NR 565 Advanced Pharmacology FundamentalsQuestions
and Answers Final Exam latest update
NR 565 Final Exam
which antacids have the highest absolute neutrophil count (ANC)?
- sodium bicarbonate and calcium carbonate
What do calcium containing antacids needs for absorption?
- vitamin D
Antacid Indications
- hyperacidity,
PUD, GERD, Calcium deficiency, Chronic Renal failure, osteoporosis prevention
What is the 1st line therapy for GERD?
- H2 blockers and PPIs
Absorbent antidiarrheals drugs
- Kaolin
pectin
Bismuth subsalicylate (Pepto-Bismol) ; use with each loose stool
opiate antidiarrheals drugs
- Diphenoxylate with atropine (Lomotil)
Diphenoxin with atropine (Motofen)
Loperamide (immodium)
anticholinergic antidiarrheals drugs
- atropine
, propantheline
what causes most diarrhea?
- infection, food or drug ingestions, or inflammatory bowel disease
antidiarrheal precautions/contraindications
- opioids: toxic megacolon
pepto: do not use in children with flu-like illness
contraindicated in most children
caution in pts with hepatorenal disease
antidiarrheal ADRs
- constipation
bismuth=black tongue, gray/black stool
anticholinergic effects
CNS effects
antidiarrheal drug interactions
- ASA: increased risk for salicylate toxicity
insulin or oral DM meds: increased risk for hypoglycemia
thrombolytics: increased risk for bleeding
lomotil & immodium: increased CNS depression with alcohol and anticholinergic effects
with other anticholinergics drugs
Lubricant laxatives
- mineral oil; soften stool, lubricates intestine
surfactant laxative
- docusate compounds (Colace); reduce surface tension on the oil water interface on the
stool & facilitate a mixture of fat & water into the stool
Cytoprotective agents
- sucralfate (Carafate)
misprostol (Cytotec); tx Peptic ulcers caused by NSAID use
Clinical Pearl for polyethylene glycol electrolyte solution
- salty taste; place on ice in Basin; drink 240 ml/10 mins; tic tac or hard candy reduces
salty taste
,5- HT3 receptor antagonist antiemetics
- ondansetron (Zofran)
palonosteron (Aloxi)
dolaseton mesylate (Anzmet)
granisetron (Kytril, Sancuso)
Anticholinergic antiemetics
- Scopolamine (Transderm Scop)
P/neurokinin 1 receptor antagonist antiemetic
- Aprepitant (emend)
Mics antiemetic
- trimethobenamide (Tigan)
monitoring of long-term use of promethazine
- CBC=monitor for bone marrow depression & blood dyscrasias
Scopalamine (Transderm Scop) precautions/contraindications
- caution: open-angle glaucoma, elderly-increases CNS effects, GI or bladder neck
obstruction
contraindicated: narrow-angle glaucoma
Aprepitant (Emend) precautions/contraindications
- contraindicated to use other drugs metabolized by CYP 34A
Phenothiazines ADR
- extrapyramidal reactions
Promethazine (Phenergan) ADR
- fatal respiratory depression in children < 2
Prokinetic drugs
- Metoclopramide (Reglan)
, prokinetic MOA
- stimulate motility of GI tract without stimulating gastric, biliary or pancreatic secretions
black box warning for metoclopramide (Reglan)
- increased risk for tardive dyskinesia
PPI drug interactions
- CYP 450 enzymes, decreased effects of certain antivirals, decreases absorption of
ketoconazole, ampicillin, digoxin, and iron salts,
monitor INR with coumadin and PPIs
PPI black box warning
- Plavix and omeprazole: decreases the active metabolite of Plavix by 46%= decreased
effectiveness
IBS with constipation treatment
- lupiprastone (Amitiza)
Traveler's Diarrhea Treatment
- bismuth subsalicylate (pepto-bismol) 2 tablets or 2 oz before each meal and at HS;
High risk destinations for traveler's diarrhea
- Central & South American, Africa, Middle East, Mexico, Asia,
Intermediate risk destinations for traveler's diarrhea
- eastern Europe, South Africa, and Caribbean Islands
the most common cause of Traveler's diarrhea
- E. coli
other causes of traveler's diarrhea
- 2) campy
3) shigella
and Answers Final Exam latest update
NR 565 Final Exam
which antacids have the highest absolute neutrophil count (ANC)?
