Podcast
Questions and Answers
Which of the following is a primary effect of Alpha 1 receptor stimulation?
Which of the following is a primary effect of Alpha 1 receptor stimulation?
A patient is prescribed Mirabegron (Myrbetriq). What is the primary mechanism of action of this medication?
A patient is prescribed Mirabegron (Myrbetriq). What is the primary mechanism of action of this medication?
A patient is experiencing a severe anaphylactic reaction. Which medication and route is most appropriate for initial management?
A patient is experiencing a severe anaphylactic reaction. Which medication and route is most appropriate for initial management?
What is the classification of Tamsulosin (Flomax)?
What is the classification of Tamsulosin (Flomax)?
Signup and view all the answers
A patient taking Sotalol (Betapace) should be educated to report which of the following adverse effects?
A patient taking Sotalol (Betapace) should be educated to report which of the following adverse effects?
Signup and view all the answers
Which antiemetic drug is contraindicated in patients with pheochromocytoma, seizure disorders, or breast cancer?
Which antiemetic drug is contraindicated in patients with pheochromocytoma, seizure disorders, or breast cancer?
Signup and view all the answers
What is an important nursing implication to monitor when a patient is taking Metoprolol (Lopressor)?
What is an important nursing implication to monitor when a patient is taking Metoprolol (Lopressor)?
Signup and view all the answers
A patient is prescribed an antiemetic prior to chemotherapy. When is the best time for the nurse to administer the medication?
A patient is prescribed an antiemetic prior to chemotherapy. When is the best time for the nurse to administer the medication?
Signup and view all the answers
Which of the following is a contraindication for the use of Dopamine (Inotropen)?
Which of the following is a contraindication for the use of Dopamine (Inotropen)?
Signup and view all the answers
A patient with motion sickness is prescribed Scopolamine transdermal patch. Which condition should the nurse identify as a contraindication for administering this medication?
A patient with motion sickness is prescribed Scopolamine transdermal patch. Which condition should the nurse identify as a contraindication for administering this medication?
Signup and view all the answers
Which antiemetic drug has a primary mechanism of action that involves blocking dopamine receptors in the CTZ and causing desensitization to impulses from the GI tract?
Which antiemetic drug has a primary mechanism of action that involves blocking dopamine receptors in the CTZ and causing desensitization to impulses from the GI tract?
Signup and view all the answers
What is the primary mechanism of action of Memantine (Namenda)?
What is the primary mechanism of action of Memantine (Namenda)?
Signup and view all the answers
What is the effect of stimulating Beta 2 receptors?
What is the effect of stimulating Beta 2 receptors?
Signup and view all the answers
A patient is receiving promethazine (Phenergan) intravenously. Which of the following is an important administration guideline the nurse should follow?
A patient is receiving promethazine (Phenergan) intravenously. Which of the following is an important administration guideline the nurse should follow?
Signup and view all the answers
Which antiemetic is classified as an antihistamine (H1 receptor blocker) and is used to treat motion sickness and allergy symptoms?
Which antiemetic is classified as an antihistamine (H1 receptor blocker) and is used to treat motion sickness and allergy symptoms?
Signup and view all the answers
A patient is taking an adrenergic agonist. Which of the below indicates a potential adverse effect?
A patient is taking an adrenergic agonist. Which of the below indicates a potential adverse effect?
Signup and view all the answers
Which medication has a contraindication of 'children less than 2 years' because of risk of fatal respiratory depression?
Which medication has a contraindication of 'children less than 2 years' because of risk of fatal respiratory depression?
Signup and view all the answers
A patient taking Ondansetron (Zofran) should be educated about which of the following side effects which can be exacerbated by the use of alcohol?
A patient taking Ondansetron (Zofran) should be educated about which of the following side effects which can be exacerbated by the use of alcohol?
Signup and view all the answers
What is a common adverse effect specifically associated with long-term use of metoclopramide (Reglan)?
What is a common adverse effect specifically associated with long-term use of metoclopramide (Reglan)?
