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Phar52 Drugs Set 0
Class, Category, Indications, Cautions
| Question | Answer |
|---|---|
| Antiemetics: Drug indications | 1. Control nausea 2. Prevent vomiting |
| Block CTZ receptors: Drug categories | 1. antidopaminergic (block dopamine) 2. 5HT3 antagonists (block serotonin) |
| Blocking CTZ best for: | Best for drug-induced N/V (PONV & CINV) |
| Block nerve pathways from the inner ear: Drug categories | 1. antihistamines 2. anticholinergics |
| Block nerve pathways best for: | Best for Vertigo |
| Antidopaminergic Antiemetics MOA: | Blocks dopamine receptors in CTZ which inhibits vomiting reflex |
| Antidopaminergic Antiemetics Indication: | Drug-induced N/V: PONV & CINV |
| Antidopaminergic Antiemetics Routes: | "Nurses Prerogative" 1. PO 2. IM 3. PR |
| Antidopaminergic Antiemetics Side-Effects: | 1. sedation 2. EPS (Extra-Pyramidal) |
| Phenothiazine: chemical group 1 | prochlorperazine = Compazine |
| Phenothiazine: chemical group 2 | thiethylperazine = Torecan |
| Phenothiazine: chemical group 3 | triflupromazine = Vesprin |
| Phenothiazine: chemical group 4 | chlorpromazine = Thorazine |
| chlorpromazine = Thorazine: additional indication: Drug category | Antipsychotic (major tranquilizer) |
| Phenothiazine: chemical group | promethazine = Phenergan |
| promethazine = Phenergan: additional indication: Drug category (1) | Anxiolytic (minor tranquilizer) |
| promethazine = Phenergan: additional indication: Drug category (2) | Antihistamine |
| NON-Phenothiazine: chemical group | metoclopramide = Reglan |
| metoclopramide = Reglan: additional indication: Drug category | Prokinetic (speed up GI intestinal transit) |
| metoclopramide = Reglan: Tx: DZ indication | Gastroparesis (delayed gastric emptying seen in diabetic patients) |
| Antihistamine Antiemetics: Drug indication | N/V 2nd degree Vertigo |
| Antihistamine Antiemetics: Side-Effects | 1. sedation 2. May Cause Drowsiness Do not drive |
| Antihistamine Antiemetics: (anticholinergic) Side-Effects | 1. constipation 2. urine retention 3. dry mouth |
| Antihistamine Antiemetics: Drug name 1 | dimenhydrinate = Dramamine (OTC) |
| Antihistamine Antiemetics: Drug name 2 | cyclizine = Marezine (OTC) |
| Antihistamine Antiemetics: Drug name 3 | meclizine = Bonine (OTC chewable tablets) |
| Antihistamine Antiemetics: Drug name 4 | meclizine = Antivert (Rx only) |
| Antihistamine Antiemetics: Drug name 5 | hydroxyzine = Vistaril (Rx only) |
| hydroxyzine = Vistaril: Primary indication | Treat anxiety (Anxiolytic) |
| hydroxyzine = Atarax: Primary indication | Treat anxiety (Anxiolytic) |
| Antihistamine Antiemetics: Drug name 6 | trimethobenzamide = Tigan (Rx only) |
| trimethobenzamide = Tigan: Dosage form | 1. PO 2. IM |
| trimethobenzamide = Tigan: MOA | Weak antihistamine (unclear MOA) |
| trimethobenzamide = Tigan: Drug indication | 1. PONV 2. NOT Vertigo |
| Anticholinergic Antiemetic: Drug name | scopolamine = Transderm-Scop (Rx only) |
| scopolamine = Transderm-Scop: Drug indication | 1. Vertigo 2. PONV |
| scopolamine = Transderm-Scop: Dosage form | 1. Patch (Transderm-Scop): 3-day duration of action 2. Injectable: Used w/pre-op medication |
| scopolamine = Transderm-Scop: Patch directions | 1. Apply 1 patch behind ear 2. Change every 72 hours |
| scopolamine = Transderm-Scop: Side-Effects | 1. sedation 2. Antihistaminic 3. Anticholinergic 4. May see rebound vertigo after removal of patch |