- sodium bicarbonate and calcium carbonate
What do calcium containing antacids needs for absorption?
- vitamin D
Antacid Indications
- hyperacidity,
PUD, GERD, Calcium deficiency, Chronic Renal failure, osteoporosis prevention
What is the 1st line therapy for GERD?
- H2 blockers and PPIs
Absorbent antidiarrheals drugs
- Kaolin
pectin
Bismuth subsalicylate (Pepto-Bismol) ; use with each loose stool
opiate antidiarrheals drugs
- Diphenoxylate with atropine (Lomotil)
Diphenoxin with atropine (Motofen)
Loperamide (immodium)
anticholinergic antidiarrheals drugs
- atropine
, propantheline
what causes most diarrhea?
- infection, food or drug ingestions, or inflammatory bowel disease
antidiarrheal precautions/contraindications
- opioids: toxic megacolon
pepto: do not use in children with flu-like illness
contraindicated in most children
caution in pts with hepatorenal disease
antidiarrheal ADRs
- constipation
bismuth=black tongue, gray/black stool
anticholinergic effects
CNS effects
antidiarrheal drug interactions
- ASA: increased risk for salicylate toxicity
insulin or oral DM meds: increased risk for hypoglycemia
thrombolytics: increased risk for bleeding
lomotil & immodium: increased CNS depression with alcohol and anticholinergic effects
with other anticholinergics drugs
Lubricant laxatives
- mineral oil; soften stool, lubricates intestine
surfactant laxative
- docusate compounds (Colace); reduce surface tension on the oil water interface on the
stool & facilitate a mixture of fat & water into the stool
Cytoprotective agents
- sucralfate (Carafate)
misprostol (Cytotec); tx Peptic ulcers caused by NSAID use
Clinical Pearl for polyethylene glycol electrolyte solution
- salty taste; place on ice in Basin; drink 240 ml/10 mins; tic tac or hard candy reduces
salty taste
,5- HT3 receptor antagonist antiemetics
- ondansetron (Zofran)
palonosteron (Aloxi)
dolaseton mesylate (Anzmet)
granisetron (Kytril, Sancuso)
Anticholinergic antiemetics
- Scopolamine (Transderm Scop)
P/neurokinin 1 receptor antagonist antiemetic
- Aprepitant (emend)
Mics antiemetic
- trimethobenamide (Tigan)
monitoring of long-term use of promethazine
- CBC=monitor for bone marrow depression & blood dyscrasias
Scopalamine (Transderm Scop) precautions/contraindications
- caution: open-angle glaucoma, elderly-increases CNS effects, GI or bladder neck
obstruction
contraindicated: narrow-angle glaucoma
Aprepitant (Emend) precautions/contraindications
- contraindicated to use other drugs metabolized by CYP 34A
Phenothiazines ADR
- extrapyramidal reactions
Promethazine (Phenergan) ADR
- fatal respiratory depression in children < 2
Prokinetic drugs
- Metoclopramide (Reglan)
, prokinetic MOA
- stimulate motility of GI tract without stimulating gastric, biliary or pancreatic secretions
black box warning for metoclopramide (Reglan)
- increased risk for tardive dyskinesia
PPI drug interactions
- CYP 450 enzymes, decreased effects of certain antivirals, decreases absorption of
ketoconazole, ampicillin, digoxin, and iron salts,
monitor INR with coumadin and PPIs
PPI black box warning
- Plavix and omeprazole: decreases the active metabolite of Plavix by 46%= decreased
effectiveness
IBS with constipation treatment
- lupiprastone (Amitiza)
Traveler's Diarrhea Treatment
- bismuth subsalicylate (pepto-bismol) 2 tablets or 2 oz before each meal and at HS;
High risk destinations for traveler's diarrhea
- Central & South American, Africa, Middle East, Mexico, Asia,
Intermediate risk destinations for traveler's diarrhea
- eastern Europe, South Africa, and Caribbean Islands
the most common cause of Traveler's diarrhea
- E. coli
other causes of traveler's diarrhea
- 2) campy
3) shigella
