Antiemetic and Antinausea Drugs Quiz
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Questions and Answers

Which of these medications is classified as an indirect-acting cholinergic drug?

  • Memantine
  • Pyridostigmine (correct)
  • Oxybutynin
  • None of the above
  • What is the primary mechanism of action for Oxybutynin?

  • Blocks the muscarinic action of acetylcholine (correct)
  • Inhibits acetylcholine release
  • Stimulates acetylcholine receptors
  • Increases acetylcholine production
  • Which of the following is a contraindication for Memantine?

  • Asthma
  • Urinary retention
  • Known drug allergy (correct)
  • Hyperthyroidism
  • What is a common adverse effect of Pyridostigmine?

    <p>GI upset/excessive salivation (D)</p> Signup and view all the answers

    Which medication is indicated for the treatment of overactive bladder (OAB)?

    <p>Oxybutynin (C)</p> Signup and view all the answers

    What nursing implication is important to consider when administering Pyridostigmine?

    <p>Check for GI mechanical obstruction (D)</p> Signup and view all the answers

    Which of the following is NOT a contraindication for Oxybutynin?

    <p>Asthma (D)</p> Signup and view all the answers

    Which of the following medications is used to treat the symptoms of myasthenia gravis?

    <p>Pyridostigmine (B)</p> Signup and view all the answers

    Which of these conditions would be a contraindication for administering Dicyclomine?

    <p>Myasthenia Gravis (C)</p> Signup and view all the answers

    What is the mechanism of action of Dicyclomine?

    <p>Blocks the action of acetylcholine at muscarinic receptors (A)</p> Signup and view all the answers

    Which of the following nursing implications would NOT be appropriate when administering Dicyclomine?

    <p>Encourage the patient to avoid drinking liquids for maximum effect (A)</p> Signup and view all the answers

    A patient is taking Dicyclomine for irritable bowel syndrome. Which of these would be most important to include in patient education?

    <p>Avoid driving or operating machinery (A)</p> Signup and view all the answers

    According to the provided information, what is the recommended dosage of Dicyclomine?

    <p>80-160 mg/day (B)</p> Signup and view all the answers

    Which ethical principle emphasizes the nurse's obligation to avoid causing harm to the patient?

    <p>Nonmaleficence (D)</p> Signup and view all the answers

    Which of the following is NOT a contraindication for administering Dicyclomine?

    <p>Gastroesophageal Reflux Disease (A)</p> Signup and view all the answers

    What is the primary benefit of administering Dicyclomine to a patient with irritable bowel syndrome?

    <p>To reduce intestinal spasms and discomfort (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of taking Mirabegron (Myrbetriq)?

    <p>Hypotension (D)</p> Signup and view all the answers

    What is the primary mechanism of action of Tamsulosin (Flomax)?

    <p>Blocks alpha-adrenergic receptors on smooth muscle within the prostate and bladder, relaxing smooth muscle fibers and improving urinary flow. (D)</p> Signup and view all the answers

    Which of the following contraindications applies to the use of Epinephrine?

    <p>Hypersensitivity (D)</p> Signup and view all the answers

    Which medication is classified as a nonselective beta-blocker?

    <p>Sotalol (C)</p> Signup and view all the answers

    What is the primary indication for using Dopamine (Inotropen) at a low dose?

    <p>Dilation of blood vessels in the brain, heart, kidneys, and mesentery to increase blood flow (C)</p> Signup and view all the answers

    Which of the following is NOT a potential adverse effect of Epinephrine?

    <p>Hypoglycemia (A)</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Sotalol (Betapace)?

    <p>Sinus bradycardia (D)</p> Signup and view all the answers

    What is the appropriate nursing implication for administering Metoprolol (Lopressor) intravenously (IV)?

    <p>Monitor blood pressure and pulses frequently. (C)</p> Signup and view all the answers

    Which of the following medications is NOT a sympathomimetic drug?

    <p>Tamsulosin (D)</p> Signup and view all the answers

    What is a potential adverse effect associated with Tamsulosin (Flomax) use?

    <p>Abnormal ejaculation (A)</p> Signup and view all the answers

    Which of the following statements is TRUE regarding Mirabegron (Myrbetriq)?

