Chapter 47 pharmacology

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  1. Loperamide HCL. (Imodium)
    Opiates/opiated-Related Antidiarrhea

    Treatment:  for diarrhea

    Newest OTC 

    Does not affect the CNS

  2. Difenoxin / atropine (Motofen) CSS IV
    Opiates/Opiate-Related A ntidiarrhea

    Treatment: for acute nonspecific chronic diarrhea, combination of a synthetic narcotic / atropine 

    Avoid use in narrow-angle glaucoma

    • Side Effects
    • Dry mouth
    • Flush
    • Tachycardia
  3. Deodorized opium tincture CSS ii
    Opiates/Opiate-Related Antidiarrhea

    • Treatment
    • For acutenonspecif diarrhea to treat withdrawl symptoms in neonates of mothers who are addicted to opiates

    Notto be used for diarrhea caused by posion

    Avoidtakingalcohol & CNS depressants

  4. Comphorated Opium tincture (paregoric) CSSII

    Opiates/Opiate-Related Antidiarrhea

    • Treatment 
    • Decrease GI peristalsis

    Side Effects:  Constipation

    Cause CNS depression when taken with alcohol sedatives, tranquilizers
  5. octreotide actate (sandostatin)
    Samatostatin Analogue

    • treatment: 
    • severe diarrhea resulting from metastatic carcinoid tumors

    action:  suppresses secretion of serotonin, gastrin, and pancreatic peptides
  6. Bismuth Subsalicylate (Peptp-Bismol)
    Kaolin-pectin (kaolin with pectin)
    Antidiarrhea Adsorbents

    • Treatment:  for diarrhea, gastric distress

    administered after each loose stool

  7. Diphenoxylate with AAtropine (lomotil)


    to treat diarrhea by slowing intestinal motility

    mode of action:  inhibition of gastric motility

    • side effects: 
    • drowsiness          dizziness
    • constipation        dry mouth
    • weakness            flush
    • rash                   blurred vision
    • mydriasis            urine retention

    • adverse reactions:
    • angioneurotic edema

    Life-threatening:  paralytic ileus, toxic megacolon, severe allergic reaction

    contraindications:  severe hepatic or renal disease, glaucoma, severe electrolyte imbalance, children <2 yr

    • Drug:  increased CNS depressants w/alcohol, narcotics antihistamines, sedative-hypnotics

    MAOls may enhance hypertensive crisis

  8. Hydroxyzine (vistaril, atarax)
    Prescription Antihistamine

    postoperative nausea/vomiting, vertigo (dizziness)

    Give preoperatively w/narcotics to decrease nausea

    Give hydroxyzine deep IM

    Side Effects: drowsiness/dry mouth
  9. Promethazine HCl (Phenergan)
    Prescription Antiemetic

    Treatment:  to treat/prevent motion sickness, nausea/vomiting

    Action:  Blocks H1 receptor sites, inhibits chemoreceptor trigger zone

    • Side Effects:
    • drowsiness          confusion
    • anorexia             dry mouth/eyes
    • constipation        blurred vision
    • hypertension       hypotension
    • photosensitivity   transient leukopenia
    • urinary retention

    Adverse Reactions:  extrapyramidal syndrome (tardive, dyskinesia, akathsia)

    • Life-threatening:  angranulocytosis, respiratory depression

    Contraindications:  hypersensitivity, narrow-angle glaucoma, severe liver disease, intestinal obstruction, blood dyscrasias, bone marrow depression

    • Caution:  Cardiovascular disease, liver dysfunction, asthma respiratory dysfunction, hypertension, older adults & debilated cilents

    Drugs:  increase CNS depression & anticholinergic effects when take w/alcohol & other CNS depressants

  10. Prochlorperazine maleate (Compazine)
    Dopamine Antagonists Phenothiazines

    • Treatment:  Primary use is for severe
    • nausea, vomiting

    Secondary use:  reduce anxiety & tension & for psychosis

    • Side Effects:
    • drowsiness
    • dizziness
    • EPS
    • dry mouth
  11. droperidol (Inapsine)

    haloperidol (Haldol)

    prevention of nausea/vomiting during surgical & diagnostic procedures

    • Side Effects:
    • hypotension (monitor Blood Pressure)
    • tachycardia
    • EPS


