BISMUTH COMPOUNDS
Selective SEROTONIN ANTAGONISTS
BENZAMIDES
BENZAMIDES
PHENOTHIAZINES
100

Why do we use BISMUTH COMPOUNDS?

What do they treat/prevent?

We utilize BISMUTH COMPOUNDS to treat: 

- DYSPEPSIA

- ACUTE DIARRHEA

- PUD

We utilize BISMUTH COMPOUNDS to PREVENT: 

- TRAVELER's DIARRHEA

CAN BE USED TO TREAT H. PYLORI!

100

Why do we use SELECTIVE SEROTONIN ANTAGONISTS?

We utilize SELECTIVE SEROTONIN ANTAGONISTS to treat: 

- PONV (post-operative nausea/vomiting)

- CIMV (chemo-induced nausea/vomiting)

- Delayed CIMV

100

Why do we use BENZAMIDES?

We utilize BENZAMIDES as an: 

- ANTIEMETIC

- GI PROKINETIC THAT INCREASES GI MOTILITY!

100

If a patient has RENAL DYSFUNCTION, what should we do if they are prescribed this medication class?

ADJUST THE DOSE

100

Why do we use PHENOTHIAZINES?

What do they treat and how do they treat it?

We utilize PHENOTHIAZINES to treat: 

- Simple NAUSEA/VOMITTING!

PHENOTHIAZINES treat N/V by BLOCKING DOPAMINE RECEPTORS (in the Chemo-Receptor Zone (CTZ))

200

What adverse effects do BISMUTH COMPOUNDS cause in patients taking this med class?

- BLACK STOOLS

- INCREASE BLEEDING TIMES

- Constipation if taken too frequently

200

What adverse effects do SELECTIVE SEROTONIN ANTAGONISTS cause in patients taking this med class?

- Diarrhea

- Headache

- Constipation

- Drowsiness

- PROLONGED QT INTERVAL

200

How do BENZAMIDES work?

1. BENZAMIDES INHIBITS CTZ STIMULATION

2. BLOCK DOPAMINERGIC RECEPTORS IN THE CTZ

3. STIMULATES CHOLINERGIC ACTIVITY IN THE GUT (INCREASING GI MOTILITY!)

200

What adverse effects can PHENOTHIAZINES cause in patients taking this med class?

- Extra Pyramidal Symptoms (EPS - tardive dyskinesia)

- DYSTONIA (involuntary muscle movements/twitching)

- EXCESSIVE SEDATION

- CARDIAC ARRHYTHMIAS

- PROLONGED QT INTERVALS

300

How do BISMUTH COMPOUNDS work?

BISMUTH COMPOUNDS treat (PUD, Dyspepsia, Acute Diarrhea)/prevent (traveler's diarrhea) by: 

STIMULATING ABSORPTION OF FLUID and ELECTROLYTES across the INTESTINAL WALL, COATING THE WALLS OF THE GI TRACT!

- EXACT MOA HAS NOT BEEN DETERMINED!

300

How do SELECTIVE SEROTONIN ANTAGONISTS work?

SELECTIVE SEROTONIN ANTAGONISTS treat PONV and CINV by:

BLOCKING SEROTONIN RECEPTORS!

300

What adverse effects can BENZAMIDES cause in patients taking this med class?

- TARDIVE DYSKINESIA (irreversible)

- RESTLESSNESS 

- Drowsiness

- Diarrhea

- Seizures

300

What nursing consideration is MOST IMPORTANT?

PUSH PHENOTHIAZINES SLOWLY TO AVOID CV EFFECTS

400

How do use BISMUTH COMPOUNDS (PETO BISMOL)?

We use BISMUTH COMPOUNDS for SHORT PERIODS ONLY!

400

How do we administer SELECTIVE SEROTONIN ANTAGONISTS?

PUSH SELECTIVE SEROTONIN ANTAGONISTS SLOWLY!

(OVER 2 MINUTES TO AVOID PROLONGED QT INTERVALS)

400

How can we avoid EXTRAPYRAMIDAL SYMPTOMS?

GIVE BENZAMIDES WITH IV DYPHENHYDRAMINE

400

What gero considerations do we need to keep in mind when administering PHENOTHIAZINES?

PHENOTHIAZINES CAUSE EXCESSIVE SEDATION (esp. in elderly populations)

500

Which patients should avoid BISMUTH COMPOUNDS?

RENAL INSUFFICIENCY!

500

What important nursing considerations do we need to implement/educate to our patients taking SELECTIVE SEROTONIN ANTAGONISTS?

SELECTIVE SEROTONIN ANTAGONISTS are the most frequently used agents to treat Nausea/Vomitting!

- This med class is generally well-tolerated

- SELECTIVE SEROTONIN ANTAGONISTS have FEW DRUG-DRUG INTERACTIONS!

500

How should we give BENZAMIDES?

PUSH SLOWLY OVER 2 MINUTES!!!

500

If a patient has complex N/V, do we still give them PHENOTHIAZINES?

YES, we would administer EMOTOGENIC DOSES of CHEMO in combination for more complex cases of N/V

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