Signup and view all the answers
Which medication is released through a transdermal patch over 72 hours and is used to prevent nausea and vomiting associated with motion sickness by blocking ACh receptors in the inner ear?
Which medication is released through a transdermal patch over 72 hours and is used to prevent nausea and vomiting associated with motion sickness by blocking ACh receptors in the inner ear?
Signup and view all the answers
A patient taking dicyclomine (Bentyl) should be educated to report which of the following adverse effects?
A patient taking dicyclomine (Bentyl) should be educated to report which of the following adverse effects?
Signup and view all the answers
Which of the following is a contraindication for the use of dicyclomine?
Which of the following is a contraindication for the use of dicyclomine?
Signup and view all the answers
The primary mechanism of action of dicyclomine involves blocking which neurotransmitter?
The primary mechanism of action of dicyclomine involves blocking which neurotransmitter?
Signup and view all the answers
A nurse is educating a patient on dicyclomine. What advice should the nurse provide regarding medication administration to minimize dry mouth?
A nurse is educating a patient on dicyclomine. What advice should the nurse provide regarding medication administration to minimize dry mouth?
Signup and view all the answers
A patient taking dicyclomine reports experiencing severe dry mouth. What nursing intervention is most appropriate?
A patient taking dicyclomine reports experiencing severe dry mouth. What nursing intervention is most appropriate?
Signup and view all the answers
Which principle is associated with maintaining patient privacy, as it relates to a patient's medical information?
Which principle is associated with maintaining patient privacy, as it relates to a patient's medical information?
Signup and view all the answers
A nurse is making treatment decisions, and believes in the principle of nonmaleficence. How would the nurse proceed?
A nurse is making treatment decisions, and believes in the principle of nonmaleficence. How would the nurse proceed?
Signup and view all the answers
A patient refuses a recommended treatment. Which ethical principle is the nurse upholding by respecting this decision?
A patient refuses a recommended treatment. Which ethical principle is the nurse upholding by respecting this decision?
Signup and view all the answers
A nurse is ensuring equitable allocation of resources among patients, regardless of their backgrounds. Which ethical principle is the nurse demonstrating?
A nurse is ensuring equitable allocation of resources among patients, regardless of their backgrounds. Which ethical principle is the nurse demonstrating?
Signup and view all the answers
What does a nurse's duty to a patient entail, in the healthcare setting?
What does a nurse's duty to a patient entail, in the healthcare setting?
Signup and view all the answers
Which medication is primarily used to treat overactive bladder?
Which medication is primarily used to treat overactive bladder?
Signup and view all the answers
What is the primary mechanism of action of pyridostigmine?
What is the primary mechanism of action of pyridostigmine?
Signup and view all the answers
A patient reports dry mouth, constipation, and blurred vision. Which medication are they most likely experiencing side effects from?
A patient reports dry mouth, constipation, and blurred vision. Which medication are they most likely experiencing side effects from?
Signup and view all the answers
A patient with myasthenia gravis is prescribed a medication to improve muscle strength. Which drug is most likely prescribed?
A patient with myasthenia gravis is prescribed a medication to improve muscle strength. Which drug is most likely prescribed?
Signup and view all the answers
Which of the following is a contraindication for the use of pyridostigmine?
Which of the following is a contraindication for the use of pyridostigmine?
Signup and view all the answers
A patient taking memantine for dementia experiences confusion and a headache. According to the text, how should the nurse respond?
A patient taking memantine for dementia experiences confusion and a headache. According to the text, how should the nurse respond?
Signup and view all the answers
Which medication is contraindicated with uncontrolled angle-closure glaucoma?
Which medication is contraindicated with uncontrolled angle-closure glaucoma?
Signup and view all the answers
A patient is newly prescribed oxybutynin. What is an important education point by the nurse?
A patient is newly prescribed oxybutynin. What is an important education point by the nurse?
Signup and view all the answers
A patient is going for surgery, and is taking Pyridostigmine. What is an important nursing implication following surgery?
