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  1. When are Group I laxatives used?
    • To clean out bowel for procedure or surgery
    • Osmotic stimulant
    • Creates a very watery bowel
    • Effective in 2-6 hours
  2. When are Group II laxatives used?
    • Stimulate gut after it has become sluggish
    • Semi-fluid in 6-12 hours
    • Osmotic stumulant
  3. When are Group III laxatives used?
    • Used on a daily basis to keep stool soft
    • Examples: bulk, surfactant, lactulose
  4. What is a bulk laxative similar to?
    Dietary fiber

    Group III

    It acts to enlarge the mass and stretch the walls of the intestine to increase peristalsis

    It also absorbs water to soften the stool
  5. How does surfactant work as a laxative?
    Group III

    Lowers surface tension

    Allows for greater water absorption
  6. Stimulant laxatives
    Increase movement

    Increase water and electrolytes in the intestinal lumen
  7. Osmotic laxatives
    Laxative Salts

    Draw water into the gut

    High doses can be harmful to cardiac patients

    Used to pull water into the gut and empty the bowels quickly
  8. Mineral Oil
    Laxative that acts as a lubricant

    Taking orally, difficult to swallow, can lead to aspiration

    Can decrease absorption of vitamins in the gut
  9. Lactulose
    Osmotic diuretic

    Enhances intestinal secretion of Ammonia
  10. Why do people with liver failure use Lactulose?
    People with liver failure have high levels of ammonia

    Lactulose enhances the intestinal secretion of ammonia

    Will decrease ammonia levels by holding it in the stool
  11. For a patient receiving chemotherapy, what would you expect to see prescribed to treat the associated N/V?
    Ondansetron (Zofran)
  12. If a patient taking Zofran is still experiencing CINV (Chemo induced nausea and vomiting), what else might be prescribed?
    Aprepitant (Emend)
  13. What would you look at before passing Emend?
    What other drugs might be effected by it

    Emend can inhibit or increase drug metabolism by altering metabolizing liver enzymes
  14. What is the action of Emend?
    It blocks Substance P

    It is a neurokinin antagonist
  15. What can be given IV with chemo to prevent N/V short term?

    • Methylprednisolone (solumedrol)
    • Dexamethasone (decadron)
  16. What is the drug of choice for Dopamine antagonists and what is it used for?
    • Reglan
    • Used as an antiemetic
    • Has psychological effects, so not used much
  17. What drug is used for motion sickness and what class is it?
    • Scopolamine
    • It is a Muscarinic antagonist (anti-cholinergic)
  18. What is the strongest class of anti-diarrheals?

    • Such as:
    • Lomotil
    • Immodium
  19. Why is Lotronex bad for treating IBS?
    It has a high mortality rate and requires special acknowledgements from the patient and the doctor to prescribe it
  20. What other drug besides Lotronex can be used for IBS?
    Lubiprostone (Amitiza)
  21. Chron's disease is an _________ disorder
  22. What drugs can be used to treat Chron's
    • Immunosuppresants
    • Antibiotics
  23. Aminosalicylates can be used to treat _______, what are two examples?


    • Mesalamine/Asacol
    • & Pentasa
  24. For acute symptoms of IBD/Chron's, use what?
  25. Long term treatment of IBD/Chron's can be treated with what?
  26. Prokinetic drugs can be used to treat ______ and the drug of choice is __________

  27. When are pancreatic enzymes taken?
    For someone who does not produce the enzymes to break down food, such as cystic fibrosis

    It is taken with every meal
  28. Actigall is taken to treat what?

    It has less side effects than Chenix, which include diarrhea and liver damage
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