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19 Cards in this Set
- Front
- Back
Antiemetics
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1) Antihistamines (H1)
2) Anticholinergics 3) 5-HT antagonists 4) Phenothiazines 5) Metoclopramide 6) Cannabinoids 7) Other |
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1) Antihistamines
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H1-receptor Antagonists
cinnarizine, cyclizine, dimenhydrinate, promethazine best given before onset of nausea (eg. sea-sickness or med induced) |
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2) Anticholinergics
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hyoscine - very good for motion sickness
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3) 5-HT antagonists
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5HT3 most useful: ondansetron, tropisetron, dolasetron
common, useful, widely used |
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4) Phenothiazines
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promethazine, chloropromazine, prochlorperazine
multiple sites of action and multiple side effects |
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5) Metoclopramide
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dopamine receptor antagonist
the one everyone knows - written up with morphine as Maxalon uncommon, but dramatic side effects |
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6) Cannabinoids
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eg. Cannabis, Nabilone
unsure MOA |
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7) Other
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-steroids
-butyropherones (antidopaminergic) -domperidone (antidopaminergic) -sedatives eg. midazolam -ginger -peppermint water |
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What are antiemetics used for?
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-chemotherapy
-postoperative N+V -morning sickness -motion sickness CETZ (dopamine & 5HT) VC (Ach) |
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Drugs for IBD
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Symptoms - antispasmotics, antimotility agents, fluid and electrolyte replacement
Specific therapy 1) Glucocorticoids 2) Salicylate compounds 3) Azathioprine 4) Anti-TNF agents 5) Antibiotics 6) Experimental drugs If you have IBD you need an anti-inflammatory, and the 2 main ones are GLUCOCORTICOIDS and SALICYLATE COMPOUNDS |
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Drugs than INCREASE gut motility
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1) Purgatives
(bulk laxatives, osmotic laxatives, faecal softeners, stimulant purgatives) 2) domperidone 3)metoclopromide 4) neostigmine 5) (cisapride) 6) erythromycin |
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Purgatives
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"hastens passage through the gut"
A) Bulk laxatives (eg. Bran) indigestable polysaccharides - retain water in lumen - promote peristalsis (takes days) B) Osmotic laxatives - eg. lactulose before colonscopy, osmotic drag fluid into gut (takes hours) C) Faecal softeners, eg. docusate sodium after anal surg, acts like a detergent -> soft stools D) Stimulant Purgatives (eg. bisacodyl for pranks), stimulate water & electrolyte secretion into lumen -> increasing peristalsis |
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Domperidone
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D2 receptor antagonist - antiemetic and increases gut motility
used for GORD and reduced gastric emptying |
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Metoclopramide
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anti-emetic, D2 receptor antagonist - stimulates gastric emptying
used for GORD and reduced gastric emptying |
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(Cisapride)
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similar to metoclopramide
no longer used it caused arrythmias |
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Erythromycin
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1/10 of antibiotic dose useful for promoting gut motility
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Drugs that REDUCE gut motility
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1) Treat the diarrhoea - fluid & electrolytes, infection
2) Reduce motility a) opioids (eg. codeine) b) anticholinergics (eg. atropine) c) bismuth subsalicylate |
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Adsorbents
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things dug out of the ground
OTC eg. chalk and charcoal |
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Antisposmadics
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not commonly used nowdays - for cramping pain and spasms in gut
eg. propantheline and dicyclomine, atropine and hyoscine mebeverine (colofac) - but probs with arrythmias |