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16 Cards in this Set
- Front
- Back
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What brain region coordinates Emesis?
What area of the vagus is it near? Does the emetic area have a BB barrier? |
central emesis center in the
lateral reticular formation of the mid-brainstem adjacent to the chemo-receptor-trigger zone (CTZ) Nucleus tractus solitarius (NTS) no, it is directly on the floor of the 4th ventricle. |
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How does the emesis recieve input from the gut? (2)
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Vagus Nerve
Splanchinic afferents |
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Which receptors predom in the CTZ? (3) NTS? (4)
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- 5HT3, D2, Opiod
- enkephalin, histamine, cholinergic, and some 5HT3 |
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What is Ondansetron?
- uses? - are these useful in motion sickness? why? |
widley used for tx of chemo-induced emesis;
5HT3 antagonist - also used for nausea from upper GI irritation and hyperemesis of pregnancy - No! Motion sickness is caused by different signals. |
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What are the Phenothiazines (proclorperazine, chlorpromazine, thiethylperazine)?
- do they have anti-histamine and anti-cholinergic actv? |
D2 receptor antag @ the CTZ
- yes, both. |
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What is the usefulness of H1 antagonists?
- Where do they act? - examples? |
Motion sickness
post-op emesis - vestibular afferents and w/i the brain stem - Cyclizine Hydroxyzine Promethazine Dipehenhydramine |
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What is dronabinol?
- uses? - why is it also used in AIDs pts? |
Naturally occuring cannabinoid
- prophylactic in pts receiving cancer chemo when other antiemtics are ineffective - it can stim appetite |
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Do Glucocorticoids and NSAIDs help with nausea?
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They can help in pts with widespread cancer
- Mechanism maybe by suppressing peritumoral inflammation and prostaglandin production .... not well characterized though. |
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What are some intraluminal agents used to treat diarrhea in IBS pts? what do they do?
When are they usually used? |
Psyllium (METAMUCIL)
Polycarbophil (FIBERCON, FIBERALL) Carboxymethylcellulose Kaolin and pectin (KAOPECTOLIN) Attapulgite (DIASORB) Absorb water Constipation pts - unclear why they work in both cases. |
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What does Cholestyramine do?
- can it be given @ the same time as other drugs? |
Bile acid binding resin, can also bind some bacterial toxins.
- no, can't be given w/i a few hours; it can b/ medications. |
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What is pepto-bismol?
- is it antisecretory? - antiinflammatory? - antimicrobial? - can it help tx h. pylori? |
bismuth subsalicylate suspended in magnesium aluminun silicate clay and
is used as an over the counter antidiarrhetic. - yes to all - yes |
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Opioids are used to tx diarrhea - where do they primarily act?
- class? |
peripherally: m-opioid receptor
- antimotility/antisecretory |
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What is Loperamide?
- mech? |
Imodium; an OTC useful for tx traveler's diarrhea
- increases small intestine transit time and sphincter tone. |
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What are Dipenoxylate and Difenoxin?
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anti-diarrhea meds related to meperidine. These drugs have CNS effects and can be addictive.
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What is the name of the drug that is an analog of somatostatin and can be used to treat severe secretory diarrhea resulting from hormone-secreting tumors of the pancreas and GI tract?
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Sandostatin (Octreotide)
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Bran and dietary fiber can usually help alleviate what?
- bonus points: name some pharmacological tx |
constipation
- Saline and osmotic laxatives - Non-digestable sugars and alcohols - PEG - stimulant laxatives |