| 5-HT3 Receptor Antagonists: MOA | 1. Block 5-HT3 (serotonin) receptors in CTZ which inhibits vomiting reflex 2. No effect on dopamine > no EPS |
| 5-HT3 Receptor Antagonists: Indication | 1. PONV 2. CINV |
| 5-HT3 Receptor Antagonists: Special note | Rx drug form of these drugs are the most powerful Antiemetics |
| 5-HT3 Receptor Antagonists: Sig label | 1. Single doses may be enough 2. Pre-treat at least 30 minutes before chemo theraphy |
| 5-HT3 Receptor Antagonists: Drug name 1 | ondansetron = Zofran (ODT) |
| ondansetron = Zofran: Caution | Causes diarrhea in 40% of patients |
| 5-HT3 Receptor Antagonists: Drug name 2 | granisetron = Kytril |
| 5-HT3 Receptor Antagonists: Drug name 3 | granisetron = Sancuso transdermal |
| 5-HT3 Receptor Antagonists: Drug name 4 | dolasetron = Anzemet |
| 5-HT3 Receptor Antagonists: Drug name 5 | palonosetron = Aloxi (Parenteral dosage form only) |
| alosetron = Lotronex: Indication | Treat diarrhea in IBS |
| 5-HT3 Receptor Antagonists: Drug name 6 | alosetron = Lotronex |
| alosetron = Lotronex: Special note 1 | Restricted prescribing (severe diarrhea-predominant IBS) |
| alosetron = Lotronex: Special note 2 | The Prescribing Program for Lotronex was implemented to help reduce risks of serious GI adverse events. Only physicians who have enrolled in based on their understanding of the benefits and risks should prescribe Lotronex |
| alosetron = Lotronex: Risk caution | Ischemic Colitis (fatal) |
| Antiemetics (miscellaneous): Drug category 1 | cannabinoids (THC derivatives: Derived from "marijuana") |
| cannabinoids (THC derivatives): Drug name 1 | nabilone = Cesamet (C-II drug) |
| cannabinoids (THC derivatives): Drug name 2 | dronabinol = Marinol (C-III drug) Storage: Refrigerator |
| cannabinoids (THC derivatives): Drug indication | 1. 2nd line Tx for CINV 2. dronabinol also FDA approved as appetite stimulant for AIDS |
| cannabinoids (THC derivatives): Side-Effects | 1. Changes mood (euphoria, disinhibition) 2. drowsiness 3. "munchies" > increased appetite 4. postural hypotension |
| Antiemetics (miscellaneous): Drug name 2 | aprepitant = Emend |
| aprepitant = Emend: MOA | Block Substance P receptors in brain |
| Substance P | Neuropeptide involved in: 1. nausea 2. pain perception 3. mood |
| aprepitant = Emend: Indication | 1. Adjunctive Tx for CINV 2. Approved for acute & delayed emesis |
| aprepitant = Emend: Dosing 1 | Rx Dosing: The recommended dose of Emend is 125 mg orally 1 hour prior to chemotherapy treatment (Day 1) and 80 mg orally once daily in the morning on Days 2 & 3 |
| aprepitant = Emend: Dosing 2 | 1. Give w/5-HT3 antagonists + steroid 2. Dosing: PO QD x 3 d |
| aprepitant = Emend: Special note | Emend = fosaprepitant dimeglumine for Injection (115 mg) is a prodrug of aprepitant & may be substituted for oral Emend (125 mg), 30 minutes prior to chemotherapy, on Day 1 only of the CINV regimen as an IV infusion administered over 15 minutes |
| Drugs that cause emesis: MOA | Clear out the stomach & upper GI tract |
| Emetic Therapy: Indication | 1. poisoning 2. drug overdose |
| Emetic Therapy: Caution | Patient must be conscious to use an emetic |
| Emetic Therapy: Drug 1 | IPECAC (syrup) |
| IPECAC (syrup): Dosage form | 30 mL bottle (BTC) |
| IPECAC (syrup): MOA | 1. gastric irritant (local effect) 2. plus stimulate the CTZ (systemic effect) 3. causes vomiting in 15-20 minutes |
