Concept of Enemas,Emetics – This book covers the entire syllabus of “Pharmacology” prescribed by BNMC- for diploma in nursing science & midwifery students. We tried to accommodate the latest information and topics. This book is an examination setup according to the teachers’ lectures and examination questions.
At the end of the book, previous questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept of Enemas
Enemas produce defecation by softening faeces and distending the bowel.
They are used in bowel preparation for:
1. CIT surgery.
2. Radiological examination.
3. Endoscopy
4. Colonoscopy.
5. Before delivery.

Drugs causing constipation:
1. Opioid analgesics.
2. Anti-muscarinic agents (atropine, scopolamine)
3. Anti-parkinsonian drugs(orphenadrine)
4. Tricyclic anti-depressants (amitryptyline)
5. Aluminum containing antacids.
6. Iron.
7. Calcium channel blockers (verapamil, diltiazem)
8. Benzodiazipines (Diazepam. clonazepam).
Emetics
Emesis (vomiting) is a productive function that serves to remove unstable materials from the stomach that have been swallowed.
Drugs causes vomiting:
1. Cytotoxic drugs (cisplatin)am J-Ha
2. Opioid analgesics (apomorphine)
3. Ipecachuanha.
4. CuSO4
5. Oestrogen (endogenous, during pregnancy)

Classification of Emetics:
According to site of action:
A. Centrally acting (by stimulation of CTZ)
1. Morphine
2. Apomorphine
3. Hydergine
4. Picrotoxin
5. Nikethamide
B.. Peripherally acting:
1. Mustard
2. Antimony and K+ tartrate
3. Hypertonic NaCl solution
4. Salts of heavy metals
B. Both centrally and peripherally acting:
Ipecacuanha (consists of two alkaloids: emetine and cephaeline).
Indication of Emetics:
1. In acute poisoning, to remove drugs and chemicals ion stomach (except corrosives).
2. In alcohol intoxication.
3. Acute indigestion.
4. Spasmodic croup, to remove materials blocking respiratory airway if facilities for suction drainage is not available.
5. In paroxysmal tachycardia.
6. In malingering.

Contraindication of Emetics:
1. Cardiac decompensation
2. Hypertension
3. Pulmonary tuberculosis
4. Pregnancy
5. Hernia
6. Advanced peptic ulcer
7. GIT erosions.
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