8: Anti-Nausea And Vomiting Pharm Flashcards
CINV and RINV
Chemo and radiation - induced N/V
PONV
Post-op N/V
NVP
N/V in pregnancy
Eight classes of drugs used to treat nausea and vomiting (2 not listed in charts)
- 5HT receptor antagonists
- NK1 receptor antagonists
- H1 receptor antagonists
- D2 receptor antagonists
- M1 receptor antagonists
- CB receptor agonists
- Glucocorticosteroids
- Benzodiazepines
Where is serotonin released from in the gut?
Intestinal enterochromaffin cells
What two pt populations should you use caution with when giving 5HT receptor antagonists?
- Pts using other QT-prolonging agents
2. Pts with electrolyte imbalances (hypoK, hypoMag)
Other name for substance P
Neurokinin 1
What are the classic anti cholinergic effects
Drowsiness, dry mouth, constipation, urinary retention, blurred vision, decreased BP
How does cannabinoids being a scheduled drug affect our use of it?
Limits the quantity/refill # and Rx lifespan
Acute vs chronic vs anticipatory CINV
- Acute: occurs <24hrs after chemo
- Chronic: occurs >24hrs after chemo
- Anticipatory: occurs before chemo given
What if 4 drug regimen for high-emetogenic chemo is failing?
Add cannabinoid
What if 3 drug regiment for moderate emetogenic chemo is failing?
Add D2 antagonist (olanzapine)
Regimen for chemo that is minimal-emetogenic
No routine prophylaxis, just treat breakthrough N/V
Drug to treat breakthrough emesis with
Any agent from this lecture series
Stepped therapy for pregnancy-induced N/V: 3 levels of drugs to try
- Vitamin B6 or Histamine antagonist or 5HT antagonist (tend to work great)
- Dopamine antagonist
- Steroid or different dopamine antagonist
