Pharm Lecture 3

Antiemetics definition

Drugs to relieve/prevent nausea and vomiting

Classes of Antiemetics (relieve nausea and vomiting)

Dopamine Antagonist, Serotonin Receptor Antagonist

Dopamine Antagonist use

moves food further into intestinal tract (antiemetics) (relieve nausea/vomiting)

What type of drugs cause EPS (movement disorder) problems?

Dopamine antagonist

Reglan/metoclopramide patient uses

Diabetics with gastroparesis, GERDs

What med is prescribed for procedures visualizing the stomach

Reglan/metoclopramide

Should you use Reglan/metoclopramide very often

Use as little as possible for EPS

What drug is used to help with oral tube insertion

Reglan/metoclopramide

Types of dopamine antagonists

Reglan/metoclopramide, prochlorperazine/compazine, haloperidol/haldol

prochlorperazine/compazine patient demographic

prochlorperazine/compazine

prochlorperazine/compazine Drug type

Dopamine antagonist (antiemetics)

Metoclopramide/reglan drug type

Dopamine antagonist (antiemetics)

Haloperidol/Haldol drug type

Dopamine antagonist (antiemetics)

Haloperidol/Haldol Patient population

Psych patients

What drug can treat hiccups

Haloperidol/Haldol

Why would antiemetics be prescribed to a patient after surgery

Avoid vomiting that could tear sutures, also fluid retention

EPS/ Extrapyramidal symptoms

Movement disorder similar to Parkinson’s effect

Who is more likely to have EPS, older or younger patients

Younger

What should you do if a patient has a adverse effect related to EPS

Never take med again, give diphenhydramine/benedryl to reverse life threatening reaction

Acute Dystonia

Sudden involuntary muscle contractions or spasms

what patient population is acute dystonia common in

younger people

Ondansetron/Zofran drug type

Anti-Emetic (prevent nausea/vomit)

Can Ondansetron/Zofran be taken in pregnancy

no, causes cleft pallet malformations

is Ondansetron/Zofran a minimally or maximally effective drug

maximally

does Ondansetron/Zofran cause EPS

no

Adverse effects of Ondansetron/Zofran

might cause headache (give Tylenol)

Anti-motion sickness drugs

Scopolamine/transderm scop & antihistamines

Scopolamine/transderm scop

anti motion sickness drug

how does Scopolamine/transderm scop work to stop motion sickness

dries things up in the body

side effects of Scopolamine/transderm scop on vision

blurring

side effects of Scopolamine/transderm scop on mouth

overall dryness

side effects of Scopolamine/transderm scop on cns

drowsiness

anti-diarrhea meds

bismuth subsalicylate/pepto bismol, loperamide/Imodium, diphenoxylate (opiod), atropine (lomotil)

anti diarrhea prototype drug

bismuth subsalicylate/pepto bismol

how does bismuth subsalicylate/pepto bismol work

coats walls of GI tract, binds to toxin, eliminates via stool

Can bismuth subsalicylate/pepto bismol be used as a preventative drug

yes

what drug works well for travelers diarrhea

bismuth subsalicylate/pepto bismol

can you take bismuth subsalicylate/pepto bismol with aspirin

no, will cause heart issues

why does bismuth subsalicylate/pepto bismol decrease effectiveness of other drugs

the coating of the intestine blocks absorption

why is bismuth subsalicylate/pepto bismol considered a salicylate

means it contains some aspirin

what color does bismuth subsalicylate/pepto bismol turn tongue

black

what patient population needs to beware of use with bismuth subsalicylate/pepto bismol

kids

what type of drug is loperamide/imodium

anti-diarrheal

do not take loperamide/imodium if there is BLANK in the stool

blood

can you take loperamide/imodium with aspirin

no

which is stronger, loperamide/imodium or pepto

loperamide/imodium

loperamide/imodium effect on CNS

drowsiness

anti-diarrheal - opiods and anti-cholinergics

diphenoxylate and atropine/lomotil

diphenoxylate (opiod) function

treats diarrhea

atropine/lomotil

treats diarrhea

how does diphenoxylate and atropine/lomotil work to treat diarrhea

allows for fluid absorbtion, firms up stool, requires perscription

should you treat infectious diarrhea

no, its best to let it run its course

What does a laxative do

Make bowel lazy over time

What drug do individuals with eating disorders overuse

Laxatives

Classifications of laxatives

Bulk forming, surfactant, stimulant, lubricant, osmotic laxative

Bulk forming laxative drug

Psyllium/metamucil

Surfactant laxative drug

Docusate sodium/colace

Stimulant laxatives drug

Mineral oil

Osmotic laxative drug

Milk of magnesia (mom) & a antacid

Psyllium/metamucil function

Laxative that bulks up poo, also used for diarrhea, acts like a plug

Is Psyllium/metamucil better for temporary or long term relief

Temporary

What patient population can use Psyllium/metamucil laxative

Diverticulitis, pregnant, and IBS patients

Should Psyllium/metamucil be taken prophylacticaly

Yes

Adverse effects Psyllium/metamucil

Esophageal obstruction, dehydration, intestinal obstruction/impaction

In depository issues, what end of the gastrointestinal tract should be worked on

Both

What drug is docusate sodium/colace

Stool softener

Should docusate sodium/colace be used for prevention or treatment of constipation

Prevention

How does docusate sodium/colace

Inhibits fluid absorption in intestinal wall and secreted water

What drug is a bisacodyl/dulcolax

Stimulant (squeezer) laxative

How does bisacodyl/dulcolax work

Works in intestinal wall to get stool to pass/get going

What laxative is cramping/no obstruction conditions a worry for

bisacodyl/dulcolax

Does bisacodyl/dulcolax need a loading dose

bisacodyl/dulcolax

What drug is senna/senokot/ex-lax

Stimulant (squeezer) laxative

Which stimulant laxative is naturally derived

senna/senokot/ex-lax

What stimulant laxative is a combination product with colace

senna/senokot/ex-lax

What does senna/senokot/ex-lax

Softens and promotes barrel squeeze

what type of drug is mineral oil

Lubricant laxative

What patient demographic is mineral oil common in

Geriatrics

What laxative can cause anal leakage, sweating, and cramping

Mineral oil/lubricants

How does mineral oil work

Slick the bowel so poo can slide out easily

What laxative should you double up on constipation drugs

Lubricant/mineral oil

What type of drug is polyethylene glycol/miralax

Osmotic laxative

What is the function polyethylene glycol/miralax

Relieves chronic contsipation, taken with drink

What drug should you take that is like polyethylene glycol/miralax to bowel prep and avoid dehydration

Golytely

Peptic ulcers definition

Acid corrodes into stomach/intestinal walls

Classes of drugs for ulcers

Antacids, anti secretory meds and agents, antibiotics, mucosal protections

What type of med is an antacid

Anti ulcer medication

types of antacids

aluminum, magnesium, calcium, sodium

aluminum antacid adverse effects

constipation

magnesium antacid adverse effects

diarrhea

calcium antacid adverse effects

kidney stones

sodium antacid adverse effects

HTN (hypertension)

antacid function

neutralizes stomach acid, decrease gut wall destruction, treats ulcers

can you drink water/milk after chewing a antacid

yes

what type of drug is a maalox

antacid

what type of drug is mylanta

antacid

what type of drug is tums

antacid

what is the first step to treatment with history of indigestion

antacid medication

what do you prescribe for indigestion after antacid

H2 blocker

H2 receptor activation causes what

gastric acid secretion, located in stomach wall