The 5-HT3 antagonist that is available as a transdermal patch for chemotherapy-induced nausea and vomiting is granisetron.
Missing Word
granisetron
Granisetron comes as tablets, injection and a skin patch applied before chemotherapy; like other 5-HT3 antagonists it blocks serotonin signals that trigger vomiting.
Category: Serotonin and NK1 Antagonists
Question 2
The dopamine-blocking antiemetic that is also approved to treat intractable hiccups and psychotic disorders is chlorpromazine.
Missing Word
chlorpromazine
Chlorpromazine blocks dopamine in the chemoreceptor trigger zone and is also an antipsychotic; it is used less often for nausea than related drugs because of its sedation, low blood pressure and extrapyramidal effects.
Category: Dopamine Blocking Antiemetics
Question 3
The bulk-forming laxative made from the husks of plantago seeds is psyllium.
Missing Word
psyllium
Psyllium is a soluble fiber that absorbs water to soften stool and add bulk, so it must be taken with plenty of fluid.
Category: Laxatives
Question 4
The first step in preventing constipation is lifestyle change: plenty of fluids, regular activity and more whole grains, fruits and vegetables to raise intake of dietary fiber.
Missing Word
fiber
Dietary fiber holds water in the stool and adds bulk, which speeds transit through the colon. Laxatives are meant for short-term use alongside these measures, because regular long-term use can lead to dependence.
Category: Laxatives
Question 5
The over-the-counter opioid-receptor antidiarrheal that does not readily cross the blood-brain barrier at usual doses is loperamide.
Missing Word
loperamide
Loperamide slows intestinal motility through mu-opioid receptors in the gut wall, and at labeled doses it causes little central opioid effect.
Category: Antidiarrheals
Question 6
The first-generation antihistamine that is given as an antiemetic and is also prescribed for anxiety and itching is hydroxyzine.
Missing Word
hydroxyzine
Hydroxyzine blocks H1 receptors and has anticholinergic and sedating effects; when injected it is given deep intramuscularly into a large muscle.
Category: Other Antiemetics
Question 7
The tumor necrosis factor blocker given by IV infusion to treat moderate to severe Crohn's disease and ulcerative colitis is infliximab.
Missing Word
infliximab
Infliximab is a monoclonal antibody that binds tumor necrosis factor and reduces bowel inflammation. Because blocking this signal weakens defenses against infection, the nurse watches for signs of infection and for reactions during and after each infusion.
Category: IBS and IBD Drugs
Question 8
Live microorganisms, such as Lactobacillus species, taken to help restore normal intestinal flora are called probiotics.
Missing Word
probiotics
Probiotics are sometimes used during antibiotic therapy or after diarrhea to support the normal balance of gut bacteria.
Category: Antidiarrheals
Question 9
The stimulant laxative that can be given either as an oral tablet or as a rectal suppository is bisacodyl.
Missing Word
bisacodyl
Bisacodyl stimulates nerves in the colon wall to increase peristalsis. The suppository works faster than the tablet; for insertion the patient lies on the left side and then holds the suppository in as long as possible.
Category: Laxatives
Question 10
The prescription opioid-related antidiarrheal that is marketed in combination with atropine is diphenoxylate.
Missing Word
diphenoxylate
Diphenoxylate acts on opioid receptors in the bowel wall to slow motility. It is a controlled substance that can cause drowsiness and dry mouth, and patients report abdominal distension or severe abdominal pain right away.
Category: Antidiarrheals
Question 11
The minimally absorbed antibiotic that is approved to treat irritable bowel syndrome with diarrhea is rifaximin.
Missing Word
rifaximin
Rifaximin stays mostly in the gut, where it changes the bacterial population; it is also used for travelers' diarrhea and hepatic encephalopathy.
Category: IBS and IBD Drugs
Question 12
The anti-inflammatory compound that colon bacteria release from sulfasalazine, and that is also given on its own for ulcerative colitis, is mesalamine.
Missing Word
mesalamine
Mesalamine, also called 5-aminosalicylic acid, acts locally on the colon lining to reduce inflammation. Given alone, it avoids the sulfa portion of sulfasalazine, which causes many of that drug's systemic adverse effects.
Category: IBS and IBD Drugs
Question 13
Prochlorperazine and promethazine belong to the class of antiemetics called phenothiazines.
Missing Word
phenothiazines
Phenothiazines block dopamine in the chemoreceptor trigger zone and also affect histamine, acetylcholine and alpha-adrenergic receptors, causing sedation and orthostatic hypotension.
Category: Dopamine Blocking Antiemetics
Question 14
The peripherally acting opioid antagonist given by subcutaneous injection to relieve opioid-induced constipation is methylnaltrexone.
Missing Word
methylnaltrexone
Methylnaltrexone blocks mu-opioid receptors in the bowel but does not reach the brain, so it restores bowel movements without reversing pain relief. It can act quickly, so the patient should stay near a toilet after the injection.
Category: Laxatives
Question 15
The chloride channel activator taken for chronic idiopathic constipation and for irritable bowel syndrome with constipation is lubiprostone.
Missing Word
lubiprostone
Lubiprostone opens chloride channels in the intestinal lining, increasing fluid secretion and softening stool; nausea is its most common adverse effect.
Category: IBS and IBD Drugs