| IPECAC (syrup): Doses | 1. Adult: 30 mL PO 2. 1-12 yr: 15 mL PO 3. <1 yr: 10 mL PO (given in ER) Give dose with lots of water |
| IPECAC abuse: Caution risk | Cardiomyopathy (cardio-=heart + myo-=muscle + opathy-=disease) |
| Antispasmodics: Indication | Rx only (Intestines/Rectum: motility disorders) |
| Antispasmodics: MOA | Block ACh receptors (anticholinergic) |
| Antispasmodics: Therapeutic Effect | 1. Decrease secretions 2. Relax smooth muscle |
| Antispasmodics: Side-Effect | 1. dry mouth (cotton mouth) 2. dry eyes (leads to tearing) 3. urinary retention 4. constipation |
| Antispasmodics: Drug 1 | belladonna alkaloids (anticholinergic) 1. atropine 2. scopolamine 3. hyoscyamine 4. w/phenobarbital in Donnatal |
| hyoscyamine = Levsin: Drug category | Antispasmodic (belladonna alkaloids: anticholinergic) |
| Antispasmodics: Drug 2 | propantheline = ProBanthine (synthetic anticholinergic) |
| Antispasmodics: Drug 3 | dicyclomine = Bentyl (synthetic) |
| dicyclomine = Bentyl: Special note | 1. direct acting 2. fewer anticholinergic side-effects |
| Antispasmodics: Drug 4 | chlordiazepoxide = Librax |
| chlordiazepoxide = Librax: Indication | relief of anxiety & tension (tranquilizer) |
| clindinium = Librax: Indication | synthetic anticholinergic |
| Antispasmodics: Drug 5 | clindinium = Librax |
| Antispasmodics: Tx | Constipation-predominant IBS |
| Antispasmodics: (constipation-predominant IBS) Drug 1 | tegaserod = Zelnorm (Rx only) |
| tegaserod = Zelnorm | 1. 5-HT4 agonist 2. stimulates peristalsis 3. limited availability through manufacturer only due to risk of MI, CVA, angina |
| tegaserod = Zelnorm: Risks | 1. MI (heart attack) 2. CVA (stroke) 3. angina |
| tegaserod = Zelnorm: Indication | 1. IBS 2. Chronic idiopathic constipation 3. In 2002, originally only FDA approved for females only 4. In 2004, FDA approved for both males & females |
| tegaserod = Zelnorm: Off-label uses | 1. gastroparesis 2. GERD |
| tegaserod = Zelnorm: Cautions | 1. servere diarrhea 2. dehydration 3. dypotension |
| Inflammatory Bowel DZ: Tx: | 1. Control diarrhea 2. Control inflammation 3. Repair / remove damaged tissues 4. Provide adequate nutrition |
| Inflammatory Bowel DZ: 1. Control diarrhea: Drug category | Antidiarrheals |
| Inflammatory Bowel DZ: 1. Control diarrhea: MOA | 1. Anti-peristaltic 2. Anticholinergic: narcotic derivatives (opiates) slows down GI tract to induce constipation 3. directly relax GI smooth muscle which decreases motility to allow more water absorption to reduce cramping & pain |
| Inflammatory Bowel DZ: 2. Control inflammation: Drug category A | Antiinflammatory drugs |
| Inflammatory Bowel DZ: 2. Control inflammation: Drug type | hydrocortisone = Solu-Cortef(steroid) |
| hydrocortisone = Solu-Cortef (steroid): Indication | Systemic / rectal for mild to moderate inflammation |
| Inflammatory Bowel DZ: 2. Control inflammation: Drug category B | 5-AminoSalicylic Acid derivatives (5-ASA) |
| Inflammatory Bowel DZ: 2. Control inflammation: 5-ASA: Drug A | 1. mesalamine = Asacol 2. mesalamine = Pentasa 3. mesalamine = Rowasa 4. mesalamine = Lialda |
| Inflammatory Bowel DZ: 2. Control inflammation: 5-ASA: Drug B | olsalazine = Dipentum |
| Inflammatory Bowel DZ: 2. Control inflammation: 5-ASA: Drug C | balsalazide = Colazal |
| Inflammatory Bowel DZ: 2. Control inflammation: 5-ASA: Drug D | salfasalazine = Azulfidine |
| salfasalazine = Azulfidine: MOA | breaks down to sulfapyridine + mesalamine > active metabolite |
