Pharmacology: Antiemetics and Antianemics

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Questions and Answers

What is the typical duration of Coumadin's therapeutic effect?

Approximately 75 days

60 to 80 seconds

30 seconds

3 to 5 days (correct)

Which of the following is an antidote for Coumadin?

Vitamin K (correct)

Aspirin

Acetaminophen

Glucocorticoids

A client taking Coumadin should be advised to avoid which of the following types of food?

Foods high in sodium

Foods high in protein

Foods high in Vitamin K (correct)

Foods high in Vitamin C

Which of the following is a common side effect associated with antiplatelet medications like Aspirin?

Hemorrhaging (D) Signup and view all the answers

What is the primary mechanism of action of antiplatelet drugs, such as clopidogrel and aspirin?

To prevent platelets from clumping together (C) Signup and view all the answers

Which of the following is NOT a food source encouraged by IROI to maintain an appropriate diet?

Green leafy vegetables (C) Signup and view all the answers

For which condition are statins MOST commonly prescribed in the US?

Primary hypercholesterolemia (A) Signup and view all the answers

Which of the following is a potential benefit of increasing HDL levels?

Decreased buildup in arteries (B) Signup and view all the answers

How often should liver function be monitored after initiating a statin medication?

After 12 weeks, then every 6 months (C) Signup and view all the answers

A patient taking statins should be instructed to report which of these symptoms to their provider?

Muscle weakness, aches, pain, tingling or tenderness (C) Signup and view all the answers

Which is a contraindication for anticoagulant medication?

Hemorrhagic brain injury (D) Signup and view all the answers

Which of the following medications is classified as a serotonin antagonist and used as an antiemetic?

Ondansetron (D) Signup and view all the answers

What is the antidote for heparin?

Protamine sulfate (D) Signup and view all the answers

A patient taking Metoclopramide is at risk for which of the following side effect?

Extrapyramidal symptoms (C) Signup and view all the answers

Which of the following medications can increase the risk of bleeding when taken with anticoagulants?

Corticosteroids (B) Signup and view all the answers

Dronabinol is classified as what kind of agent?

Cannabinoid (B) Signup and view all the answers

Which of the following agents used for erectile dysfunction operates by increasing levels of nitric oxide?

Sildenafil (B) Signup and view all the answers

What is a potential side effect associated with taking Sildenafil?

Muscle aches (C) Signup and view all the answers

Which of the following is a correct administration guideline for oral iron supplementation?

Take on an empty stomach one hour before meals (C) Signup and view all the answers

Why is it important to advise patients taking iron supplements about the color of their stool?

To differentiate iron stool color from internal bleeding (C) Signup and view all the answers

A patient is prescribed a proton pump inhibitor, which of the following adverse effects could occur with extended use?

Vitamin B12 deficiency (C) Signup and view all the answers

Study Notes

Antiemetics

Serotonin antagonists: Used to prevent nausea and vomiting. Example: Ondansetron.
Dopamine antagonists: Examples include Promethazine and Metoclopramide. These drugs often have extrapyramidal side effects, affecting motor control.
Antihistamines: Histamine receptor antagonists, such as Diphenhydramine and Dimenhydrinate, treat nausea and vomiting. Meclizine is another example.
Cannabinoids: Cannabis and Dronabinol are schedule I and III drugs, respectively, used as antiemetics.
Proton Pump Inhibitors (PPIs): These drugs (e.g., Zole) decrease stomach acid production. Long-term PPI use can result in vitamin B12 deficiency.
Erectile Dysfunction Agents: These agents (e.g., Sildenafil, Vardenafil, Tadalafil) increase nitric oxide, thus relaxing blood vessels in the penis leading to increased blood flow. Side effects include headache, flushing, back pain, and temporary vision changes.

Antianemics

Iron Deficiency Anemia: Iron supplements are prescribed. Iron is considered a "heavy" mineral and should be taken cautiously.
Side Effects of Iron Supplements: Possible side effects of consuming iron supplements include staining of teeth and skin, as well as tissue staining and injection side effects.
Patient Care Considerations: Iron supplements should ideally be taken on an empty stomach for optimal absorption, but if this causes discomfort, consuming iron supplements with food can improve absorption. Antacids or tetracyclines should be taken at least two hours apart from iron supplements to avoid decreased absorption. Avoid vitamin C when taking iron to avoid absorption issues. Eating foods high in vitamin C with iron supplements reduces absorption. Space doses evenly throughout the day for optimal iron absorption and red blood cell (RBC) production. Encourage practices like consuming water, fiber, and exercise to prevent constipation. A healthy diet that includes a sufficient amount of iron is important.

Statins

Use: Statins are commonly prescribed in the US for primary hypercholesterolemia, to prevent coronary events (like heart attacks and strokes), and to control high cholesterol, especially in patients with diabetes and/or experiencing a stroke or mini-stroke
Mechanism: Statins lower LDL ("bad") cholesterol levels. They also protect the liver and muscles from damage caused by high cholesterol.
Contraindications: Patients should avoid alcohol, and baseline liver function studies should be performed and monitored for at least 12 weeks and then every six months thereafter.
Side Effects: Possible side effects include myopathy (muscle pain, weakness) and neuropathy (nerve pain, numbness). Patients should report any muscle-related symptoms immediately to their doctor.

Anticoagulants

Heparin: Used to prevent blood clots. E.g., heparin sodium converts fibrinogen to fibrin.
Low-Molecular-Weight Heparin: Examples such as enoxaparin and dalteparin; these have longer half-life than other heparin forms.
Antidote for Heparin: Protamine sulfate.
Contraindications: Active bleeding, presence of ulcers, and hemorrhagic brain injury.
Monitoring: Regular monitoring for potential side effects such as bleeding is important.
Avoid these: Corticosteroids and salicylates and NSAIDs, and foods/dietary supplements containing vitamin K, including leafy greens

Antiplatelets

Mechanism: These drugs prevent blood platelets from clumping together to decrease the risk of blockage in blood vessels and prevent heart attacks or strokes. Examples include aspirin, clopidogrel (Plavix), and pentoxifyline (Trental).
Route(s): Oral and IV
Important Considerations: Avoid taking with foods if the patient has a peptic ulcer and be cautious in patients with or who have a history of renal or hepatic failure; these medications can exacerbate existing health issues. It is important to stay alert and monitor the patient carefully, particularly those with a history of heart attack or stroke. Avoid combining with corticosteroids to avoid increased negative side effects; be cautious in concurrent use of drugs that reduce the effectiveness of Beta-blockers

Coumadin

Mechanism: Coumadin, also known as warfarin, works by inhibiting vitamin K.
Route: Oral (taken by mouth)
Monitoring: Prothrombin time (PT) and International Normalized Ratio (INR) are monitored to ensure therapeutic levels are achieved.
Antidote: Vitamin K is the antidote.
Contraindications: Certain conditions like severe liver disease or recent surgery
Important Considerations: Avoid foods high in vitamin K to avoid interfering with medication effectiveness.

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Description

Explore key concepts related to antiemetics and antianemics in this pharmacology quiz. Learn about different drug classes, including serotonin and dopamine antagonists, antihistamines, and their uses in preventing nausea and treating anemia. Test your knowledge on their mechanisms, side effects, and relevant examples.