Elimination (1) Part III of the Pharmacology 3 Test notes. This material is the final piece of infomation for the next test that we need to review before Thursday. jebaham published on November 11, 20132 responses 0 Questions in vertical order Which anti-emetic dopamine antagonists GI tract disorder drug increases GI motility and has a neurological side effect that mimics parkinson's disease (i.e. shaking) Prochlorperzine (Compazine) Metaclopramide (Reglan) Promethazine (Phenergan) What does the PSA indicate in a patient if it is elevated? urinary retention UTI Cancer What is the first thing you do regarding BPH? You must first rule out cancer of the prostate and UTI Baseline prostate-specific antigen (PSA) should be obtained C&S Which of the following are a stool softner? Select the three correct answers Docusate calcium (Surfak) Docusate sodium (Colace) Docusate potassium (Dialose) Which appetite stimulant is an anti-neoplastic hormone? Dronabinol (Marinol) Megestrol acetate (Megace) Oxandrolone (Oxandrin) An antispasmodic used to treat disorders of the genitourinary tract has what type of effect? cholinergic effect anticholinergic effect sympathetic response Which drug works on the GI tract? Bismuth subsalicylate (Pepto-Bismol) Sodium Bicarbonate (Alka-Selzer, Tums) Apsrin Decreased force of urinary stream, urinary hesitancy, dribbling, urinary retention, and small frequent voidings are signs & symptoms of what urinary disorder? urinary incontinence Prostate Cancer Benign prostatic hypertrophy (BPH) Appetite stimulants are used to treat cachexia (wasting) typically with what kind of patients? chemotherapy HIV/AIDS DM What are the nursing considerations for antiseptics & anti-infectives? Select the three correct answers Obtain urine C & S before starting an antiseptic or anti-infective therapy Prescription should be completely finished to prevent recurrence of UTI Encourage fluid intake to flush out the bladder How would you confirm a UTI? C & S UA Blood culture Which appetite stimulant is an androgenic/anabolic steroid? Dronabinol (Marinol) Megestrol acetate (Megace) Oxandrolone (Oxandrin) True/False. Stool softners reduce surface tension of interfacing liquid contents of bowel and promotes incorporation of additional liquid in stool. Type answer (4 letters) How do Anti-diarrheal absorbents work on the GI tract? increase fluid content of stool decrease fluid content of stool decrease fluid content in the intestines It is not safe to give an anti-diarrheal opiate with someone who has Down's Syndome because the patient can be at risk for what? Type answer (17 letters) Drugs for urinary retention have what type of effect? Type answer (18 letters) What is the action of a urinary retention drug? stimulate urination by activating the CNS stimulate urination by decresing bladder tone & increasing urinary sphincter tone stimulate urination by increasing bladder tone & decreasing urinary sphincter tone; used post-op, post-partum; bladder atony What kind of urinary tract disorder drug can you use to decrease buning with urination (urogesic), have a localized effect, and can be used in conjunction with anti-infectives? urinary tract antispasmodics Urinary tract anesthetics drugs for urinary retention What can alpha adrenergic blockes cause? hypertension orthostatic hypotension headaches What drug can also work for nausea? antacids anti-diarrheals laxatives What is the vomiting center activated by? odor, smell, taste odor, smell, sight drugs and toxins What do anticholinergic agents cause the bladder to do? Select the three correct answers decrease bladder tone- spasmolytic effect increase bladder capacity & reduces urinary frequency improves tone of urinay sphincter thereby decreasing incontinence In the disease process colitis, Crohn's, & cancer of colon can cause what? Type answer (8 letters) Which anti-emetic antihistamine/anti-cholinergic GI tract disorder drug is used for motion sickness? Dimenhydrinate (Dramamine) Hydroxyzine (Vistaril) Meclizine (Antivert) True/False. It is safe to give and anti-diarrheal opiate to a patient with glaucoma. Type answer (5 letters) An anti-ulcer proton pump inhibitor causes what action? reduces activity of proton (acid) pump least effective than H2 receptor blocker blocks hydrogen-potassium adenosine triphosphatase in parial cells What will the anti-ulcer prostaglandin analog cause in pregnancy? Type answer (8 letters) E.coli, Salmonella, Shigella, and C.diff are common organisms of what? Type answer (8 letters) What is the onset of the bulk-forming laxative Pysllium hydrophilic? 