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19 Cards in this Set

  • Front
  • Back
Antiemetics
1) Antihistamines (H1)
2) Anticholinergics
3) 5-HT antagonists
4) Phenothiazines
5) Metoclopramide
6) Cannabinoids
7) Other
1) Antihistamines
H1-receptor Antagonists
cinnarizine, cyclizine, dimenhydrinate, promethazine

best given before onset of nausea (eg. sea-sickness or med induced)
2) Anticholinergics
hyoscine - very good for motion sickness
3) 5-HT antagonists
5HT3 most useful: ondansetron, tropisetron, dolasetron

common, useful, widely used
4) Phenothiazines
promethazine, chloropromazine, prochlorperazine

multiple sites of action and multiple side effects
5) Metoclopramide
dopamine receptor antagonist

the one everyone knows - written up with morphine as Maxalon

uncommon, but dramatic side effects
6) Cannabinoids
eg. Cannabis, Nabilone

unsure MOA
7) Other
-steroids
-butyropherones (antidopaminergic)
-domperidone (antidopaminergic)
-sedatives eg. midazolam
-ginger
-peppermint water
What are antiemetics used for?
-chemotherapy
-postoperative N+V
-morning sickness
-motion sickness

CETZ (dopamine & 5HT)
VC (Ach)
Drugs for IBD
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
Drugs than INCREASE gut motility
1) Purgatives
(bulk laxatives, osmotic laxatives, faecal softeners, stimulant purgatives)
2) domperidone
3)metoclopromide
4) neostigmine
5) (cisapride)
6) erythromycin
Purgatives
"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
Domperidone
D2 receptor antagonist - antiemetic and increases gut motility

used for GORD and reduced gastric emptying
Metoclopramide
anti-emetic, D2 receptor antagonist - stimulates gastric emptying

used for GORD and reduced gastric emptying
(Cisapride)
similar to metoclopramide
no longer used
it caused arrythmias
Erythromycin
1/10 of antibiotic dose useful for promoting gut motility
Drugs that REDUCE gut motility
1) Treat the diarrhoea - fluid & electrolytes, infection

2) Reduce motility
a) opioids (eg. codeine)
b) anticholinergics (eg. atropine)
c) bismuth subsalicylate
Adsorbents
things dug out of the ground
OTC

eg. chalk and charcoal
Antisposmadics
not commonly used nowdays - for cramping pain and spasms in gut

eg. propantheline and dicyclomine, atropine and hyoscine

mebeverine (colofac) - but probs with arrythmias