    <p>It relaxes the detrusor muscle, leading to increased bladder capacity. (C)</p> Signup and view all the answers

    Which of the following nursing implications is MOST important when administering Dopamine (Inotropen)?

    <p>Monitor blood pressure, heart rate, ECG, urine input/output, and signs of ischemia. (C)</p> Signup and view all the answers

    Which of the following is NOT a common indication for using Epinephrine?

    <p>Hypertension (A)</p> Signup and view all the answers

    What is the primary mechanism of action of Sotalol (Betapace)?

    <p>Blocks potassium channels, prolonging the action potential duration and refractory period of cardiac muscle. (A)</p> Signup and view all the answers

    Which of the following medications is classified as a beta 1 adrenergic agonist?

    <p>Dopamine (B)</p> Signup and view all the answers

    Which of the following medications, when used long-term, can cause irreversible tardive dyskinesia?

    <p>Metoclopramide (Reglan) (B)</p> Signup and view all the answers

    Which antiemetic medication is classified as an antihistamine (H1 receptor blocker)?

    <p>Meclizine (Antivert) (B)</p> Signup and view all the answers

    What is the preferred route of administration for promethazine (Phenergan)?

    <p>Intramuscular (IM) (A)</p> Signup and view all the answers

    Which drug class does Ondansetron (Zofran) belong to?

    <p>Serotonin Blocker (D)</p> Signup and view all the answers

    Which of the following medications is contraindicated in patients with glaucoma?

    <p>Scopolamine (Transderm-Scop) (A)</p> Signup and view all the answers

    Which of the following medications is classified as a prokinetic drug?

    <p>Metoclopramide (Reglan) (B)</p> Signup and view all the answers

    What is the mechanism of action of promethazine (Phenergan)?

    <p>Blocks dopamine receptors in the CTZ (C)</p> Signup and view all the answers

    Which of these medications is contraindicated for breastfeeding mothers?

    <p>Meclizine (Antivert) (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of promethazine (Phenergan)?

    <p>Sedation (C)</p> Signup and view all the answers

    What is the primary indication for scopolamine (Transderm-Scop) medication?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the contraindication for promethazine (Phenergan) in children less than 2 years old?

    <p>Risk of fatal respiratory depression (B)</p> Signup and view all the answers

    What is the mechanism of action of ondansetron (Zofran)?

    <p>Blocks serotonin receptors in the GI tract, CTZ, and VC (D)</p> Signup and view all the answers

    When administering promethazine (Phenergan) intravenously, which of the following is important?

    <p>Administer through a large bore vein (D)</p> Signup and view all the answers

    What is the primary mechanism of action of meclizine (Antivert)?

    <p>Inhibits acetylcholine by binding to H1 receptors (C)</p> Signup and view all the answers

    Which of these medications should be diluted in at least 10 ml of fluid before IV administration?

    <p>Promethazine (Phenergan) (D)</p> Signup and view all the answers

    Which of these medications is available as a transdermal patch?

    <p>Scopolamine (Transderm-Scop) (C)</p> Signup and view all the answers

    Flashcards

    Memantine

    A drug that blocks stimulation of certain receptors to reduce cognitive symptoms in dementia.

    Contraindications for Memantine

    Conditions where Memantine should not be used, like drug allergies.

    Adverse Effects of Memantine

    Uncommon side effects include confusion and GI upset.

    Pyridostigmine

    An indirect-acting cholinergic that improves muscle strength in myasthenia gravis.

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    Mechanism of Action of Pyridostigmine

    Increases acetylcholine by inhibiting acetylcholinesterase.

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    Oxybutynin

    An antimuscarinic drug used to treat overactive bladder.

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    Adverse Effects of Oxybutynin

    Can cause dry mouth, constipation, and urinary retention.

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    Patient Education for Oxybutynin

    Take with food to lessen dry mouth; stay hydrated.

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    Dicyclomine

    A synthetic antispasmodic used to treat irritable bowel syndrome and GI disturbances.

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    Anticholinergic effects

    Side effects of medications like Dicyclomine, including dry mouth and urinary retention.

