+g NG tube or mixed with apple juice

omeprazole cannot

be crushed, opened, or chewed

proton pump inhibitors may increase serum

diazepam, phenytoin, warfarin

bismuth subsalicylate is a

antidiarrheal- absorbent

bismuth subsalicylate

coats walls of GI

bismuth subsalicylate do not give to

children with influenza or chickenpox

bismuth subsalicylate causes

temporary darkening of the tongue and stools- black/gray

bismuth contains salicylates similar to aspirin

risk of reyes syndrome

methylnaltrexone is a

laxative

methylnaltrexone approved only for

terminally ill patients with opiod induced constipation

give other medications before or after antacids due to

50% reduced absorption

omeprazole combination therapy is for

H. pylori induced ulcers

omeprazole will be given with an antibiotic for

H. pylori induced ulcers

H. pylori is resistant to acid suppresion, what combination therapy is needed

omeprazole reduces stomach acid allowing antibiotics to work better

hepatitis a is transmitted

fecal-oral route- crowded unsanitary conditions, food/water contamination

polyuria

large overproduction of urine

sulfamethoxazole +trimehoprin treats

UTI

sulfamethoxazole +trimehoprin SE/AE

bone marrow supression, skin issues

sulfamethoxazole +trimehoprin drug interactions

sulfonylureas, phenytoin, warfarin

amoxicillin + clavulanic acid treats

UTIs

cephalosporines are pharmacologically related to

penicillins

all gen cephalosporines treat

UTIs

cephalopsporine use for UTI depends on

severity and type of UTI

cefiximie is a

third gen ceph

nitrofurantoin treats

UTIs

nitrofurantoin monitor

renal and liver function

rifampin treats

UTis

rifampin works best

taken 1 hr before or 2 hr after meal