Questions and Answers
What is a contraindication for the use of osmotic laxatives?
What is the main mechanism of action of bulk-forming laxatives?
What is the purpose of the Gastric Mucosal Barrier (GMB)?
What is a common complication of laxative abuse?
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What is the name of the somatostatin analog used to treat severe diarrhea related to metastatic cancer?
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Which class of medications is primarily used to block dopamine 2 receptors in the CTZ?
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Which medication is NOT a dopamine antagonist?
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What is a common side effect associated with long-term use of butyrophenones?
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Which of the following medications is used for chemotherapy-induced nausea/vomiting?
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What is a contraindication for using metoclopramide?
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What serious side effect can glucocorticoids have if used for extended periods?
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What symptom is NOT associated with cannabinoid use in nausea management?
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What is the primary aim of treatment for diarrhea according to the provided information?
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Study Notes
Dopamine Antagonists
- Block dopamine 2 receptors in the chemoreceptor trigger zone (CTZ).
- Phenothiazines (e.g., Promethazine, Prochlorperazine, Thorazine) are effective for severe nausea from surgery, anesthesia, chemotherapy, and radiation.
- Doses used are smaller compared to psychiatric treatments, with rapid onset via IV or IM routes.
- Potential side effects include hypotension, sedation, extrapyramidal symptoms (EPS), dry mouth, constipation, and urinary retention.
Butyrophenones and Metoclopramide
- Common agents include Haldol and Inapsine.
- Long-term use can result in EPS; blood pressure should be monitored due to the risk of hypotension.
- Metoclopramide can cause sedation and diarrhea at high doses and should not be administered with gastrointestinal obstruction, hemorrhage, or perforation.
- EPS is more frequent in children.
Benzodiazepines and Serotonin Receptor Antagonists
- Benzodiazepines like Lorazepam and Diazepam indirectly manage nausea and vomiting associated with chemotherapy.
- Serotonin receptor antagonists, including Ondansetron (Zofran), are used specifically for nausea and vomiting induced by cancer chemotherapy without causing EPS.
- Common side effects for these agents include headaches, diarrhea, dizziness, and fatigue.
Glucocorticoids and Cannabinoids
- Used to treat nausea and vomiting related to cancer treatment; glucocorticoids are administered IV and used short-term to minimize side effects.
- Cannabinoids are derived from marijuana but should not be given to patients with psychiatric disorders; side effects may include mood changes, euphoria, dizziness, and confusion.
Poisoning/Overdose Treatment
- Gastric lavage and activated charcoal are standard procedures.
- Specific antidotes include:
- Acetaminophen: Mucomyst
- Narcotics: Narcan
- Benzodiazepines: Flumazenil
- Lanoxin: Digibind
- Warfarin and Xarelto: Vitamin K
- Heparin: Protamine sulfate
Diarrhea Management
- Can lead to severe electrolyte imbalances or dehydration if prolonged; antidiarrheals should not be used for more than two days or if fever is present.
- Treatment aims to decrease diarrhea and hypermotility.
- Common antidiarrheals include opiates (e.g., tincture of opium, Imodium); potential side effects include CNS depression and dependence.
Constipation Remedies
- Prevention strategies consist of a high-fiber diet, increased water intake, and regular exercise.
- Laxatives or cathartics may be utilized, but they are contraindicated in cases of intestinal obstruction, appendicitis, ulcerative colitis, or diverticulitis.
- Laxative abuse should be avoided to prevent dependence.
- Types of laxatives include:
- Osmotics (saline) - contraindicated in poor renal function or CHF.
- Stimulants (contact or irritant).
- Bulk forming.
- Emollients (stool softeners).
Antiulcer Drugs and Gastrointestinal Agents
- Peptic ulcers can occur in the stomach, esophagus, duodenum, or upper GI region, named by their location.
- Caused by hypersecretion of hydrochloric acid and pepsin, which erodes the GI mucosal lining.
- The gastric mucosal barrier (GMB) provides protection against corrosive substances.
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Description
This quiz covers the properties and effects of dopamine antagonists, including their use in treating nausea from surgery, anesthesia, and chemotherapy. It also discusses their side effects and administration methods.