| Inflammatory Bowel DZ: 2. Control inflammation: Drug category C | Monoclonal Antibody |
| Inflammatory Bowel DZ: 2. Control inflammation: Monoclonal Antibody: Drug A | infliximab = Remicade |
| infliximab = Remicade: MOA | neutralizes TNF to decrease chronic inflammation |
| infliximab = Remicade: additional indication | Rheumatoid Arthritis |
| Inflammatory Bowel DZ: 3. Repair/remove damaged tissue: Surgical procedure A | Hemi-colectomy (hemi-=half) |
| Inflammatory Bowel DZ: 3. Repair/remove damaged tissue: Surgical procedure B | Anastomosis |
| Inflammatory Bowel DZ: 3. Repair/remove damaged tissue: Surgical procedure C | Colostomy |
| Inflammatory Bowel DZ: 3. Repair/remove damaged tissue: Surgical procedure D | ileostomy |
| Inflammatory Bowel DZ: 4. Provide adequate nutrition: | 1. Practice of feeding a person w/o using the GI tract 2. TNA: CHO, protein, fat, vitamins, minerals = in water |
| Antiperistaltic Antidiarrheals: Drug 1 | diphenoxylate (opiate)/atropine (anticholinergic) = Lomotil (C-V) |
| Anticholinergics: MOA | decrease peristalsis |
| atropine = Lomotil: Indication | 1. prevents patient from talking enough diphenoxylate to cause euphoria 2. Less risk of addiction (C-V) |
| Antiperistaltic Antidiarrheals: Drug 2 | paragoric = camphorated tincture of opium (C-III drug in CA) |
| paragoric = camphorated tincture of opium (C-III drug in CA): Caution | Do Not confuse w/opium tincture (C-II) |
| Antiperistaltic Antidiarrheals: Drug 3 | loperamide = Imodium (OTC) |
| loperamide = Imodium (OTC): MOA | direct effect to relax smooth muscle |
| loperamide = Imodium (OTC): Indication | acute and/or chronic diarrhea |
| AGE=Acute GastroEnteritis Tx: | 1. Anti-Emetics 2. Anti-Diarrheals |
| Traveler's Diarrhea=dysentery (amebic) Tx Drug category 1: | amebecide |
| Traveler's Diarrhea=dysentery (amebic): amebecide: Drug 1 | metronidazole = Flagyl |
| metronidazole = Flagyl: Caution | 1. Do Not Drink Alcoholic Beverage when taking this medication 2. Alcohol intolerance 3. "disulfiram=Antabuse effect" |
| Traveler's Diarrhea=dysentery (amebic) Tx Drug category 2: | Adsorbent Anti-Diarrheals |
| Adsorbent Anti-Diarrheals: MOA | 1. ADsorb (stick to) micro-organisms 2. Trap microbes in intestine 3. Diarrhea washes microbes out |
| Adsorbent Anti-Diarrheals: Special note | Diarrhea will stop when the microbes & toxins leave the body |
| Traveler's Diarrhea: Adsorbent Anti-Diarrheals: Drug 1 | bismuth subsalicylate BSS = Pepto-Bismol, Kaopectate (OTC) |
| Tritec & Helidac | 1. contain bismuth 2. will absorb H. pylori |
| Adsorbent substances (other): | 1. kaolin-pectin 2. attapulgite=Diasorb, Kaopectate Maximum Strength |
| Food Poisoning Tx: | requires both (antiperistaltic & adsorbent) |
| antiperistaltic: Indication | reduces pain |
| adsorbent: Indication | slows diarrhea but does not stop it |
| Mixtures w/paregoric (controlled substances): Drug name | bismuth + paregoric |
| Antidiarrheals (miscellaneous): Drug category 1 | Lactobacillus acidophilus |
| Antidiarrheals (miscellaneous): Lactobacillus acidophilus: Drug 1 | Lactinex tablets / granules (OTC refrigerated) |
| Antidiarrheals (miscellaneous): Lactobacillus acidophilus: Drug 2 | Probiotica chewable tablets |
| Antidiarrheals (miscellaneous): Lactobacillus acidophilus: Drug 3 | Culturelle capsules |
| Antidiarrheals (miscellaneous): Drug name 1 | calcium polycarbophil = Equalactin (OTC) |