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    Contraindications

    Conditions that make Dicyclomine unsafe to use, like glaucoma and GI obstructions.

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    Patient Education

    Instructions for patients on how to take Dicyclomine effectively and safely.

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    Veracity

    The principle of truthfulness and honesty in nursing communication.

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    Beneficence

    The nursing principle of promoting good and well-being for patients.

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    Duty

    The legal and ethical responsibility nurses have to provide competent care.

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    Justice

    Providing fair and equal treatment to all patients regardless of circumstances.

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    Antiemetics

    Drugs used to relieve nausea and vomiting.

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    Chemoreceptor Trigger Zone (CTZ)

    Brain area involved in nausea and vomiting sensations.

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    Metoclopramide (Reglan)

    A prokinetic drug that blocks dopamine in CTZ.

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    Contraindications of Metoclopramide

    Conditions where Metoclopramide should not be used.

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    Tardive Dyskinesia

    Irreversible movement disorder from long-term metoclopramide use.

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    Ondansetron (Zofran)

    Serotonin blocker used to treat nausea from chemo.

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    Antihistamine

    H1 receptor blockers used to prevent nausea and motion sickness.

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    Meclizine (Antivert)

    Antihistamine used for motion sickness and vertigo.

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    Promethazine (Phenergan)

    Antidopaminergic drug used in psychotic disorders and nausea.

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    Contraindications of Promethazine

    Who should not take Promethazine.

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    Scopolamine

    Anticholinergic drug for motion sickness and postoperative nausea.

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    Adverse Effects of Scopolamine

    Dizziness, blurred vision, and confusion from scopolamine.

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    Assessment for Allergies

    Evaluating patient's allergy history before administering drugs.

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    N/V in Pregnancy

    Hyperemesis gravidarum refers to nausea and vomiting during pregnancy.

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    Adrenergic Agonists

    Medications that stimulate the sympathetic nervous system, mimicking neurotransmitters.

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    Alpha 1 Receptors

    Receptors located on post-synaptic cells causing vasoconstriction when activated.

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    Alpha 2 Receptors

    Receptors located on pre-synaptic cells, inhibiting the release of neurotransmitters.

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    Beta 1 Receptors

    Receptors primarily located in the heart, increasing heart rate and contractility.

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    Beta 2 Receptors

    Receptors found in the lungs and blood vessels, causing bronchodilation and vasodilation.

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    Dopamine

    A neurotransmitter that dilates blood vessels, increasing blood flow to vital organs.

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    Epinephrine (Epi-Pen)

    A potent adrenergic agonist used for severe allergic reactions and cardiac arrest.

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    Adverse Effects of Adrenergics

    Possible negative reactions such as palpitations, tachycardia, and anxiety.

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    Mirabegron (Myrbetriq)

    A GU adrenergic agonist that relaxes the bladder muscle to treat overactive bladder.

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    Tamsulosin (Flomax)

    An alpha-adrenergic blocker used primarily for benign prostatic hyperplasia (BPH).

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    Sotalol (Betapace)

    A nonselective beta blocker used for treating dysrhythmias.

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    Metoprolol (Lopressor)

    A beta-1 blocker used to treat hypertension and heart failure.

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    Nursing Implications of Adrenergics

    Monitoring vital signs and cardiac rhythm while administering adrenergic drugs.

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    Contraindications of Epinephrine

    Conditions like hypertension and CAD that prevent its safe use.

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    Mechanism of Action of Beta Blockers

    They block beta receptors, leading to decreased heart rate and blood pressure.

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    Study Notes

    Antiemetic and Antinausea Drugs

    • Antiemetics are drugs used to relieve nausea and vomiting.
    • Seven categories exist, with different mechanisms of action, primarily by blocking pathways that induce vomiting.
    • Chemoreceptor Trigger Zone (CTZ): a brain area responsible for nausea and vomiting sensations.