10-24 hours 24-48 hours 2-6 hours True/False. Pepto Bismol has a water-binding effect and absorbs toxins; can cause peptic ulcers Type answer (4 letters) Which appetite stimulant is a controlled substance? Dronabinol (Marinol) Megestrol acetate (Megace) Oxandrolone (Oxandrin) Which over the counter herb helps with BPH? garlic Saw palmetto dill weed What color will the urinary tract anesthetic pyridium change your urine to? Type answer (6 letters) Which route is the best route for anti-emetics? PO supp IM Which anti-emetic 5-HT3 Receptor Blocker for GI tract disorders is strong and used to block serotonin receptors in CTZ, as well as, used for chemotherapy, radiation therapy, & post-op? Granisetron (Kytril) Ondasetron (Zofran) Dimenhydrinate (Dramamine) When should you not use pyridium? In liver failure In renal insufficiency In heart failure The chemoreceptor triggerzone is activated by? odor, smell, taste odor, smell, sight drugs and toxins What would you administer with a bulking anti-diarrheal agent? 8oz of water; follow with 8 oz of water 24 oz of water decrease fluid intake so the drug can be effective When would you administer an anti-ulcer pepsin inhibitor? At least 30 minutes before meals & in the morning At least 1/2 hour before meals & at bedtime at least 1/2 hour after meals & at bedtime In patients taking MAOIs and prescribed an anti-diarrheal opiate what can happen if these drugs are taken together? orthosatic hypotension shock HTN crisis Which anti-emetic 5-HT3 Receptor Blocker for GI tract disorders is strong and used for chemotherapy? Granisetron (Kytril) Ondasetron (Zofran) Dimenhydrinate (Dramamine) Which anti-emetic cannabinoid used for GI tract disorders is extracted from marijuana, adminisered PO, a controlled substance, and given before & after chemotherapy? Dronabinol (Marinol) Aprepitant (Emend) Granisetron (Kytril) Which anti-emetic anti-cholinergic GI tract disorder drug used for sea sickness that comes in the form of a transdermal patch that you have to apply 4 hours before a trip? Meclizine (Antivert) Scopolamine (Hycosine) Dimenhydrinate (Dramamine) A UTI is treated in how many days? 14-28 days 1-14 days 28-42 days What are some other side effects of Pyridium? Select the three correct answers Nausea Vomiting Diarrhea What does the antacid Aluminum/magnesium (Maalox, Mylanta) do? Type answer (17 letters) What is important to consider as the nurse administering a urinary retention drug? Select the three correct answers bronchoconstriction due to increased bronchial secrections abdominal cramping & diarrhea reverse effects of anti-cholinergic drugs & do not use with BPH True/False. Anti-ulcer GI stimulants increase peristalsis in bowel atony or paralytc ileus. Type answer (4 letters) An anti-ulcer antacid will...? lower PH of HCl & reduce pepsin activity raise PH of HCl & reduce pepsin activity Raise ph of HCl & increase pepsin activity When do anti-emetics work best? if given after vomiting if given at the onset of nausea if given 30 minutes after onset of nausea What imbalances does diarrhea cause? Select the two correct answers H2O, Na+, K+, and bicarbonate Dehydration, electrolyte, acid-base GI tract The Nurse should inform the patient if they use pyridium for more than 2 days what will happen? Select the two correct answers urine orange- stains clothing skin orange- sweating sclera orange- contact lens True/False. You need a prescription to receive an anti-diarrheal opiate. Type answer (4 letters) When administering a histamine 2 receptor blocker Ranitidine what can be a side effect with this drug? Type answer (10 letters) True/False. Stool softners do not incease peristalsis. Type answer (4 letters) What gastrointestinal tract disorder drug is used to contol nausea and vomiting by reflexes in GI tract, the medulla of the brain, & vestibular part of ear? Type answer (12 letters) Which anti-emetic dopamine antagonists GI tract disorder drug can cause confusion and have to be used with caution in HTN patients? Prochlorperzine (Compazine) Metaclopramide (Reglan) Promethazine (Phenergan) True/False. It is ok to combine an anti-diarrheal opiate & antihistamine. Type answer (5 letters) Androgen inhibitors and alpha adrenergic blockers are used for what action? improve urine flow by decreasing size of prostate or relaxing smooth muscles of prostate & bladder neck improve urine flow by increasing size of prostate or relaxing smooth muscles of prostate & bladder neck impove urine flow by acting on the distal tubes An osmoic laxative will perform what action? Pull water into the colon & stimulate peristalsis push water out of the colon & stimulate peristalsis Pull water into the colon & decrease peristalsis True/False. The anti-ulcer drug a pepsin inhibitor is not required to have a prescription? Type answer (5 letters) If a UTI is untreated what can it lead to? bacteremia urosepsis death Which drug decreases acidity in he stomach? Bismuth subsalicylate (Pepto-Bismol) Sodium Bicarbonate (Alka-Selzer, Tums) Apsrin Which drug is used for watery diarrhea caused by tumors; fistulas? Octreotide (Sandostatin) Psyllium hydrophilic (Metamucil) Cholestryamine (Questran) An antispasmodic is contraindicated what type of patient? Type answer (8 letters) Which bulking anti-diarrheal agent firms stool? Select the two correct answers Docusate Calcium (Surfak) Cholestryamine (Questran) Psyllium hydrophilic (Metamucil) Which