| calcium polycarbophil = Equalactin: MOA | 1. "equalizes intestinal water" a. absorbs water in intestine & swalls to form a bulky stool b. fewer bowel movements c. reduced abdominal pain |
| calcium polycarbophil = Equalactin: Caution | 1. calcium salt leads to chelation of drugs which binds & reduces absorption 2. Dehydration occurs where patient still loses water, yet stools do not look as "watery" |
| Antidiarrheals (miscellaneous): Drug name 2 | doxycycline = Vibramycin (Rx only) |
| doxycycline = Vibramycin: MOA | tetracycline antibiotic (TCN) |
| doxycycline = Vibramycin: Indication | prevent Traveler's Diarrhea |
| doxycycline = Vibramycin: Caution | 1. Photosensitivity 2. You should avoid prolonged or excessive exposure to direct and/or artificial sunlight while taking this medication |
| Antidiarrheals (miscellaneous): Drug name 3 | rifaximin = Xifaxan (Rx only) |
| rifaximin = Xifaxan | 1. non-systemic antibiotic 2. not absorbed: local effect |
| rifaximin = Xifaxan Tx: Indication | Traveler's Diarrhea |
| rifaximin = Xifaxan Tx: Off-Label | IBS |
| Laxatives: Indication | constipation |
| Stool Softeners: Indication | constipation |
| Laxative: Type 1 | stimulant (irritant) |
| Laxative: Type 2 | saline cathartics |
| Laxative: Type 3 | bulk-forming |
| Laxative: Type 4 | lubricant |
| Laxative: Type 5 | hyper-osmotic |
| Laxative: Type 1 Stimulant (irritant): MOA | increase peristalsis w/direct effect on smooth muscle |
| Laxative: Type 1 Stimulant (irritant): Indication | 1. occasional constipation 2. Spinal cord injury patients (routine use) 3. "Prep" (clean out lower GI tract) a. before X-rays, procedures or surgery b. administered as a single dose |
| Laxative: Type 1 Stimulant (irritant): Cautions | 1. increase muscle contraction leading to cramping pain 2. chronic use may cause dependence |
| Laxative: Type 1 Stimulant (irritant): Drug 1 | bisacodyl = Dulcolax (OTC) |
| bisacodyl = Dulcolax: MOA | 1. acts on large intestine 2. onset: PR: 15-30 minutes 3. onset: PO: 6-12 hours |
| bisacodyl = Dulcolax: Other indication | Often used in combination w/other prep kits eg: Halflytely |
| Laxative: Type 1 Stimulant (irritant): Drug 2 | castor oil (OTC) Available as flovored oil or emulsion |
| castor oil: MOA | 1. acts in small intestine > produces very watery stool 2. onset: <=3 hours |
| Laxative: Type 1 Stimulant (irritant): Drug 3 | senna = Senokot, X-Prep, Ex-Lax (OTC) |
| senna = Senokot, X-Prep, Ex-Lax | "sennosides" = natural vegetable laxative |
| senna = Senokot, X-Prep, Ex-Lax: MOA | 1. acts on large intestine 2. onset: ~6 hours |
| Caster oil: Caution | 1. Castor oil acts more quickly than other laxatives, so do not take at bedtime 2. To avoid the bad taste of castor oil, chill it in the refrigerator & mix it w/cold orange juice just before drinking 3. should not be used routinely for constipation |
| Laxative: Type 2 Saline Cathartics: MOA | 1. pulls H2O into intestinal lumen 2. stretches smooth muscle walls 3. reflex peristalsis 4. patient must have good fluid intake to work |
| Laxative: Type 2 Saline Cathartics: Drug type 1 | Magnesium Salts (OTC) Caution: Renal patients |
| Magnesium salt: Drug 1 | magnesium hydroxide = Milk of Magnesia (MOM) |
| magnesium hydroxide = Milk of Magnesia | 1. laxative dose: 30 mL 2. onset: ~8 hours (give dose hs) 3. may be mixed w/mineral oil to form an emulsion |
| Magnesium salt: Drug 2 | magnesium sulfate = "Epsom Salts" |
| magnesium sulfate = "Epsom Salts" | 1. MgSO4 2. Hospital Use: a. Tx drug OD: 50% PO solution b. onset: 3-6 hours c. IV additive: Mg++ supplement |
