NCLEX Medications Affecting Digestion and Nutrition (part 2)


NCLEX Medications Affecting Digestion and Nutrition (part 2)

You can find part 1 here –

Prostaglandin E Analog

Expected Action:

ò acid secretion / ñ secretion of HCO3 and mucus / ñ submucosal vasodilation.

Example: misoprostol (Cytotec)

Therapeutic Uses: Long-term NSAID therapy, induce labor by causing cervical ripening.

Adverse Effects: Diarrhea and abdominal pain, Dysmenorrhea and spotting


Pregnancy (X), Potential to become pregnant


Antiemetics (Types)

  • Serotonin antagonists…………….. ondansetron (Zofran)
  • Dopamine antagonists prochlorperazine (Compazine)
  • Glucocorticoids……………. dexamethasone (Decadron)
  • Cannabinoids…………………………… dronabinol (Marinol)
  • Anticholinergics………. scopolamine (Transderm Scop)
  • Antihistamine…………….. dimenhydrinate (Dramamine)
    • Others
  • Granisetron (Kytril)
  • Promethazine (Phenergan)
  • Metoclopramide (Reglan)
  • Hydroxyzine (Vistaril)
  • Aprepitant (Emend)



(Action, Use, Effects, Interactions)

Agent – Action – Use

Ondansetron — V SERR in CTZ & vagal nerve — Chemo, radiation, postop

Prochlorperazine — V DOPR in CTZ — Chemo, opioids, postop

Dexamethasone – Unknown — Combo for chemotherapy

Dronabinol – Unknown — Chemotherapy (CINV)

Scopolamine — V impulses: inner ear ’ VC — Motion sickness

Dimenhydrinate  — V HISR MUSR inner ear ’ VC — Motion sickness


Agent —- Adverse Affect

Ondansetron — Headache, diarrhea, dizziness

Prochlorperazine — EPS (Tx ĉ Benadryl or Ativan), hypotension, sedation, and anticholinergic effects.

Dronabinol — Dissociation, dysphoria, hypotension, tachycardia

AntiCh, AntiHis — Sedation, anticholinergic effects


CTZ = chemoreceptor trigger zone

CNS depressants / Antihypertensives / Anticholinergics ’ Additive Effects

Watch for Antagonists ĉ urinary retention, asthma, and narrow-angle glaucoma

Combo therapy allows lower doses of each \ decreased side effects



Expected Action:

Activate opioid receptors in GI to decrease motility and increase absorption of water & Na+

Example: diphenoxylate (Lomotil), Others: loperamide (Imodium), difenoxin (Motofen)


  • Adverse Effects: At recommended doses, diphenoxylate has no CNS effects, ñ diphenoxylate doses ’ typical opioid responses


Contraindications/Precautions: Pregnancy  (?) , increased risk of megacolon with inflammatory bowel disorders ’ serious complications including perforated bowel.

Interactions: CNS depressants increased depressive effect

Education: Encourage use of electrolyte replacement drinks, Avoid plain water (no electrolytes) and caffeine (increased motility), Manage dehydration (weight, VS, I&O) – 0.45% NS may be prescribed


Prokinetic Agents

Expected Action:

  • V dopamine and serotonin receptors in CTZ \ decreases emesis

Augments action of acetylcholine to increases upper GI motility

Proto: metoclopramide (Reglan)

Therapeutic Uses: Postop and chemo-induced nausea and vomiting, GERD, Diabetic gastroparesis

Adverse Effects: EPS: Restlessness, spasms of face & neck. Minimize EPS with benzodiazepine like lorazepam (Ativan)., Diarrhea, Sedation


Pregnancy (?), Seizure disorder (increased seizure risk), Caution with Kids and older adults due to increased risk of EPS


Concurrent EtOH or CNS depressant: ñ seizure / sedation risks, Opioids and anticholinergics ò effects of metoclopramide.


Dose ≥ 10 mg — dilute in 50 mL D5W or Ringer’s; Infuse over 15m


Past Medication posts –

Diuretics –

Respiratory Meds –

Blood –

Nervous System Meds (4 parts)


Cardiac Medications

Part 1 –
Part 2 –
Part 3-

Pain Meds and Inflammation –

Immunity and Chemo –

Anti Infective Drugs –

More information can be found on our blog –


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