Magnesium Citrate

Saline laxative

Increases osmotic pressure & draws water into the colon, producing a watery stool usually w/ in 3-6 hrs

Constipation (Causes explosion)

Before endoscopic exams

Removal of parasites, helminthes

Mg. toxicity (w/ renal failure)

Electrolyte imbalances, cramping, diarrhea, increased thirst

Contra: Renal disease, abd pain, N/V, obstruction, rectal bleeding

Senna

(Senakot)

Stimulant laxative

Induces intestinal peristalsis

Site of action: entire GI tract

Most likely class to cause dependence

Stimulates the nerves that innervate the intestines

Acute constipation

Bowel surgery prep

SE: nutrient malabsorption, skin rash, gastric irritation, discolored urine

~Can decrease absorption of antibiotics, digoxin, tetracyclines, oral anticoagulants

Scopolamine

(Transderm-Scop)

Anticholinergic-

Antiemetic

Binds to & blocks ACh receptors in inner ear and reticular formation

~Corrects imbalance between ACh and NE

Motion sickness

SE: dizziness, disorientation, drowsy, blurred vision, dilated pupils, dry mouth, constipation, rash

Contra: glaucoma, additive drying effects when given w/ antihistamines and antidepressants

Meclizine

(Antivert)

Antihistamine

Antiemetic

Inhibits ACh by binding to H1 receptors, preventing cholinergic stim in both vestibular & reticular systems

Motion sickness

Dizziness

Vertigo

SE: drowsiness, confusion, blurred vision, dilated pupils, dry mouth, urinary retention

Increased CNS depression

Drug

Drug Class

MOA / Drug effects

Used for

SE / Contraindications

Prochlorperazine

(Compazine)

Neuroleptic antiemetic

Presctiption

Prevent N/V by blocking dopamine receptors in the CTZ

May also block ACh

Nausea, vomiting

Psychotic disorders

Hiccups

Rx

SE: ortho hypo, ECG changes, tachycardia, HA, extrapyramidal symptoms, pseudo PD, akathesia, TD

Dry mouth, constipation

May cancel benefits of Levadopa

Ondansetron
(Zofran)

Serotonin Blocker- antiemetic

Prescription

Blocks serotonin receptors in the GI tract, CTZ, VC

Prevention of V from chemotherapy

Radiation induced N/V

Oral/ IV Rx

Cause few adverse effects- have specific actions

SE: HA, diarrhea, transient increased AST/ALT, bronchospasm

Metoclopramide

(Reglan)

Prokinetic – antiemetic

(dopamine antagonist)

Prescription

Block dopamine in the CTZ

Stimulates peristalsis in GI tract, enhancing emptying of stomach contents into duodenum and enhancing intestinal movements

Treatment of delayed gastric emptying

GERD

Antiemetic

SE: hypotension, SV tachycardia, dry mouth, diarrhea, HA

~Additive CNS depression

Not for: seizures, breast cancer, GI obstruction

Somatropin

&

Somatrem

Pituitary hormones

Have effects equivalent to those of GH

Promote linear growth in children who lack normal amts of GH

Hypopituitary dwarfism (growth failure)

*can only use if bones have not stopped growing

*usually given SubQ, can be IM

SE: HA, hyperglycemia, ketosis, hypothyroidism, hypercalciuria, rash, antibodies to GH

Vasopressin

(Pitressin)

ADH pituitary hormone

Mimics actions of ADH (antidiuretic hormone)- increases water resorption, concentrates urine; directly stimulates capillary smooth muscle = vasoconstriction

To prevent or control polydipsia (excess thirst), polyuria, and dehydration in pts w/ diabetes insipidus caused by low ADH

Increased BP, drowsiness, HA, lethargy, nausea, cramps, heartburn, uterine cramping, tremor, sweating, vertigo

Desmopressin

(DDAVP)

ADH pituitary hormone

Like vasopressin-

Causes a dose=dependent increase in the plasma level of factor VIII, von Willlebrand’s factor, and tissue plasminogen activator

Hemophilia A

Type I von Willebrand’s disease

Nasal spray, parenteral injection, oral

Increased BP, drowsiness, HA, lethargy, nausea, cramps, heartburn, uterine cramping, tremor, sweating, vertigo

**Careful in pts w/ chronic migraines, seizures or asthma

*don’t take w/ OTC cold meds

Drug

Drug Class

MOA / Drug effects

Used for

SE / Contraindications

Levothyroxine

Hypothyroidism drug

T3

Causes an increase in the rate of protein, carb, and lipid metabolism

Has cardiostimulating effect- increases sensitivity of the heart to catecholamines

Increases CO, renal blood flow & GFR = diuretic

Hypothyroidism

*Preferred when a rapid effect is desired

*Its hormonal content is standardized and its effect is therefore predictable

SE: cardiac dysrhythmia, tachycardia, hypertension, tremors, HA, nausea, weight loss, insomnia, anxiety, diarrhea, menstrual irregularities, heat intolerance, fever, thyroid storm

*Geriatric dose is 25% less

Contra: increases activity of oral anticoagulants, so lower the anticoagulant’s dose

May decrease serum digitalis levels

Propylthiouracil

(PTU)

Hyperthyroid drug

Inhibits the incorporation of iodine molecules into the amino acid tyrosine- impedes the formation of thyroid hormone

Hyperthyroidism

Liver and bone marrow toxicity

Drowsiness, HA, vertigo, fever

N/V, diarrhea, jaundice, smoky colored urine, low urine output

Agranulocytosis, leucopenia, bleeding

*Increased BUN and Creatinine

*Don’t eat iodine

Hydrocortisone

(Solu-cortef)

Adrenocortical steroid

Short acting- has strong mineralocorticoid actions (K+ excretion and Na+ and water retention)

Weak anti-inflammatory

*Short half life

Replacement therapy in pts w/ adrenocortical insufficiency

~Oral, injectable, topical

SE: peptic ulcers, HF, hypertension, hyperglycemia, osteoporosis, weight gain, steroid psychosis

*decreased resistance to infection

*can produce Cushing’s syndrome

~ fat face, shoulders, trunk & abd (moon face)

*need baseline NA, K, BUN, HgB, Hct , blood glucose levels

Prednisone

(Deltasone)

Glucocorticoid

Intermediate acting

Longer half life and duration of action

Anti-inflammatory or immunosuppressant

Asthma, chronic bronchitis

*is NOT adequate alone to treat adrenocortical insufficiency (Addison’s)

~oral

SE: peptic ulcers, HF, hypertension, hyperglycemia, osteoporosis, weight gain, steroid psychosis

*decreased resistance to infection

*can produce Cushing’s syndrome

~ fat face, shoulders, trunk & abd (moon face)

*need baseline NA, K, BUN, HgB, Hct , blood glucose levels