| Magnesium salt: Drug 3 | magnesium citrate aka Citrate of Magnesia |
| magnesium citrate aka Citrate of Magnesia | 1. Dose: 10 oz x 1 2. Chill to improve flavor |
| Laxative: Type 2 Saline Cathartics: Drug type 2 | Phosphate Salts |
| Phosphate Salt: Drug 1 | sodium phosphates = Visicol, OsmoPrep tablets (Rx only) Bowel Prep |
| sodium phosphates = Visicol: Dose | 1. 20 tabs PM before colonoscopy 2. 20 tabs AM of colonoscopy |
| sodium phosphates = OsmoPrep: Dose | 1. PM take 4 tabs q15 min x 5 doses 2. AM take 4 tabs q14 min x 3 doses 3. Total Dose = 32 tablets total |
| sodium phosphates: Special note | Take with ginger ale to clear residue |
| Phosphate Salt: Drug 2 | Fleet's Phospho-Soda / Fleet's enema (OTC) |
| Fleet's Phospho-Soda / Fleet's enema | 1. Sodium Phosphates also 2. Fleet's Phospho-soda recalled due to "Acute Phosphate Nephropathy" |
| Laxative: Type 3 Bulk-Forming | Laxatives (Fiber) |
| Laxative: Type 3 Bulk-Forming: MOA | 1. non-digestible fibers 2. Fibers absorb H2O > softens stool & distend intestine > reflex peristalsis 3. Best choice for routine use 4. No dependence |
| Laxative: Type 3 Bulk-Forming: Onset | 1 - 3 days of use |
| Laxative: Type 3 Bulk-Forming: Caution | Take w/ a lot of water to prevent bowel obstruction |
| Laxative: Type 3 Bulk-Forming: Other indications | 1. Soften stool by increasing H2O content 2. OTC diet control: FiberTrim |
| Bulk-forming Laxatives: Drug 1 | psyllium = Metamucil, Konsyl |
| Bulk-forming Laxatives: Drug 2 | methylcellulose = Citrucel (less bloating) |
| Bulk-forming Laxatives: Drug 3 | calcium polycarbophil = Equalactin, Phillips Fibercaps, Fibercon |
| Bulk-forming Laxatives: Drug 4 | guar gum = Benefiber (clear / not gritty) |
| guar gum = Benefiber: Key Points | Medication should be taken w/plenty of water 1. drink lots of fluid 2. common side-effect: "Gas" 3. good for patients w/ low fiber diets, after-child birth, elderly, IBS, pregnancy 4. superior to other meds as "stool softener" |
| Laxative: Type 4 Lubricant Laxative: MOA | 1. "emollient" effect 2. softens & lubricates stool |
| Lubricant Laxative: Drug 1 | mineral oil (OTC) |
| mineral oil: Dose | 15 - 45 cc |
| mineral oil: Caution | 1. Do not use routinely 2. may decrease absorption of fat-soluble drugs & vitamins (ADEK) 3. Do not take w/ stool softeners (eg: docusate) 4. may absorb mineral oil > risk of lipoid pneumonia |
| Laxative: Type 5 Hyper-Osmotic Laxatives: MOA | 1. pulls H2O into intestinal contents a. softens stool b. reflex peristalsis 2. local irritant / stimulant effect |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Route | PR as suppository / enema |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Drug 1 | glycerin (OTC suppository) Caution: adult & pediatric sizes Onset: 30 minutes |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Drug 2 | sorbitol (enema) Dose: 120 mL of 25-30% solution |
| Mix: Sorbitol w/Kayexalate (K+ binding resin) | 1. Give PR to Tx hyperkalemia 2. Kayexalate will pull K+ from blood & trap it in intestine 3. K+ levels in blood decrease 4. Sorbitol helps eliminate resin & the bound K+ from GI tract |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Drug 3 | polyethylene glycol = PEG, Miralax (OTC) |
| polyethylene glycol = PEG, Miralax: Indication | occasional constipation |
| polyethylene glycol = PEG, Miralax: MOA | 1. osmotic action only on the stool 2. given PO for 2 weeks maximum |
