Al-Mehdi: Drugs for Nausea and Vomiting

Question 1

pt experiences vomiting w/out nausea and shows sign of papilledema

Answer 1

tumor

Question 2

drug used for testicular cancer w/ SE of N/V

Answer 2

Cisplatin

Question 3

feeling of a need to vomit; involves cerebral cortex

Answer 3

nausea

Question 4

emesis

Answer 4

vomiting

Question 5

effortless passage of gastric contents into mouth

Answer 5

regurgitation

Question 6

repeated regurgitation of food residue; may be rechewed and reswallowed

Answer 6

rumination

Question 7

uses antiperstalsis

Answer 7

emesis

Question 8

controller of all emesis info. in brainstem and sends for action

Answer 8

emesis center

Question 9

area in brainstem that regulates both appetite and emesis

Answer 9

area postrema

Question 10

CTZ (chemoreceptor trigger zone) located where

Answer 10

area postrema

Question 11

area in brainstem that receives peripheral neural input

Answer 11

NTS

Question 12

area in brainstem that receives input from sympathetic afferents and vagal afferents about N/V

Answer 12

NTS

Question 13

area in brainstem that receives peripheral humoral input

Answer 13

area postrema

Question 14

drugs in the blood reach emesis center through what

Answer 14

area postrema

Question 15

areas in brainstem that receives central neural input

Answer 15

vestibular nuclei and emesis center

Question 16

nausea develops as a result of activation of the ______ from emesis center info.

Answer 16

cerebral cortex

Question 17

retroperistalsis
pyloric constriction
abd and thoracic wall contraction

Answer 17

effectors for emesis

Question 18

2 routes to cause vomiting from emesis center

Answer 18

straight to effectors
to dorsal nucleus then vagus

Question 19

Answer 19

vestibular nuclei

Question 20

Answer 20

NTS

Question 21

Answer 21

area postrema

Question 22

Answer 22

emesis center

Question 23

drugs that bind what 2 receptors are most effective (b/c the receptors are in the 3 main centers for N/V in brainstem)

Answer 23

5-HT3 and D2

Question 24

_____ receptor found in vestibular nuclei, NTS, and emesis center

Answer 24

H1

Question 24

Anti-5-HT3 drugs

Answer 24

-setrons

Question 24

anti-H1 and anti-M drugs

Answer 24

Diphenhydramine Dimenhydrinate

Question 25

corticosteroid that binds GR in NTS

Answer 25

Dexamethasone

Question 26

Anti-D2 drugs

Answer 26

Metoclopramide Domperidone

Question 27

Answer 27

anti-psychotics that act as anti-D2 too

Question 28

Meclizine Cyclizine

Answer 28

Anti-H1

Question 29

Anti-H1 drug that is used in pregnancy

Answer 29

Doxylamine

Question 30

emesis Gq receptors

Answer 30

H1 NK1 a1 M1 M3

Question 31

emesis Gi receptors

Answer 31

u, D2, CB1

Question 32

-setron used for IBS-D that is not antiemetic drug

Answer 32

Alosetron

Question 33

Answer 33

-setrons not including Alosetron

Question 34

anti-emetic effects______ long after 5-HT3 blockers disappear from circulation

Answer 34

persist

Question 35

use this type of drug w/ chemo, radiation and pre and post op; safe in pregnancy

Answer 35

-setrons

Question 36

SE of -setrons

Answer 36

constipation (blocks 5-HT3 effect on Ach (M3)

Question 37

Answer 37

Anti-D2 Metoclopramide

Question 38

use this Anti-D2 drug in N/V and gastroparesis

Answer 38

Anti-D2 Metoclopramide

Question 38

acute adverse effects of this drug include acute dystonia (muscle spasms) and akathisia (restlessness)

Answer 38

Anti-D2 metoclopramide

Question 39

____blocks prolactin

Answer 39

dopamine

Question 40

SE of this drug is hyperprolactinemia

Answer 40

anti-D2 metoclopramide

Question 41

CI in Achalasia

Answer 41

anti-D2 metoclopramide

Question 42

this anti-D2 drug does not cross BBB

Answer 42

Domperidone

Question 43

antiemetic D2 block in area postrema and D2 block in stomach

Answer 43

Anti-D2 domperidone

Question 44

this Anti-D2 drug is used in GERD and postsurgical gastroparesis and diabetic gastroparesis

Answer 44

Anti-D2 Domperidone

Question 45

1st generation cross BBB and also block M1

Answer 45

anti-H1 drugs

Question 46

M1 blocker (which would mainly target M1 in brain)

Answer 46

SCOPOLAMINE

Question 47

blocks NK1 (receptor for substance P) in CTZ

Answer 47

anti-NK1 APREPITANT

Question 48

what drug to use in Cisplatin-induced emesis in early phase

Answer 48

Ondansetron

Question 49

Anti-NK1 drugs to use in late phase Cisplatin induced emesis

Answer 49

APREPITANT and FOSAPREPITANT

Question 50

why is there morning sickness in the first 1/2 of pregnancy

Answer 50

elevated hCG

Question 51

an elevation in this causes stimulation of gastric CCK receptors

Answer 51

hCG

Question 52

Answer 52

to treat emesis in first 1/2 of pregnancy

Question 53

main drug that is now used in morning sickness during first 1/2 of pregnancy

Answer 53

Doxylamine

Question 54

when is hyperemesis most common in the 1st and 2nd trimesters

Answer 54

multiple gestation

Question 55

to Rx hyperemesis in pregnancy

Answer 55

hospitalize and antiemetics

Question 56

explain effect of protracted emesis (metabolic alkalosis)

Answer 56

lose HCl- when vomiting HCO3-/Cl- exchanger activated increase in serum HCO3-

Question 57

____required to breakdown food after a meal and leads to postprandial alkalosis

Answer 57

HCl (turns on exchanger and increase in HCO3- in blood)

Question 58

what maintains Cl- depleted alkalosis

Answer 58

pendrin in beta-intercalated cells of collecting duct

Question 59

decreased delivery of Cl- to beta-intercalated cells does what to Cl-/HCO3- exchanger (pendrin)

Answer 59

turns it off

Question 60

how to treat Cl- depletion alkalosis

Answer 60

NaCl (brings Cl- to beta-intercalated cells and brings it in and secretes HCO3-)

Question 61

Pendrin exchanger brings what into cell and secretes what into urine (lumen)

Answer 61

brings Cl- in and secretes HCO3-

Question 62

no nausea + VOMITING=

Answer 62

intestinal obstruction (peripheral neural input)

Question 63

morning vomiting + no nausea=

Answer 63

increased intracranial pressure (ICP) (central neural input)

Question 64

morning vomiting + nausea=

Answer 64

pregnancy (peripheral neuro-humoral input)

Question 65

nausea + vomiting=

Answer 65

metabolic toxins/drugs (peripheral humoral input)

Question 66

newborn + persistent, non-bilious projectile

Answer 66

hypertrophic pyloric stenosis (peripheral neural input)