What are antiemetic drugs?

drugs for treatment of nausea and vomiting

What is nausea?

a feeling of sickness that may cause urge to vomit

What are the 5 neurotransmitters that affect the vomiting central of the brain?

dopamine, serotonin, histamine, acetylcholine, substance P

Serotonin receptor antagonists (5-HT3) have what suffix?

setron

What might substance P/neurokinin 1 antagonist cause?

neutropenia

Promethazine is what type of drug?

dopamine antagonists

When would you usually give serotonin antagonists?

before chemotherapy or after surgery

Patients receiving chemotherapy should not use what type of medications?

over the counter medications

aprepitant and fosaprepitant are what type of drug?

substance P/neurokinin antagonists

What is a side effect of substance P/ neurokinin antagonists?

decreased neutrophil count

A patient taking dopamine antagonists (phenothiazines) should do what at home?

ask for help when getting up or changing positions

Dopamine antagonists and Promotility drugs may cause what type of symptoms?

extrapyramidal symptoms

What are extrapyramidal symptoms?

Pseudoparkinsonism - shuffling, propulsive gait, masklike face, drooling

Akathisia - continuous restlessness and fidgeting

acute dystonia - facial grimacing, involuntary upward eye movement

tardive dyskinesia: smacking of lips, chewing motion, facial dyskinesia

Dronabinol is what type of drug?

cannabinoids

Cannabinoids should be reserved for what type of patients?

patients who continue to have nausea and vomiting who do not respond to other categories of antiemetics

When taking cannabinoids what should a patient avoid and why?

avoid alcohol, sedatives, or other CNS depressants because they may increase the risk

Metoclopramide (Reglan) is what type of drug?

promotility drugs

What is metoclopramide (Reglan) used for?

used to increase contraction of the upper GI tract to move contents more quickly through the tract

Promotility drugs may cause what?

suicidal ideation and orthostatic hypotension

What are recommendations you should give to a patient with peptic ulcer disease or GERD?

stop smoking, avoid alcohol and NSAIDs, eat smaller portions, don't eat within 3 hours of bedtime

What do antacids do?

neutralize stomach acid and increase gastric pH

What suffix do histamine 2 receptor antagonists have?

tidine

What do Histamine receptor antagonists do?

decrease production of stomach acid

What do proton pump inhibitors do?

block acid secreting pumps inside the stomach

What suffix do proton pump inhibitors have?

prozole

What do cryoprotective drugs do?

attach to the stomach ulcer to protect it from damage due to acid

What are the common ingredients in antacids?

aluminum, calcium and magnesium

Aluminum hydroxide and calcium carbonate may cause?

constipation

Magnesium hydroxide may cause?

diarrhea

What is magnesium hydroxide?

antacid and laxative

If a patient takes magnesium hydroxide what may it cause?

hypermagnesemia

What are side effects of hypermagnesemia?

weak muscles and bradycardia

When is the best time to take antacids?

between meals and at bedtime or one hour after meals and before bedtime

When should you take other medications when taking antacids?

one hour before or two hours after taking the antacid

What are side effects and adverse effects of Histamine H2 receptor antagonists?

sedation, change in mental status, and increase risk of pneumonia

Cimetidine can increase the levels of what other drugs?

warfarin, phenytoin, theophylline and lidocaine

What levels should you monitor if your patient is taking cimetidine?

INR and PT

What are side effects and adverse effects of proton pump inhibitors?

sedation, photosensitivity, increase risk of osteoporosis and fractures, and increase risk of pneumonia

What do laxative treat?

constipation

What should you recommend to your patient with constipation?

take 6-8 glasses of water everyday, high fiber diet, regular exercise

Why do you hesitate to give laxatives?

can cause burning sensation, abdominal pain, electrolyte imbalance, causes diarrhea, increases risk of intestinal rupture

Psyllium is what type of laxative?

bulk-forming laxative

Bulk-forming laxative can treat?

both constipation and diarrhea

Docusate sodium is what type of laxative?

surfactant laxative

What do surfactant laxatives do?

lower surface tension of the stool to allow penetration of water to make the stool softer

How do stimulant laxatives work?

stimulate the intestinal peristalsis and increase the amount of water and electrolytes within the intestinal lumen

Bisacodyl is what type of laxative?

stimulant laxative

Stimulant laxatives should not be taken with what?

milk, dairy products and calcium

If your patient has been taking Bisacodyl for a few days what blood level should you check?

potassium

What kind of patients should not take laxatives and why?

patients with congestive heart failure or high blood pressure due to the sodium it contains

You should give high dose of osmotic laxatives to what kind of patients?

patients preparing for surgery or diagnostic tests such as a colonoscopy and Barium Enema

What are contraindications for laxatives?

patients who have any abdominal condition such as bowel obstruction or fecal impaction

What should you give a patient with diarrhea?

water and electrolytes

How long should you give antidiarrheal for?

only for 1 or 2 days and no longer

Dicyclomine is what type of antidiarrheal?

anticholinergic

Diphenoxylate and loperamide are what type of antidiarrheal?

opioid agonists

Diphenoxylate is what type of substance?

controlled substance

What type of patients should never receive dicyclomine?

patients with history of glaucoma