| polyethylene glycol = PEG, Miralax: Onset | 2 - 4 days of routine use |
| polyethylene glycol = PEG, Miralax: Cautions | 1. mix in at least 8 oz of water 2. Urticaria allergies AX |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Drug 4 | polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only) |
| polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only): Indication | "bowel evacuant" |
| polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only): MOA | PEG: osmotic laxative > diarrhea + electrolytes (replenish loss) |
| polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only): Dose | 1. powder for reconstitution 2. Dose: 1 gallon of solution 3. drink 8 oz Q 10 min until gone |
| polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only): Onset | 1. 30 - 60 minutes of first dose 2. complete cleansing within 4 hours |
| polyethylene glycol = PEG (electrolyte solution) GoLytely, CoLyte (Rx only): Special note | Bad Taste: Salty-sweet taste that cannot be masked by glavoring packets available for most solutions. Recommended to chill in refrigerator before use often the evening before colonoscopy. Also, best to drink quickly, not sip, taste makes you gag |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Drug 5 | Low-volume PEG = MoviPrep, Halflytely (Rx only) |
| Low-volume PEG = MoviPrep | consists of 1 liter solution of PEG which is repeated a few hours later |
| Low-volume PEG = Halflytely | involves taking bisocodyl tablets followed by 2 liters of PEG solution |
| Laxative: Type 5 Hyper-Osmotic Laxatives: Low-volume PEG = MoviPrep, Halflytely: Main disadvantage | Main disadvantage over other generic (4 liter) PEG solutions: Price = Too expensive |
| Laxatives (miscellaneous): Drug 1 | lubiprostone = Amitiza |
| lubiprostone = Amitiza: Indication | Treat chronic idiopathic constipation |
| lubiprostone = Amitiza: MOA | 1. increases intestinal fluid secretion 2. increases peristalsis |
| lubiprostone = Amitiza: Dose | PO BID with food to decrease N/V |
| lubiprostone = Amitiza: Caution | 1. 2 different strengths available w/different indications 2. 24mcg > Tx of chronic idiopathic constipation (CIC) 3. 8mcg > Tx of IBS-C in females > 18 yr |
| Laxatives (miscellaneous): Drug 2 | methylnaltrexone = Relistor |
| methylnaltrexone = Relistor: Indication | Treat constipation due to opioids |
| methylnaltrexone = Relistor: MOA | 1. opioid antagonist that block opioid 2. effects gut w/o blocking analgesic effects in CNS |
| methylnaltrexone = Relistor: Caution | only for palliative care patients who are not getting relief from laxatives |
| methylnaltrexone = Relistor: Dose | 1. SQ QOD 2. Inform patients it usually works within 4 hours 3. Most side-effects are mild eg: nausea, diarrhea, dizziness |
| Stool Softeners: MOA | surfactants increases H2O in stool |
| Stool Softeners: Indication | 1. patients who should avoid straining: a. s/p MI b. post-op c. post-partum |
| Stool Softeners: Onset | 1. 1 - 2 days of routine use 2. Requires good fluid intake to be effective |
| Stool Softeners: Drug type | Docusate Salts (OTC all) |
| Docusate Salts: Drug 1 | docusate sodium = Colace, DSS |
| docusate sodium = Colace: Dose | 50 mg, 100 mg, 250 mg |
| docusate sodium = Colace: Off-label use | remove ear wax |
| Docusate Salts: Drug 2 | docusate calcium = Surfak |
| docusate calcium = Surfak: Dose | 240 mg |
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