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