10.2.3 Corticosteroids and Cannabinoids

Question 1

How do corticosteroids act as anti-emetics?

Answer 1

Act on the CTZ

Can also act as D2 antagonists

Question 2

When are corticosteroids used as anti-emetics?

Answer 2

Perioperative nausea and vomiting

Chemotherapy

Palliation

Question 3

Give 2 examples of corticosteroids

Answer 3

Dexamethasone
Methylprednisolone

Question 4

What are the adverse effects of corticosteroids?

Answer 4

Insomnia
Osteoporosis
Weight gain
Increased appetite
Increased blood sugar
Cushing’s syndrome

Question 5

When do you not give corticosteroids?

Answer 5

Osteoporosis
Diabetes mellitus
Peptic ulcer disease

Question 6

How cannabinoids act as anti-emetics?

Answer 6

Acts on the CTZ
Good for chemotherapy- last line drug

Question 7

What is present in cannabinoids that acts on the CTZ?

Answer 7

Delta 9-THC

Question 8

Give an example of a cannabinoid

Answer 8

Nabilone

Question 9

What are the adverse effects of nabilone?

Answer 9

Confusion
Depression
Drowsiness
Dizziness
Movement disorders
Psychosis
Tremor
Visual impairment

Question 10

When should you not give nabilone?

Answer 10

Elderly patients
Heart disease
Psychiatric disorders

Question 11

What medications are used commonly for post-operative vomiting?

Answer 11

Metoclopramide
Prokinetics e.g. chewing gum
Hyoscine- reduces secretions

Question 12

How does chewing gum help reduce post-operative emesis?

Answer 12

Increases peristalsis due to chewing action and helps with ileus