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Pharmacy > 301 N + V > Flashcards

301 N + V Flashcards

1
Q

Aetiology of N + V

A

Medulla oblongata - vomiting centre results in trigger of vomiting when activity reaches threshold
CTZ - located outside BBB and detects harmful toxins and compounds in blood
Involves CNS, ANS, gastric dysrhythmias & endocrine system

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2
Q

Why does chemotherapy cause N + V?

A

Body wants to expel it as it is killing body’s cells

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3
Q

Symptoms of N + V

A

Nausea, retching and emesis

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4
Q

Causes of N + V

A

Pregnancy
Motion sickness
Gastroenteritis
Migraine
Appendicitis
Cholecysitis
Cholelithiasis
Peptic or duodenal ulcers

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5
Q

N + V in pregnancy

A

Nausea affects 70% of women and vomiting 60%
Most common in 1st trimester
Occurs early morning
Caused by surge in hormone levels
Most much OTC due to licensing, refer to GP

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6
Q

Motion sickness

A

Nausea, pallor, vague abdominal discomfort & occasional vomiting
More common in children
Symptoms improve after prolonged exposure (habituation)
Inability of brain to process conflicting information from sensory nerve terminals regarding movement & position

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7
Q

Migraines

A

5 million sufferers in UK
Affects adolescence
Headache, visual disturbances, N + V
Headache and N + V treated separate

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8
Q

Gastroenteritis

A

Caused by virus or bacteria
Vomiting, diarrhoea, systemic illness
Vomiting precedes diarrhoea (do not treat diarrhoea as infection last longer and no vomiting)
Self limiting (up to 10 days)
Advise electrolytes for dehydration

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9
Q

Conditions to eliminate in N + V

A

Gastritis
Infants
<1 month (Hirschsprung’s disease)
1 month - 1 year
Children 1-12 years
Medicine induced
Excess alcohol consumption
Pregnancy

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10
Q

Medicine induced N + V

A

Cytotoxic meds
NSAIDs
Opiates
Iron
Antibiotics
SSRIs
Theophylline
Digoxin

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11
Q

RED flag symptoms in N + V

A

Suspected pregnancy
Vomiting under 1 for >24 hours
Children who fail to respond to OTC
Unexplained N + V in any age
Moderate to severe abdominal pain
Haematemesis

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12
Q

N + V management

A

Eat cold food
Drink plenty of fluids
Ginger products
Avoid laying down after eating
Eat small regular meals
Fresh air
Sir in front of car/bus
Choose window seat on planes/trains
Try to lay down, shut eyes, sleep or look at horizon
Distract yourself
Flavoured lozenges

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13
Q

N + V OTC management

A

Domperidone - no license
Prochlorperazine - only licensed in migraines
Antihistamines - motion sickness
Anticholinergics - motion sickness

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14
Q

Antihistamines used OTC for motion sickness

A

Cyclizine
Cinnarizine
Promethazine

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15
Q

Anticholinergics used OTC for motion sickness

A

Hyoscine
Scopolamine

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16
Q

MOA of domperidone (motilium)

A

Dopamine receptor antagonist
No crossing BBB
Antiemetic

17
Q

MOA of prochlorperazine

A

Antipsychotic
Blocks dopamine receptors located in CTZ

18
Q

Buccal administration

A
  1. Place tablet between upper lip and gum
  2. Allow tablet to dissolve slowly, tablet softens & becomes gel-like in 1-2 hours
  3. Tablet will take 3-5 hours to dissolve 4. Tablet should not be chewed crushed or swallowed
  4. Touching tablet with tongue or fluids can make it dissolve quicker
19
Q

Side effects of antihistamines

A

Dry mouth, constipation and sedation

20
Q

Interactions with antihistamines

A

Increased sedation with alcohol
Opioid analgesics, hypnotics and antidepressants

21
Q

Caution with antihistamines

A

Angle-closure glaucoma
Prostate enlargement

22
Q

Side effects of anticholinergics

A

Dry mouth, sedation and anticholinergics effects

23
Q

Interactions with anticholinergics

A

Increase anticholinergic side effects with TCAs, neuroleptics and other anticholinergic or antimuscarinic medication

24
Q

Caution with anticholinergics

A

Angle-closure glaucoma
Prostate enlargement

25
Q

Non-pharmacological treatments for N + V

A

Ginger - helps GI motility, safe in pregnancy, could be related to antagonist effects on serotonergic & cholinergic receptors
Acupressure bands - median nerve at pericardium 6 acupuncture point stimulated

Pharmacy (11 decks)

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