A patient is going for surgery, and is taking Pyridostigmine. What is an important nursing implication following surgery?
Signup and view all the answers
Which of the following adverse effects are associated with Memantine?
Which of the following adverse effects are associated with Memantine?
Signup and view all the answers
Study Notes
Antiemetic and Antinausea Drugs
- Antiemetics are medications used to treat nausea and vomiting.
- Seven categories exist, with varying mechanisms of action, primarily via blocking pathways that initiate vomiting.
- Chemoreceptor Trigger Zone (CTZ) is the brain area involved in nausea and vomiting sensations.
Metoclopramide (Reglan)
- Class: Prokinetic Drug
- Routes: Oral, Parenteral (injection), prescription-only
- Indications include Gastroesophageal Reflux Disease (GERD), delayed gastric emptying, and nausea/vomiting (N/V).
- Mechanism of Action: blocks dopamine receptors in the CTZ, desensitizing it to GI tract impulses; stimulates GI tract peristalsis to enhance stomach emptying.
- Contraindications: seizure disorders, pheochromocytoma (adrenal gland tumor), breast cancer, and GI obstruction.
- Allergies to metoclopramide or related drugs (procaine, procainamide) are also contraindications.
- Adverse effects include long-term tardive dyskinesia (movement disorder) and extrapyramidal effects (tremors, muscle contractions, eye spasms, lip smacking, tongue protrusion).
Ondansetron (Zofran)
- Class: Serotonin Blocker
- Routes: Oral, injectable (IV push over 2 minutes)
- Indications include nausea/vomiting associated with chemotherapy and post-surgical procedures; also used for hyperemesis gravidarum (severe nausea and vomiting during pregnancy).
- Mechanism of Action: blocks serotonin receptors in the GI tract, CTZ, and vomiting center, preventing nausea and vomiting.
- Contraindications: known drug allergies, some concerns about use during the first trimester of pregnancy related to potential effects on fetal development (cat B medication).
Meclizine (Antivert)
- Class: Antihistamine (H1 receptor blocker)
- Route: Oral
- Indications include motion sickness, non-productive cough, allergy symptoms, and vertigo.
- Mechanism of Action: Inhibits acetylcholine (ACh) action in the vestibular and reticular areas, which prevents nausea and vomiting.
- Contraindications include shock and breastfeeding (lactation).
Promethazine (Phenergan)
- Class: Antidopaminergic
- Routes: Oral, Intramuscular (IM, preferred), Intravenous (IV).
- Indications include psychotic disorders, intractable hiccups, hay fever, and allergic conjunctivitis.
- Mechanism of action: Blocks dopamine receptors in the chemoreceptor trigger zone (CTZ).
- Contraindications: Children under 2 years old due to risk of fatal respiratory depression.
Scopolamine (Transderm-Scop, Scopace)
- Class: Anticholinergic (acetylcholine blocker)
- Route: Transdermal patch (72-hour release)
- Indications include nausea/vomiting associated with motion sickness, post-surgical procedures, and pre-operative use to reduce secretions.
- Mechanism of Action: blocks acetylcholine receptors in the inner ear labyrinth, CTZ, and the reticular formation to prevent nausea and vomiting.
- Contraindications for use include glaucoma, pyloric obstruction, urinary bladder neck obstruction.
Adrenergic Agonists (Sympathomimetics)
- Catecholamines (epinephrine, norepinephrine, and dopamine) play a role as endogenous adrenergic agonists.
- Alpha 1 receptors are located on postsynaptic cells (effector cells).
- Alpha 2 receptors are on presynaptic cells.
- Beta 1 receptors are mainly in the heart; Beta 2 receptors are primarily in the lungs and some arteries.
- Dopamine receptors dilate blood vessels in renal, mesenteric, coronary, and cerebral regions.
- Indications: include cardiovascular conditions (heart failure, shock); respiratory conditions (bronchodilation, nasal congestion); some urinary conditions.