anti-emetic antihistamine/anti-cholinergic GI tract disorder drug is used for vertigo & nausea caused by inner ear disorders? Dimenhydrinate (Dramamine) Hydroxyzine (Vistaril) Meclizine (Antivert) Which anti-emetic Substance P/ Neurokinin 1 Receptor Antagonist for GI tract disorders is the strongest out there and blocks receptors associated with nausea & vomiting? Ondasetron (Zofran) Granisetron (Kytril) Aprepitant (Emend) When is an anti-diarrheal opiate used? Adult addicts In severe diarrhea & neonates addicted to opium adolescents with addictions What can aluminum cause? nausea & vomiting diarrhea constipation What are the signs and symptoms of a UTI? fever, urinary frequency, urinary retention, abdominal pain, low back bain hematuria, crystalluria, suprapubic pain, fever, urinary urgency, urinary frequency Urinary urgency, urinary frequency, hematuria, suprapubic pain, & fever Which anti-emetic dopamine antagonists GI tract disorder drug can be given PO, IM, Supp, & topical? Prochlorperzine (Compazine) Metaclopramide (Reglan) Promethazine (Phenergan) How long does it take an androgen inhibitor to work? 2 weeks 6-12 months 4-8 months The anti-ulcer GI stimulant affects the upper GI tract and causes EPS symptoms like.... Select the three correct answers pseudoparkinsonism dystonia tardive dyskinesia When administering a non-systemic antacid anti-ulcer drug it is importsnt for the nurse to remember to do what? give with milk give on an empty stomach If giving an aluminum hydroxide (Amphogel) give with meals and at bedtime When taking an anti-ulcer GI stimulant what do you want to avoid? sunlight crowds alcohol What are some side effects of an antispasmodic? Dry mouth, constipation, urinary retention, blurred vision dehydration, diarrhea, nausea, vomiting nephrotoxicity, ototoxicity, hepatotoxicity When taking an antacid you want to avoid which foods? avoid acidic fruits & juices sodas & nuts avoid milk & high vitamin D foods What can magnesium cause? nausea & vomiting diarrhea constipation If you are a nurse of childbearing age and administering dutasteride and finasteride what action would you take regarding the proper safety precauions when giving this medication? wear goggles wear a face mask wear gloves Regarding a bowel prep laxative.... Select the two correct answers Osmotic agent; consists of water & electrolytes; give po or NG tube 4L must be consumed for bowel prep GoLYTELY, Fasting & on a clear liquid diet the day before 8L must be consumed for bowl prep GoLYTELY True/False. Intestinal irritant laxatives stimulate or relax sensory nerve endings in intestinal mucosa; works with smooth muscle to gently increase peristalsis; prolonged use can damage nerve which cause loss of intestinal tone Type answer (5 letters) What are the nursing consideations regarding antacids & anti-emetics? Select the three correct answers Determine the cause of nausea, vomiting, & dizziness and all agents that affect CNS cause drowsiness Implement safety measures as may cause drowsiness and monitor for aspiraion if drowsy or debilitated Anti-dopaminergic drugs can cause Parkinson-like syndrome or worsen symptoms in a patient with Parkinson's disease Which anti-emetic antihistamine/anti-cholinergic GI tract disorder drug can be given PO & IM? Dimenhydrinate (Dramamine) Hydroxyzine (Vistaril) Meclizine (Antivert) What does an anti-diarrheal opiate drug work on? PNS the medulla CNS What is the action of an Anti-diarrheal opiate? inhibit GI motility & increase propulsions; increase intestinal secretions inhibit GI motility & propulsions; decrease intestinal secretions inhibit GI motility & decrease propulsions; increase intestinal secretions What does a histamine 2 receptor blocker do? Select the three correct answers Block H2 receptor sites of partial cells of the stomach reduction of gastric acid & raises pH of HCl causes vitamin B12 deficiency Anti-diarrheal drugs are selected based on...? Select the two correct answers occult blood amount & frequency consistency & cause of diarrhea How many days is prostatitis treated? 1-14 days 28-42 days 14-28 days What are some things for the nurse to consider when administering a bulk-forming laxative? Select the three correct answers Powdered form; mix with juice or water must take at least 8oz of water or will solidify & cause obstruction in throat, esophagus, colon fibrous substances that absorb water in intestine & form bulk which stimulates peristalsis & does not cause dependence What are some nursing considerations when administering an anti-diarrheal? Select the two correct answers Determine the cause of diarrhea; collect stool specimen as ordered and if infectious process, appropriate anti-infectives need to be given Diarrhea should be stopped if toxins need to be eliminated in stool; opium, paregoric & lomoil can cause CNS depression and constipation. Diarrhea should not be stopped if toxins need to be eliminated in stool; opium, paregoric & lomoil can cause CNS depression and constipation.