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GI - 2 > Agents for Nausea and Vomiting - specific applications > Flashcards

Agents for Nausea and Vomiting - specific applications Flashcards

1
Q

What Serotonin Receptor Antagonist is used to treat IBS-D?

A

Alosetron

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2
Q

Adverse effects of Serotonin Receptor Antagonists?

A

Serotonin Syndrome - occurs with other 5HT drugs

Dose-Dependent QT prolongation (Torsades)

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3
Q

What is the most worrisome Serotonin Receptor Antagonist adverse effect and when should you used extra caution?

A

Dose-Dependent QT prolongation (Torsades)

- When patients are taking other antiarrhythmic drugs or have hypokalemia/hypomagnesemia

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4
Q

When should you use extra caution with Serotonin Receptor Antagonists to avoid Dose-Dependent QT prolongation?

A

When patients are taking other antiarrhythmic drugs or have hypokalemia/hypomagnesemia

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5
Q

What Serotonin Receptor Antagonist drug specifically, has the highest risk to cause QT prolongation?

A

Dolasetron

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6
Q

Which Serotonin Receptor Antagonists are effective SINGLE dose agents for delayed chemo N/V?

A

Palonosetron

Granisetron

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7
Q

When are Neurokinin1 Receptor Antagonists the most effective?

A

When used in combination with other agents to treat chemo-induced N/V

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8
Q

When are Neurokinin1 Receptor Antagonists the most effective?

A

When used in combination with other agents to treat chemo-induced N/V

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9
Q

Which NK1 Receptor Antagonists have the most active metabolites and longer half lives?

A

Netupitant

Rolapitant

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10
Q

Initial pregnancy N/V treatment?

A

Doxylamine + B6

H1 receptor antagonist

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11
Q

Initial pregnancy N/V treatment?

A

Doxylamine + B6

H1 receptor antagonist

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12
Q

Adverse effects of Histamine1 Receptor Antagonists?

A

Anticholinergic:

  • Drowsy, blurred vision, low BP
  • Constipation and urinary retention
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13
Q

Adverse effects of Histamine1 Receptor Antagonists?

A

Anticholinergic:

  • Drowsy, blurred vision, low BP
  • Urinary retention, constipation
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14
Q

What is the only indication to use Meclizine and Cyclizine?

A

Motion sickness/vertigo

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15
Q

What is the only indication to use Meclizine and Cyclizine?

A

Motion sickness/vertigo

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16
Q

Which Histamine1 Receptor Antagonists are used to treat motion sickness/vertigo?

A

Meclizine

Cyclizine

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17
Q

What Dopamine (D2) Receptor Antagonist is used ONLY for Post-op N/V?

A

Amisulpride

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18
Q

Amisulpride is only used for?

A

Post-op N/V

D2 receptor antagonist

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19
Q

Amisulpride is only used for?

A

Post-op N/V

D2 receptor antagonist

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20
Q

What Dopamine (D2) Receptor Antagonist can also enhance GI motility/treat gastroparesis?

A

Metoclopramide

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21
Q

Metoclopramide can also treat?

A

GI dysmotility

Gastroparesis

22
Q

Metoclopramide can also treat?

A

GI dysmotility

Gastroparesis

23
Q

Adverse effect of ALL of the D2 Receptor Antagonists?

A

Drowsy

24
Q

Adverse effect of ALL of the D2 Receptor Antagonists?

A

Drowsy

25
Q

Adverse effects of Prochlorperazine?

A
  • urinary retention and constipation

- dry mouth and blurred vision

26
Q

Adverse effects of Amisulpride?

A

Chills, hypokalemia, hyperprolactinemia

27
Q

Which drug/class is a patch that can be worn for 72 hours?

A

Scopolamine

- Muscarinic1 Receptor Antagonist

28
Q

When is Scopolamine most commonly used?

A

Motion sickness

End-of-life care for excessive secretions

29
Q

When is Scopolamine most commonly used?

A

Motion sickness

End-of-life care for excessive secretions

30
Q

Adverse effects of Scopolamine?

A

Anticholinergic:

  • Drowsy and blurred vision
  • Urinary retention and constipation
  • Dry mouth
31
Q

What drug class is FDA-scheduled (controlled) due to abuse potential?

A

Cannabinoid (CB) Receptor Agonists

32
Q

Cannabinoid receptor agonists (+) which receptors?

A

Central (CB1) and Peripheral (CB2)

33
Q

Once the CB1/2 receptors are activated, what does that do?

A

Decreases excitability of neurons

34
Q

When are CB receptor agonists used?

A

TREATMENT-RESISTANT scenarios

35
Q

When are CB receptor agonists used?

A

Treatment - Resistant scenarios

36
Q

Adverse effects of CB receptor agonists usually effect?

A

CNS

37
Q

The proper focus of therapy from Chemo-induced N/V is on?

A

Prevention

38
Q

Acute chemo-induced N/V

A

Less than 24 hours after chemo

39
Q

Chronic chemo-induced N/V

A

More than 24 hours after chemo

40
Q

Anticipatory chemo-induced N/V

A

BEFORE chemo

41
Q

HIGH-ematogenic regimen involves how many drugs?

A

4

42
Q

What 4 drug classes are chosen for HIGH-ematogenic regimens?

A
  1. D2 receptor antagonist
  2. NK1 antagonist
  3. 5HT antagonist
  4. Corticosteroid (Dexamethasone)
43
Q

4 drugs are given the day of chemo for HIGH-ematogenic regimens. For 3 days after, what 3 drugs are given?

A
  1. D2 receptor antagonist
  2. NK1 antagonist
  3. Corticosteroid (Dexamethasone)
44
Q

MODERATE-ematogenic regimen involves how many drugs?

A

3

45
Q

What 3 drug classes are chosen for MODERATE-ematogenic regimens?

A
  1. NK1 antagonist
  2. 5HT antagonist
  3. Corticosteroid (Dexamethasone)
46
Q

3 drugs are given the day of chemo for MODERATE-ematogenic regimens. For 2 days after, what 2 drugs are given?

A
  1. NK1 antagonist

2. Corticosteroid (Dexamethasone)

47
Q

LOW-ematogenic regimens involve how many drugs?

A

1

48
Q

Minimal-ematogenic regimens involve how many drugs?

A

0

49
Q

For Breakthrough Emesis, what drug do you give?

A

ANY in this lecture

50
Q

For Breakthrough Emesis, what drug do you give?

A

ANY in this lecture

GI - 2 (61 decks)

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