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52 Cards in this Set

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  • Back
What are the most common physical symptoms experienced at the end of life?
asthenia, anorexia, nausea, constipation, sedation, confusion, dyspnea
What are the causes of constipation?
mechanical obstruction, neurological, drug induced, metabolic, functional
What are the fiber agents used to treat constipation?
fiber (bran) psylluim (metamucil)
How do the fiber agents work?
inc fecal mass to stim peristalsis
Who should use fiber agents?
debilitated patients who can't drink 1.5-2L
What are the non absorbative sugar osmotic laxative?
lactulose and sorbitol
How do the non-abs sugar laxative work?
softens stool with inc acidity and inc water content
Why can't some patients tolerate the non-abs sugar laxative?
too sweet
What are the potential side effect of non-abs sugar laxative?
worsen dehydration, bloating, cramping, flatulence
What are the saline and Mg laxatives?
MgCitrate, MgHydroxide, Sodium phosphate
How does the saline laxative work?
osmotic effect inc intraluminal volume stimulates intestinal motility
How do the Mg laxatives work?
stim CCK which inc intraluminal accumulation of fluid and electrolytes and promotes sm bowel transit
How long before Mg Laxatives work?
1-3 hours at high does
How shouldn't use Mg laxative?
bowel obstructed, CHF, LF, KF
What can Mg laxatives cause?
ischemic colitis
What are the polyethylene glycol agents?
miralz, glycolax, colyte, golytely
How does PEG work?
retention of H2O
What are PEG in large volume used for?
rapid evacuation for endoscopy
What are small dose PED used for?
constipation
What are the stimulent laxatives?
senna, bisacodyl
How do the stimulant laxatives work?
stim sensory nerve endings to produce parasympathetic reflexes, stim myenteric plexus
What is melanosis coli?
brown pigmentation of the colon
How can you tell a pt has been taking stimulant laxatives?
presence of melanosis coli
What are the detergent laxative?
docusate/colase
How does docusate work?
stimulate intestinal secretion and increase the penetration of fluids by emulsifying feces, water, and fat
What is docusate used for?
soften or prevent hard stools
What should a patient after surgery be put on to prevent constipation?
ducasate
What are the lubricant laxatives?
glycerin and mineral oil
How shouldn't lubricant laxatives be administered and why?
orally because of lipoid pneumonitis
What are the types of large volume enemas?
warm water, soapsuds, sodium phosphate enema
When should large vol enemas be used?
fecal impaction
What is special about the area postremia?
outside BBB
Where do drugs, uremai, ketosis, and irradiation work to cause nausea?
chemoreceptor trigger zone
What receptors are in the chemoreceptor trigger zone?
5HT3, DA
What receptors are important for vestibular apparatus?
H1 and choline
What receptors are important in gastric irritation, intestinal distention, and gag reflex?
H, DA, 5HT3, choline
How does metoclopramide work?
central and peripheral DA R I
What does the phase the metro is a dope mean?
Metoclopramide works as a DA R inhibitor
What are the side effects when dopamine receptors are involved?
extrapyramidal
When should metoclopramide be used?
dysmobility of upper GI, diabetic paresthesia, chemotx
How does prochlorperazine work?
inhibits DA R in tigger zone and blocks vagus nerve
What is prochlorperazine used for?
opioid related n/v, GI disorders
What is promethazine used for?
motionsickness
How does promethazine work?
H1 receptor blocker
What does promethazine cause?
sedation
How does ondansetron work?
5HT3 R antagonist
What are the side effects of ondansetron?
HA, prolonged QT
When should ondansetron be used?
Chemo/Rad tx,
Why shouldn't ondansetron be prescribed like candy?
it is very expensive
How does scopolamine work?
anticholinergic
What are the side effects of scopolamine?
can't see, pee, spit, shit
What is scopolamine used for?
motion sickness