Control nausea and prevent vomiting. Include: phenothiazines, anticholinergics, antihistamines, 5HT3-receptor antagonists, and dopamine receptor antagonists.
Block dopamine receptors in the chemotrigger zone of the brain, inhibiting one or more of the vomiting reflex pathways. DRUGS: promethazine (Phenergan) and prochlorperazine (Compazine). SE: involuntary muscle spasms, jitteriness, mouth puckering, rash, sedation. AE: neuroleptic malignant syndrome, neutropenia. P/AE: tardive dyskinesia, respiratory depression.
Inhibit other pathways of the vomiting reflex, stop intestinal cramping, and inhibit vestibular input (balance and position) into the CNS. DRUG: scopolamine (L-hyoscine). SE: blurred vision, dilated pupils, rash, urinary retention.
Block the action of histamine at the H1 receptor sites. Inhibit the same pathways as anticholinergic drugs and depress inner ear excitability, reducing vestibular stimulation. DRUGS: cyclizine (Marezine) and meclizine (Antivert). SE: hypotension. AE: respiratory depression.
5HT3-Receptor Antagonist Drugs
Bind to and block serotonin receptors in the intestinal tract and the chemotrigger zone of the brain, interrupting at least two pathways of the vomiting reflex. DRUGS: granisetron (Kytril) and ondansetron (Zofran).
Dopamine Antagonist Drugs
Directly block dopamine from binding to receptors in the chemtrigger zone and the intestinal tract, making food move more quickly, less likely to stimulate vomiting reflex. DRUGS: metoclopramide (Reglan) and trimethobenzamide (Tigan). SE: increased depression, restlessness. R/AE: neuroleptic malignant syndrome, tardive dyskinesia. T/AE: coma, seizures.
Help the body eliminate hard stools, include: bulk-forming laxatives, stool softeners, lubricants, saline laxatives, and stimulant laxatives.
Bulk-Forming Laxative Drugs
Add bulk to the stool, stimulating peristalsis. DRUGS: methylcellulose (Citrucel) and psyllium (Fiberall, Metamucil). SE: bronchospasm, intestinal or esophageal obstruction. AE: hyperglycemia.
Emollients / Stool-Softening Drugs
Soften stool, allowing it to mix with fatty substances, making it easier to eliminate. DRUGS: docusate (Colace) and docusate sodium and casanthranol (Peri-Colace). SE: throat irritation, rashes.
Stimulate peristalsis. DRUG: bisacodyl (Dulcolax). SE: hypokalemia, rectal burning. AE: hypokalemia.
Osmotic Laxative Drugs
Cause retention of fluid in the bowel, increasing the water content in stool. DRUGS: lactulose (Cephulac), lubiprostone (Amitiza), magnesium hydroxide (Milk of Magnesia), polyethylene glycol (GoLYTELY, MiraLax) and sodium phosphate (Fleet Enema). SE: belching, flatulence, hypoglycemia, abdominal distension, peripheral swelling, reflux, flushing, sweating, electrolyte imbalance.
Coat the surface of stool and help it hold water so the body can more easily expel it. DRUGS: castor oil (Purge) and glycerin suppository (Sani-Supp). SE: belching, hyperemia of rectal mucosa, rectal discomfort. AE: confusion, irregular heartbeat, muscle cramps, skin rash, unusual tiredness or weakness.
Control diarrhea and some of the symptoms that occur with this condition. Three types: antimotility, adsorbent/absorbent, and antisecretory.
Slow the movement of stool through the bowel, allowing more time for water and essential salts to be absorbed by the body. DRUGS: difenoxin with atropine (Motofen), dephenoxylate with atropine (Lomotil), loperamide (Imodium) and paregoric (Camphorated Opium Tincture). SE: blurred vision, insomnia, urinary retention, tachycardia, distension, loss of appetite.
Remove substances that cause diarrhea from the body. DRUGS: attapulgite, bismuth subsalicylate (Kaopectate) and calcium polycarbophil (FiberCon). SE: tinnitus, impaction, flatulence. PEDS: no bbismuth.
Decrease secretion of intestinal fluids and slow bacterial activity. DRUGS: bismuth subsalicylate (Pepto-Bismol). SE: tinnitus, impaction. PEDS: no bismuth.