Advanced Pharmacology 6521 Mid Term with Complete Solutions

Advanced Pharmacology 6521 Mid Term with Complete Solutions Anti-diarrheals Stops further occurrence of diarrhea. Notable medicines are Loperamide "Immodium", Diphenoxylate Hcl with Atropine "Lomotil", Bismuth subsalicylate "Pepto bismul" Pepto s/e: black stools and tongue Laxatives Used to ease or stimulate defecation Soften the stool Increase stool volume Hasten fecal passage through the intestine Facilitate evacuation from the rectum *Misuse comes from misconceptions of what constitutes normal bowel function Fiber Laxatives absorbs water, softening feces and increasing their mass. Can be digested by colonic bacteria, whose subsequent growth increases fecal mass. ex. Bran, veggies and fruits. Meds: mehylcellulose, psyllium, polycarbophil Surfactant Laxatives Meds: Docusate sodium (Colace) Docusate calcium (Surfak) temporary treatment of constipation * avoid if narrowing of intestines Give with a full glass of water or juice Stimulant Laxatives bisacodyl: (tablets: give at night to have BM in am , no crushing or chewing, no milk or antacids;Suppositories: BM within 15-60 min, may cause proctitis); senna: BM 6-12 hours after. May cause pink or brown urine. castor oil: acts on small intestine 2-6 hour BM. Limit to only when prep for radiology procedures. Chill and mix in juice. * easily abused, Give with a full glass of water. Osmotic Laxatives Salts draw water into the intestine causing fecal mass to soften and swell stimulating peristalsis. Low dose 6-12 hours, high dose 2-6 hours. magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose (can be used to lower blood ammonia in liver disease) * Increase fluid intake. Not good for kidney disease. Sodium phosphate exacerbates cardiac disease. Miscellaneous Laxatives Lubiprostone, mineral oil, glycerin suppository, polyethylene glycol- electrolyte solution, Sodium picosulfate / magnesium oxide/anhydrous citric acid antiemetic a medication that is administered to prevent or relieve nausea and vomiting Ondesetron Class: 5HT3 receptor antagonist Zofran Indication: Chemotherapy N/V, postoperative N/V, radiation induced N/V Oral or Parental * Prolonges QT interval (leading to torsades de pointes) Glucocorticoids used as antiemetic Not approved by FDA. Solumedrol and dexamethasone. Given IV. Metoclopramide (Reglan) controls post-op NV suppresses emesis and increases upper GI mobility Cannabinoids Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV. Alosetron (Lotronex) Used for IBS-D in women that has lasted > 6 months