NURS 521 Exam 3 Drugs Questions with Correct Answers Verified by Experts| Latest Update
Docusate sodium (Colace) •MOA: Facilitates mixture of stool fat and water (Stool softener)
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Excreted in feces primarily; No drug interactions
•Indications: Treat constipation in adults and children; Prevention of constipation
•Contraindications: Fecal impaction, appendicitis, acute abdomen, GI obstruction
•Precautions: Use with caution in patient's c/o nausea and vomiting
•Patient Education
•Delivery: Capsules and solution; Dose dependent on age; Mix oral solution with juice or milk
•Monitoring: No routine tests recommended
•Evaluation
•Efficacy: Relief of symptoms
•Side Effects: Diarrhea, abdominal cramps, throat irritation, rash, electrolyte disorders, bitter
taste
Bisacodyl (Dulcolax) •MOA: Increases peristalsis (stimulant laxative)
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in liver and excreted in feces
•Indications: Constipation in those 6 years and older
•Contraindications: Acute abdomen, undiagnosed n/v, GI obstruction, ileus, GI perforation,
toxic megacolon, gastroenteritis, rectal bleeding and appendicitis
•Precautions: Use with caution in IBD
•Patient Education
•Delivery: OTC; Do note cut/crush or chew tab; Dose (5-15 mg) dependent on age (1-3 tabs QD
prn)
•Monitoring: Long term use can cause electrolyte imbalance, cathartic colon and ischemic
colitis
•Evaluation
,•Efficacy: Relief of constipation
Side Effects: n/v/d/abdominal cramps, rectal sensation of burning
Lactulose (Cephulac) •MOA: Increases stool water content and stool acidity by trapping and
expelling NH4 ions
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in colon and excreted in feces
•Indications: Constipation and decrease ammonia levels due to chronic liver disease (cirrhosis)
in infants/children/adults
•Contraindications: Galactosemia
•Precautions
•Reserved for patients with no response to bulk-forming agent
•Use with caution in patients with DM or undergoing a colorectal electrocautery procedure
•Patient Education
•Delivery: 10 g/15 ml solution, oral powder for reconstitution; Dose dependent upon indication
•Monitor for severe diarrhea, electrolyte disorders and metabolic acidosis with excessive dose
use; electrolytes in elderly/debilitates patients if tx is >6mo
•Evaluation
•Side Effects: flatulence, intestinal cramps, abdominal distension and n/v
•Lab interpretation of electrolytes
Ondansetron (Zofran) •MOA: Works as an antiemetic by selectively antagonizing serotonin
5-HT3 receptors
•Safety: Weigh risk/benefit in pregnancy and lactation (1st trimester risk of oral cleft and CV
defects)
•Pharmacokinetics: Metabolized liver CYP450 and excreted in urine; Half life is 5 hr (20 hr in
severe hepatic impairment- adjust dose amount)
•Indications: Nausea/vomiting chemo-related, post-op, gastroenteritis-related in adult and
pediatric population
,•Contraindications: Long QT syndrome
•Precautions: Use with caution in MI, tornadoes de pointes, prolong QT, GI obstruction, hepatic
impairment, electrolyte abnormalities, heart failure, bradyarrythmias
•Patient Education
•Delivery: tablet, solution and injectable
•Monitoring: S/S of MI during and after treatment; ECG if electrolyte abnormalities, CHF, or
bradyarrythmias
•Evaluation
•Side Effects: headache, constipation, fatigue, diarrhea, serotonin syndrome, EPS, QT
prolongation, MI
Prochlorperazine (Compazine) •MOA: Antiemetic- selectively antagonizes dopamine D2
receptors
•Safety:
•BBW- increased mortality in elderly pts on antipsychotic treatment for dementia related
psychosis
•Weigh risk/benefit in pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in liver and GI tract; Excreted in urine/bile/feces
