Taking ondansetron with an SSRI antidepressant can contribute to serotonin syndrome.
Correct Answer
True
True. Ondansetron labeling warns of serotonin syndrome when it is combined with other serotonergic drugs such as SSRIs, so patients are watched for agitation, fever, tremor and rapid heart rate.
Category: Serotonin and NK1 Antagonists
Question 2
A scopolamine patch can be left in place during an MRI scan.
Correct Answer
False
False. The scopolamine patch has a metal-containing layer that can burn the skin during MRI, so its labeling directs that it be removed before the scan.
Category: Other Antiemetics
Question 3
Bismuth subsalicylate can temporarily turn the tongue and stool black.
Correct Answer
True
True. Bismuth combines with sulfur in the mouth and gut to form a black compound; the change is harmless, but tarry stool with other signs of bleeding still needs evaluation.
Category: Antidiarrheals
Question 4
Taking loperamide in amounts far above the labeled dose can cause serious heart rhythm problems.
Correct Answer
True
True. Misuse and abuse of loperamide at very high doses has caused QT prolongation, torsades de pointes, cardiac arrest and death, so patients are taught to use only the labeled amount.
Category: Antidiarrheals
Question 5
Castor oil is a recommended laxative for pregnant patients.
Correct Answer
False
False. Castor oil is a stimulant laxative that can trigger uterine contractions, so it is avoided in pregnancy.
Category: Laxatives
Question 6
Docusate should not be taken together with mineral oil unless a provider directs it.
Correct Answer
True
True. The detergent action of docusate can increase absorption of mineral oil from the bowel, so docusate labeling warns against using the two together unless a provider advises it.
Category: Laxatives
Question 7
Watery stool leaking around a fecal impaction can be mistaken for diarrhea.
Correct Answer
True
True. Liquid stool can seep around a hardened mass, so a patient with constipation risk who suddenly has small watery stools is assessed for impaction before an antidiarrheal is given.
Category: Laxatives
Question 8
Bulk-forming laxatives are a good choice when the bowel must be emptied quickly before a procedure.
Correct Answer
False
False. Bulk-forming laxatives act slowly and are used to promote regularity; rapid bowel evacuation calls for a saline, osmotic or stimulant product.
Category: Laxatives
Question 9
Diarrhea is the most common adverse effect of linaclotide.
Correct Answer
True
True. Linaclotide increases fluid secretion into the bowel, so diarrhea is its most common effect, and severe diarrhea means the drug is stopped and the provider contacted.
Category: IBS and IBD Drugs
Question 10
Bismuth subsalicylate is a safe choice for a patient with an aspirin allergy.
Correct Answer
False
False. Bismuth subsalicylate contains a salicylate, the same chemical family as aspirin, so its labeling says not to use it in people who are allergic to salicylates, including aspirin.
Category: Antidiarrheals
Question 11
Sulfasalazine can reduce folic acid absorption, so a folic acid supplement is often prescribed.
Correct Answer
True
True. Sulfasalazine interferes with folate absorption and metabolism, so patients on long-term therapy commonly receive folic acid.
Category: IBS and IBD Drugs
Question 12
Metoclopramide is safe to use when a mechanical bowel obstruction is suspected.
Correct Answer
False
False. Metoclopramide increases GI motility, so it is contraindicated when obstruction, perforation or GI bleeding is present or suspected.
Category: Dopamine Blocking Antiemetics
Question 13
Dronabinol acts by blocking cannabinoid receptors.
Correct Answer
False
False. Dronabinol is a synthetic cannabinoid that activates cannabinoid receptors, which reduces nausea and increases appetite.
Category: Other Antiemetics
Question 14
Aprepitant has no effect on how well hormonal contraceptives work.
Correct Answer
False
False. Aprepitant speeds the metabolism of hormonal contraceptives and can make them less effective, so a nonhormonal backup method is advised during treatment and for a period after the last dose.
Category: Serotonin and NK1 Antagonists
Question 15
Phenothiazine antiemetics such as prochlorperazine can cause orthostatic hypotension, so fall precautions are needed.
Correct Answer
True
True. Phenothiazines block alpha-adrenergic receptors as well as dopamine receptors, causing low blood pressure on standing along with sedation, so patients rise slowly and are protected from falls.
Category: Dopamine Blocking Antiemetics
Question 16
Mineral oil is a good laxative choice for a patient who has trouble swallowing.
Correct Answer
False
False. If mineral oil is aspirated it can cause lipid pneumonia, so it is avoided in patients with swallowing problems.
Category: Laxatives
Question 17
Methylnaltrexone and naloxegol are contraindicated when a GI obstruction is known or suspected.
Correct Answer
True
True. These peripherally acting opioid antagonists increase bowel activity and can cause perforation if the bowel is obstructed.
Category: Laxatives
Question 18
Diphenoxylate with atropine is a suitable antidiarrheal for a patient with obstructive jaundice.
Correct Answer
False
False. Obstructive jaundice is a contraindication to diphenoxylate with atropine, which also should not be used for diarrhea caused by pseudomembranous enterocolitis or toxin-producing bacteria.
Category: Antidiarrheals
Question 19
Senna is changed into its active form by bacteria in the colon.
Correct Answer
True
True. The sennosides in senna pass unchanged through the small intestine, and colon bacteria convert them into the active compound, which is why its laxative effect is delayed rather than immediate after an oral dose.
Category: Laxatives
Question 20
Ondansetron is an effective drug for preventing motion sickness.
Correct Answer
False
False. Motion sickness arises from inner-ear signals carried mainly through histamine and acetylcholine pathways, so anticholinergics such as scopolamine and antihistamines such as meclizine are used; 5-HT3 antagonists such as ondansetron do not prevent it.
Category: Serotonin and NK1 Antagonists