    Metoclopramide (Reglan)

    • Class: Prokinetic drug.
    • Routes: Oral, Parenteral.
    • Indications: Gastroesophageal reflux disease (GERD), delayed gastric emptying, nausea, and vomiting (N/V).
    • Mechanism: Blocks dopamine receptors in the CTZ, desensitizing it to impulses from the GI tract. Stimulates GI peristalsis to aid stomach emptying.
    • Contraindications: Patients with seizure disorders, pheochromocytoma, breast cancer, and GI obstruction.
    • Allergic to procaine or procainamide.
    • Adverse Effects: Long-term use can cause irreversible tardive dyskinesia, extrapyramidal symptoms (tremors, muscle contractions, eye spasms, lip smacking, tongue protrusion).

    Ondansetron (Zofran)

    • Class: Serotonin Blocker.
    • Route: Oral, injection.
    • Indications: Nausea and vomiting, chemotherapy, and postoperative settings, hyperemesis gravidarum.
    • Mechanism: Blocks serotonin receptors in the GI tract, CTZ, and vomiting center (VC).
    • Contraindications: Category B medication; concern about cleft palate development during first trimester; known drug allergy.
    • Adverse effects: Known drug allergy. This medication is available by prescription only due to potential adverse effects if used incorrectly.

    Meclizine (Antivert)

    • Class: Antihistamine (H1 receptor blockers).
    • Route: Oral.
    • Indications: Motion sickness, non-productive cough, allergy symptoms, sedation and vertigo.
    • Mechanism: Inhibits the cholinergic stimulation of the vestibular and reticular systems; this prevents nausea and vomiting.
    • Contraindications: Shock and lactation.
    • Adverse Effects: Drowsiness, fast heartbeat, hives, itching, rash, and headaches.
    • Nursing Implications : Assess for drug allergy.

    Promethazine (Phenergan)

    • Class: Antidopaminergic.
    • Routes: Oral, Intramuscular, intravenous.
    • Indications: Psychotic disorders, intractable hiccups, relieving hay fever symptoms, allergic conjunctivitis.
    • Mechanism: Blocks dopamine receptors in the CTZ.
    • Contraindications: Children under two years due to potential for fatal respiratory depression.
    • Adverse Effects: Sedation (common) drowsiness, dry mouth, lightheadedness.
    • Nursing Implications: Dilute in fluid, administer via large bore vein rather than hand veins, discontinue immediately if pain is experienced.

    Scopolamine (Transderm-Scop, Scopace)

    • Class: Anticholinergic blocker.
    • Route: Transdermal patch.
    • Indications: Motion sickness, postoperative nausea/vomiting, pre-surgical use to reduce secretions.
    • Mechanism: Blocks acetylcholine receptors in the inner ear labyrinth, preventing nausea-inducing stimuli from reaching the vomiting center.
    • Contraindications: Glaucoma, pyloric obstruction, and urinary bladder obstruction.
    • Adverse Effects: Blurred vision, confusion, hallucinations, urinary retention.
    • Nursing Implications: Caution with glaucoma patients , avoid intra-arterial administration.

    Adrenergic Agonists (Sympathomimetics)

    • The autonomic nervous system (ANS) and sympathetic nervous system (SNS) play crucial roles.
    • Catecholamines (epinephrine, norepinephrine, dopamine) are endogenous.
    • Alpha 1 and 2 receptors; Beta 1 and 2 receptors mediate various actions.
    • Alpha 1 receptors are postsynaptic. Beta 1 receptors primarily affect the heart.
    • Beta 2 receptors are present in the lungs and arteries. Dopaminergic receptors dilate blood vessels in the renal, mesenteric, coronary, and cerebral regions.
    • Indications: Cardiovascular (heart failure, shock), respiratory (bronchodilation, nasal congestion), and genitourinary (overactive bladder, benign prostatic hyperplasia).

    Epinephrine (Epi-Pen)

    • Class: Alpha and Beta adrenergic agonist.
    • Indications: Anaphylaxis, bronchospasm, cardiac arrest, asthma.
    • Mechanism: Binds to alpha receptors, causing vasoconstriction.
    • Contraindications: Hypertension, hypersensitivity, CAD, tachyarrhythmias.
    • Adverse effects: Palpitations, tachycardia, anxiety, tremors, hypertension, headache.
    • Nursing Implications: Monitor vitals, cardiac rhythm.