Epinephrine (Epi-Pen)
- Class: Alpha and Beta adrenergic agonist
- Indications for use include anaphylaxis, bronchospasm, cardiac arrest, and asthma.
- Mechanism of Action: binds to alpha receptors causing vasoconstriction
- Contraindications: hypertension, hypersensitivity, CAD, tachyarrhythmias.
- Adverse effects include palpations, leading to dysrhythmias; seizures and stroke (extreme BP).
- Antidotes include sympatholytic medications, frequently clonidine
Dopamine (Inotropen)
- Class: Beta 1 adrenergic agonist.
- Route: Intravenous (IV)
- Indications: Low to moderate doses dilate blood vessels in the brain, increasing blood flow; higher doses improve cardiac contractility and output; highest dose indicated for vasoconstriction.
Mirabegron (Myrbetriq)
- Class: GU Adrenergic Agonist (Beta 3 adrenergic)
- Route: Oral (PO)
- Indications: overactive bladder
- Mechanism of Action: relaxes detrusor muscles to increase bladder capacity
Tamsulosin (Flomax)
- Class: Alpha adrenergic blocker
- Route: Oral (PO)
- Indications include benign prostatic hyperplasia (BPH) in males; kidney stones or urinary retention in females.
- Mechanism of Action: blocks alpha adrenergic receptors in the prostate and bladder to improve urinary flow
Sotalol (Betapace)
- Class: Nonselective beta blocker
- Route: Oral (PO)
- Indications: difficult to treat dysrhythmias
- Mechanism of Action: Class III antiarrhythmic properties
Metoprolol (Lopressor)
- Class: Beta-1 blocker
- Routes: IV and PO
- Indications: hypertension; Angina, heart failure
- Mechanism of Action: acts on beta-1 receptors in the heart to reduce the effects of catecholamines on cardiac function
Memantine (Namenda)
- Class: NMDA receptor antagonist
- Route: Oral (PO)
- Indications: Alzheimer's dementia
- Mechanism of Action: blocks the stimulation of NMDA receptors, reducing the development or progression of dementia symptoms
Pyridostigmine (Mestinon)
- Class: Indirect-Acting Cholinergic Drugs
- Route: Oral (PO)
- Indications: Myasthenia gravis, to reverse the effects of nondepolarizing neuromuscular drugs after surgery
- Mechanism of Action: increases acetylcholine by inhibiting acetylcholinesterase
Oxybutynin (Ditropan)
- Class: Anticholinergic
- Route: Oral (PO), Transdermal patch
- Indications: overactive bladder (OAB), neurogenic bladder associated with spinal cord injuries and congenital conditions
- Mechanism of Action: blocks muscarinic action of acetylcholine on smooth muscle cells in the bladder to inhibit involuntary contractions and increase bladder capacity
Dicyclomine (Bentyl)
- Class: Synthetic Antispasmodic Cholinergic Blocker
- Route: Oral (PO)
- Indications: irritable bowel syndrome, functional disturbances of the GI tract
- Mechanism of Action: blocks the muscarinic action of acetylcholine on smooth muscle cells in the GI tract
Cultural and Ethical Considerations
- Veracity: truthfulness and honesty.
- Nonmaleficence: avoiding harm to patients.
- Autonomy: patients' right to make medical decisions.
- Beneficence: doing good and promoting wellbeing for patients.
- Confidentiality: protecting patient information.
- Justice: fairness and equal treatment.
- Breach of Duty: deviating from the expected standard of care.
- Causation: establishing a direct link between the breach and harm.
- Damage: the harm or injury suffered by the patient.
- Cultural Assessment: systematic process to understand patient's background, beliefs, values, and preferences, including language, family, diet, traditional healing, views of health, illness, suffering, spirituality, and death.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the classifications, mechanisms, and indications of antiemetic and antinausea drugs. This quiz covers various drug categories, with a focus on Metoclopramide (Reglan), its uses, contraindications, and adverse effects. Test your understanding of how these medications work to alleviate nausea and vomiting.