    Action:  blocks the dopamine2 receptors in the CTZ
  12. lorazepam (Ativan)

    • Treatment:  Prevention of nausea/vomiting resulting from cancer chemotherapy

    Usually administered w/antiemetic such as metoclopramide

    Other Drugs:  vilaum, diazepam

    emesis control, sedation, anxiety reduction, amnesia.  When use w/glucocorticoid serotonin 5 HT3 receptor antagonist
  13. dolasetron mesylate (anzemet)
    Serotonin (5-HT3) Receptor Antagonists

    prevent nausea/vomiting before chemotherapy or pre & postoperatively

    Act on serotonin 5-HT3 receptor in stomach and CTZ
  14. granisetron (kytril)

    palonosetron (aloxi)
    Serotonin (5-HT3) Receptor Antagonists

    prevention of nausea/vomiting caused by cancer chemotherapy

    Acts on the CTZ and vomiting center

    Side Effects: headache
  15. ondansetron HCl (Zofran)
    Serotonin (5-HT3) Receptor Antagonist

    for nausea/vomiting related to cancer chemotherapy especially treatment with cisplatin
  16. Dronabinol (marinol)  CSS ll

    for nausea/vomiting caused by cancer chemotherapy

    taken before and for 24 hours after chemotherapy

    Can be on appetite stimulant for clients AIDS

    • Side Effects:
    • drowsiness             dizziness
    • dry mouth              impaired thinking
    • euphoria                headache
    • nightmares            confusion
    • incoordination        memory loss
    • tachycardia            hypertension/hypotension
  17. Metoclopramide HCl (reglan)
    Prescription Antiemetics

    for nausea/vomiting related to cancer chemotherapy/postoperatively

    increase gastric & intestinal emptying

    Avoid alcohol & CNS depressant

    Side Effects:  EPS may occur

    Action:  suppress emesis by blocking the dopamine receptors in the CTZ

    • Contraindications: 
    • GI obstruction
    • hemorrhage
    • perforation

    high doses can cause sedation/diarrhea
  18. trimethobenzamide HCl (tigan)

    diphenidol (vontrol)
    Prescription Antiemetics

    for postoperative nausea/vomiting motion sickness, vertigo

    Avoid with CNS depressants and if sensitive to benzocaine or similar local anesthetics

    • Side Effects: 
    • dry mouth           increase heart rate
    • urine retention     constipation
    • blurred vision

    • Adverse Reactions:
    • hypotension          diarrhea
    • EPS (abnormal involuntary movements, postural disturbances, alteration in muscle tone
  19. Bisacodyl (dulcolax)

    castor oil (neoloid, purge)

    Laxative Stimulant

    Short-term treatment for constipation, bowel preparation for diagnostic tests

    Action:  Increases peristalsis by direct effect on smooth muscle of intestine

    • Side Effects: 
    • anorexia          nausea
    • vomiting          cramps
    • diarrhea

    • Adverse Reactions:
    • dependence     hypokalemia

    Life-threatening:  Tetany

    • Contraindications:
    • hypersensitivity     fecal impaction
    • appendicitis          abdominal pain
    • nausea                 vomiting
    • rectal fissures
    • intestinal/biliary obstruction

    • Drug:  decrease effect with antacids, histamine2 blockers, milk
  20. Psyllium hydrophilic mucilloid (Metamucil)

    methylcllulose (Citrucel)

    Laxative Bulk Forming

    Treatment:  to control chronic constipation

    Action:  acts as bulk-forming laxative by drawing water into intestine

    • Side Effects:
    • anorexia            nausea
    • vomiting            cramps
    • diarrhea

    Adverse Reactions:  esophageal or intestinal obstruction if not take with adequate water

    • Life-threatening: Bronchospasm, anaphylaxis

    Contraindications:  hypersensitivity, fecal impaction, intestinal obstruction, abdominal pain

    Drug:  decrease absorption of oral anticoagulants, aspirin, digoxin, nitrofurantoin
  21. polycarbophil (FiberCon)
    Laxatives: Bulk Forming

    Treatment:  for prevention of constipation.  Also used to treat acute nonspecific diarrhea associated with irritable bowel syndrome.

    For diarrhea, absorb water and produces formed stool.  For constipation:  chew tablet and follow with a full glass of water

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Chapter 47 pharmacology
2013-07-13 19:44:24

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