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DIG: Biweekly 1 > Al-Mehdi: Drugs for Nausea and Vomiting > Flashcards

Al-Mehdi: Drugs for Nausea and Vomiting Flashcards

1
Q

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

A

tumor

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2
Q

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

A

Cisplatin

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3
Q

feeling of a need to vomit; involves cerebral cortex

A

nausea

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4
Q

emesis

A

vomiting

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5
Q

effortless passage of gastric contents into mouth

A

regurgitation

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6
Q

repeated regurgitation of food residue; may be rechewed and reswallowed

A

rumination

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7
Q

uses antiperstalsis

A

emesis

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8
Q

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

A

emesis center

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9
Q

area in brainstem that regulates both appetite and emesis

A

area postrema

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10
Q

CTZ (chemoreceptor trigger zone) located where

A

area postrema

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11
Q

area in brainstem that receives peripheral neural input

A

NTS

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12
Q

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

A

NTS

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13
Q

area in brainstem that receives peripheral humoral input

A

area postrema

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14
Q

drugs in the blood reach emesis center through what

A

area postrema

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15
Q

areas in brainstem that receives central neural input

A

vestibular nuclei and emesis center

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16
Q

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

A

cerebral cortex

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17
Q

retroperistalsis
pyloric constriction
abd and thoracic wall contraction

A

effectors for emesis

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18
Q

2 routes to cause vomiting from emesis center

A

straight to effectors
to dorsal nucleus then vagus

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19
Q
A

vestibular nuclei

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20
Q
A

NTS

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21
Q
A

area postrema

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22
Q
A

emesis center

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23
Q

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

A

5-HT3 and D2

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24
Q

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

A

H1

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24
Q

Anti-5-HT3 drugs

A

-setrons

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24
Q

anti-H1 and anti-M drugs

A

Diphenhydramine
Dimenhydrinate

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25
Q

corticosteroid that binds GR in NTS

A

Dexamethasone

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26
Q

Anti-D2 drugs

A

Metoclopramide
Domperidone

27
Q
A

anti-psychotics that act as anti-D2 too

28
Q

Meclizine
Cyclizine

A

Anti-H1

29
Q

Anti-H1 drug that is used in pregnancy

A

Doxylamine

30
Q

emesis Gq receptors

A

H1
NK1
a1
M1
M3

31
Q

emesis Gi receptors

A

u, D2, CB1

32
Q

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

A

Alosetron

33
Q
A

-setrons not including Alosetron

34
Q

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

A

persist

35
Q

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

A

-setrons

36
Q

SE of -setrons

A

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

37
Q
A

Anti-D2 Metoclopramide

38
Q

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

A

Anti-D2 Metoclopramide

38
Q

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

A

Anti-D2 metoclopramide

39
Q

____blocks prolactin

A

dopamine

40
Q

SE of this drug is hyperprolactinemia

A

anti-D2 metoclopramide

41
Q

CI in Achalasia

A

anti-D2 metoclopramide

42
Q

this anti-D2 drug does not cross BBB

A

Domperidone

43
Q

antiemetic D2 block in area postrema and D2 block in stomach

A

Anti-D2 domperidone

44
Q

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

A

Anti-D2 Domperidone

45
Q

1st generation cross BBB and also block M1

A

anti-H1 drugs

46
Q

M1 blocker (which would mainly target M1 in brain)

A

SCOPOLAMINE

47
Q

blocks NK1 (receptor for substance P) in CTZ

A

anti-NK1 APREPITANT

48
Q

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

A

Ondansetron

49
Q

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

A

APREPITANT and FOSAPREPITANT

50
Q

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

A

elevated hCG

51
Q

an elevation in this causes stimulation of gastric CCK receptors

A

hCG

52
Q
A

to treat emesis in first 1/2 of pregnancy

53
Q

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

A

Doxylamine

54
Q

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

A

multiple gestation

55
Q

to Rx hyperemesis in pregnancy

A

hospitalize and antiemetics

56
Q

explain effect of protracted emesis (metabolic alkalosis)

A

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

57
Q

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

A

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

58
Q

what maintains Cl- depleted alkalosis

A

pendrin in beta-intercalated cells of collecting duct

59
Q

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

A

turns it off

60
Q

how to treat Cl- depletion alkalosis

A

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

61
Q

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

A

brings Cl- in and secretes HCO3-

62
Q

no nausea + VOMITING=

A

intestinal obstruction (peripheral neural input)

63
Q

morning vomiting + no nausea=

A

increased intracranial pressure (ICP) (central neural input)

64
Q

morning vomiting + nausea=

A

pregnancy (peripheral neuro-humoral input)

65
Q

nausea + vomiting=

A

metabolic toxins/drugs (peripheral humoral input)

66
Q

newborn + persistent, non-bilious projectile

A

hypertrophic pyloric stenosis (peripheral neural input)

DIG: Biweekly 1 (11 decks)

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