•Indications: Nausea and vomiting in patients 2 years of ago and old
•Contraindications: Comatose pts, Reye syndrome, blood dyscrasia hx, bone marrow
depression, patients less than yoa and < 9 kg
•Precautions: Peds and elderly patients; CV dz; leukopenia
•Patient Education
•Monitoring: CBC with diff to monitor for leukopenia/neutropenia; ophthalmic exam if
prolonged treatment
•Evaluation
•Side Effects: blood dyscrasias, EPS, drowsiness, dizziness, blurred vision, constipation, urinary
retention
•Lab interpretation: CBC with differential
, Dronabinol (Marinol) •MOA: Binds to cannabinoid receptors producing CNS effects
•Safety
•DEA/FDA: Schedule III
•Not indicated for children
•Pharmacokinetics
•Avoid use with other meds that cause CNS depression
•Metabolized in liver extensively CYP450: CYP2C9 and CYP3A4 substrates
•Indications: Chemo related nausea and vomiting
•Contraindications: Pregnancy and while breastfeeding
•Precautions: Avoid abrupt withdrawal
•Patient Education
•Delivery: PO capsules
•Scheduled medication so keep secured
•Monitoring: Vital signs after initiation and dose adjustment
•Evaluation
•Side Effects: Dependency, abuse, withdrawal symptoms, dizziness, somnolence, euphoria,
abnormal thinking, orthostatic hypotension, hypertension, tachycardia
Vital signs
Lubiprostone (Amitiza) •MOA: Activates chloride channels increasing intestinal fluid
secretion and stimulating mucosal barrier function
•Pharmacokinetics
•Metabolized in stomach; Excreted in urine and feces
•May use while breastfeeding but weigh risk/benefit in pregnancy
•Indications: IBS- C, Chronic idiopathic constipation (adults only)
•Contraindications: GI obstruction and severe diarrhea
•Precautions: Monitor for signs of ischemic colitis (rectal bleeding, bloody diarrhea, and new or
worsening abdominal pain); Hepatic impairment
Docusate sodium (Colace) •MOA: Facilitates mixture of stool fat and water (Stool softener)
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Excreted in feces primarily; No drug interactions
•Indications: Treat constipation in adults and children; Prevention of constipation
•Contraindications: Fecal impaction, appendicitis, acute abdomen, GI obstruction
•Precautions: Use with caution in patient's c/o nausea and vomiting
•Patient Education
•Delivery: Capsules and solution; Dose dependent on age; Mix oral solution with juice or milk
•Monitoring: No routine tests recommended
•Evaluation
•Efficacy: Relief of symptoms
•Side Effects: Diarrhea, abdominal cramps, throat irritation, rash, electrolyte disorders, bitter
taste
Bisacodyl (Dulcolax) •MOA: Increases peristalsis (stimulant laxative)
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in liver and excreted in feces
•Indications: Constipation in those 6 years and older
•Contraindications: Acute abdomen, undiagnosed n/v, GI obstruction, ileus, GI perforation,
toxic megacolon, gastroenteritis, rectal bleeding and appendicitis
•Precautions: Use with caution in IBD
•Patient Education
•Delivery: OTC; Do note cut/crush or chew tab; Dose (5-15 mg) dependent on age (1-3 tabs QD
prn)
•Monitoring: Long term use can cause electrolyte imbalance, cathartic colon and ischemic
colitis
•Evaluation
,•Efficacy: Relief of constipation
Side Effects: n/v/d/abdominal cramps, rectal sensation of burning
Lactulose (Cephulac) •MOA: Increases stool water content and stool acidity by trapping and
expelling NH4 ions
•Safety: May use during pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in colon and excreted in feces
•Indications: Constipation and decrease ammonia levels due to chronic liver disease (cirrhosis)
in infants/children/adults
•Contraindications: Galactosemia