    Dopamine (Inotropen)

    • Class: Beta 1 adrenergic agonist.
    • Route: Intravenous.
    • Indications: Lower doses dilate blood vessels in the brain, heart, kidneys, and mesentery, increasing blood flow to these areas, and higher doses are used to improve cardiac contractility and output, including cases involving vasoconstriction, dilation pupil, rate heart, arterioles BP, gi motility,
    • Contraindications: Hypertension, hypersensitivity.
    • Adverse Effects: Palpitations, tachycardia, anxiety, tremors, hypertension, headache.
    • Nursing Implications: Monitor vital signs (vitals), cardiac rhythm.

    Mirabegron (Myrbetriq)

    • Class: GU Adrenergic Agonist (Beta 3 adrenergic).
    • Route: Oral.
    • Indication: Overactive bladder.
    • Mechanism of Action.: Relaxes the detrusor muscle, increasing bladder capacity.
    • Contraindications: None reported.
    • Adverse Effects: Hypertension, urinary tract infections, headache, nausea, nasopharyngitis, dizziness.

    Tamsulosin (Flomax)

    • Class: Alpha Adrenergic Blocker.
    • Route: Oral.
    • Indication: Benign prostatic hyperplasia (BPH), kidney stones, and retention.
    • Mechanism: Blocks alpha-adrenergic receptors on the prostate and bladder smooth muscles, relaxing the muscles to improve urinary flow.
    • Contraindications: Current use of phosphodiesterase-5 inhibitors (e.g., sildenafil).
    • Adverse Effects: Dizziness, orthostatic hypotension, abnormal ejaculation, rhinitis, abdominal pain.
    • Nursing Implications: Monitor for dizziness, orthostatic hypotension and urinary retention.

    Sotalol (Betapace)

    • Class: Nonselective Beta Blocker.
    • Route: Oral.
    • Indication: Difficult-to-treat dysrhythmias.
    • Mechanism of Action: Class III antiarrhythmic properties.

    Metoprolol (Lopressor)

    • Class: Beta 1 Blocker.
    • Routes: Intravenous, oral.
    • Indications: Hypertension, angina, heart failure.
    • Mechanism: Acts on beta-1 receptors in the heart, reducing catecholamine effects on cardiac function.
    • Contraindications: Bronchial asthma, sinus bradycardia, cardiogenic shock.
    • Adverse Effects: Torsades de pointes, fatigue, dizziness, bronchospasm, heart failure.

    Cholinergic Drugs

    • Memantine (Namenda): N-methyl-D-aspartate (NMDA) receptor antagonist used in Alzheimer's dementia treatment.
    • Mechanism: Blocks NMDA receptor stimulation, potentially reducing cognitive decline.
    • Pyridostigmine (Mestinon): Indirect-acting cholinergic drug enhances acetylcholine effects, used in myasthenia gravis to relieve symptoms and reverse neuromuscular blocking drugs.

    Oxybutynin (Ditropan)

    • Class: Anticholinergic (muscarinic blocker).
    • Route: Oral, transdermal patch (OTC).
    • Indications: Overactive bladder (OAB), neurogenic bladder issues.
    • Mechanism: Inhibits involuntary contractions of bladder muscles, increasing bladder capacity.
    • Contraindications: Allergic response, urinary/gastric retention, uncontrolled angle-closure glaucoma.
    • Adverse Effects: Dry mouth (common), constipation, blurred vision, drowsiness, dizziness.

    Dicyclomine (Bentyl)

    • Class: Synthetic antispasmodic cholinergic blocker.
    • Route: Oral.
    • Indications: Irritable bowel syndrome, functional gastrointestinal tract disturbances.
    • Mechanism of action: Blocks muscarinic receptors in the GI tract, inhibiting smooth muscle contractions.
    • Contraindications: Angle-closure glaucoma, GI tract obstruction, myasthenia gravis, paralytic ileus, and toxic megacolon.

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    Description

    Test your knowledge on antiemetic and antinausea drugs, focusing on their mechanisms of action and specific medications like Metoclopramide and Ondansetron. This quiz covers indications, contraindications, and potential side effects of these medications. Perfect for students in pharmacology or nursing.

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