Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
32 Cards in this Set
- Front
- Back
|
Name 5 neurotransmitters involved with nausea & vomiting
|
- M1 - D2 - H1 - 5HT-3 - NK1
|
|
|
What are physiologic causes of nausea & vomiting?
|
- constipation - gastric stasis/outlet obstruction - brain metasteses - increased intercranial pressure - bowel/intestinal obstruction - hepatomegaly - oral thrush - cough
|
|
|
What are some metabolic causes of nausea & vomiting?
|
- uremia - endocrine imbalance - electrolyte imbalance (hypercalcemia, hyponatremia)
|
|
|
What are some treatment-related causes of nausea & vomiting?
|
- chemotherapy - radiation therapy - opioid therapy (narcotics) - antibiotics (tetrocyclines, quinolones) - aspirin/NSAIDS - Carbamazepine - Steroids
|
|
|
Where is the Chemotrigger Zone?
|
underneath the 4th ventricle; in front of the cerebellum
|
|
|
What is the area postrema?
|
the area of the vomiting center where the majority of the neurotransmitters are located
|
|
|
Name different types of nausea & vomiting
|
- Post-op N/V - obstruction - chemotherapy - gastroenteritis/gastroperesis - pregnancy - vestibular neuritis (labyrinthitis) - unidentified origin
|
|
|
Name a muscarinic (M1) receptor antagonist used to treat nausea & vomiting
|
Scopolamine (aka transdermscop)
|
|
|
Name 4 antihistamines used to treat nausea & vomiting
|
- Diphenhydramine (Benadryl) - Dimenhydrate (Dramamine) - Meclizine (Antivert) - Promethazine (Phenergan)
|
|
|
Meclizine (Antivert) blocks which receptor?
|
Histamine 1 (H1)
|
|
|
Promethazine (Phenergan) blocks which receptors?
|
5HCT, muscarinic, and histamine receptors
|
|
|
What is a common side effect of anticholinergic agents?
|
sedation
|
|
|
Name the 3 classes of Dopamine receptor antagonists
|
1. Phenothiazines 2. Butyrophenone 3. Benzamides
|
|
|
What is the mechanism of action for Phenothiazines?
|
- antagonize D2 receptors in the postrema - also have M1 and H1 blocking effects
|
|
|
Give 2 examples of phenothiazines
|
1. Prochlorperazine (Compazine) 2. Chlorpromazine (Thorazine)
|
|
|
What are the different formulations of Compazine and Thorazine?
|
IV, IM, supp, PO
|
|
|
Which drug is used to treat hiccups?
|
thorazine
|
|
|
When is compazine given orally?
|
to treat anticipitory nausea & vomiting
|
|
|
What are some side effects of phenothiazines?
|
- dytonias (involuntary rigid muscle movements) - tardive dyskinesia (repetitive movements)
|
|
|
What is used to treat acute dystonias?
|
anticholinergic drugs (benadryl)
|
|
|
When are butyrophenones used?
|
- for nausea & vomiting of preanesthetic or post-op patients
|
|
|
Name 2 types of Butyophenones
|
- Droperidol (Inapsine) - Haloperidol (Haldol)
|
|
|
What is the half-life of Haloperidol (Haldol)?
|
18 hrs
|
|
|
Give an example of a Benzamide
|
Metoclopramide (Reglan)
|
|
|
What are some effects of Metoclopramine (Reglan)?
|
- at low doses, it is a central and peripheral D2 antagonist - at high doses, it is a 5-HT3 blocker - stimulates cholinergic receptors on gastrin smooth muscle (slows down gastric motility)
|
|
|
Give 4 examples of Serotonin antagonist
|
- Ondasteron (Zofran) - Granisetron (Kytril) - Dolasetron (Anzemet) - Palonosetron (Aloxi)
|
|
|
Which serotonin antagonist is used for chemo-induced nausea & vomiting?
|
Palonosetron (Aloxi)
|
|
|
Which drug is indicated to treat N/V in pregnant women?
|
Ondasteron (Zofran)
|
|
|
What is Arprepitant (Emend)?
|
- a new class of antiemetics - used to treat chemo-induced nausea & vomiting
|
|
|
Name 2 corticosteroids used for N/V
|
Dexamethasone (Decadron) Methylprednisilone (Medrol)
|
|
|
Give an example of a cannabinoid used to treat N/V
|
Marinol
|
|
|
What are some side effects of Cannabinoids?
|
- Xerostomia (dry mouth) - vertigo - hypotension
|