•Precautions
•Reserved for patients with no response to bulk-forming agent
•Use with caution in patients with DM or undergoing a colorectal electrocautery procedure
•Patient Education
•Delivery: 10 g/15 ml solution, oral powder for reconstitution; Dose dependent upon indication
•Monitor for severe diarrhea, electrolyte disorders and metabolic acidosis with excessive dose
use; electrolytes in elderly/debilitates patients if tx is >6mo
•Evaluation
•Side Effects: flatulence, intestinal cramps, abdominal distension and n/v
•Lab interpretation of electrolytes
Ondansetron (Zofran) •MOA: Works as an antiemetic by selectively antagonizing serotonin
5-HT3 receptors
•Safety: Weigh risk/benefit in pregnancy and lactation (1st trimester risk of oral cleft and CV
defects)
•Pharmacokinetics: Metabolized liver CYP450 and excreted in urine; Half life is 5 hr (20 hr in
severe hepatic impairment- adjust dose amount)
•Indications: Nausea/vomiting chemo-related, post-op, gastroenteritis-related in adult and
pediatric population
,•Contraindications: Long QT syndrome
•Precautions: Use with caution in MI, tornadoes de pointes, prolong QT, GI obstruction, hepatic
impairment, electrolyte abnormalities, heart failure, bradyarrythmias
•Patient Education
•Delivery: tablet, solution and injectable
•Monitoring: S/S of MI during and after treatment; ECG if electrolyte abnormalities, CHF, or
bradyarrythmias
•Evaluation
•Side Effects: headache, constipation, fatigue, diarrhea, serotonin syndrome, EPS, QT
prolongation, MI
Prochlorperazine (Compazine) •MOA: Antiemetic- selectively antagonizes dopamine D2
receptors
•Safety:
•BBW- increased mortality in elderly pts on antipsychotic treatment for dementia related
psychosis
•Weigh risk/benefit in pregnancy and while breastfeeding
•Pharmacokinetics: Metabolized in liver and GI tract; Excreted in urine/bile/feces
•Indications: Nausea and vomiting in patients 2 years of ago and old
•Contraindications: Comatose pts, Reye syndrome, blood dyscrasia hx, bone marrow
depression, patients less than yoa and < 9 kg
•Precautions: Peds and elderly patients; CV dz; leukopenia
•Patient Education
•Monitoring: CBC with diff to monitor for leukopenia/neutropenia; ophthalmic exam if
prolonged treatment
•Evaluation
•Side Effects: blood dyscrasias, EPS, drowsiness, dizziness, blurred vision, constipation, urinary
retention
•Lab interpretation: CBC with differential
, Dronabinol (Marinol) •MOA: Binds to cannabinoid receptors producing CNS effects
•Safety
•DEA/FDA: Schedule III
•Not indicated for children
•Pharmacokinetics
•Avoid use with other meds that cause CNS depression
•Metabolized in liver extensively CYP450: CYP2C9 and CYP3A4 substrates
•Indications: Chemo related nausea and vomiting
•Contraindications: Pregnancy and while breastfeeding
•Precautions: Avoid abrupt withdrawal
•Patient Education
•Delivery: PO capsules
•Scheduled medication so keep secured
•Monitoring: Vital signs after initiation and dose adjustment
•Evaluation
•Side Effects: Dependency, abuse, withdrawal symptoms, dizziness, somnolence, euphoria,
abnormal thinking, orthostatic hypotension, hypertension, tachycardia
Vital signs
Lubiprostone (Amitiza) •MOA: Activates chloride channels increasing intestinal fluid
secretion and stimulating mucosal barrier function
•Pharmacokinetics
•Metabolized in stomach; Excreted in urine and feces
•May use while breastfeeding but weigh risk/benefit in pregnancy
•Indications: IBS- C, Chronic idiopathic constipation (adults only)
•Contraindications: GI obstruction and severe diarrhea
•Precautions: Monitor for signs of ischemic colitis (rectal bleeding, bloody diarrhea, and new or
worsening abdominal pain); Hepatic impairment
