anti emetics Flashcards
1. Describe the pathophysiology of nausea and vomiting including the afferent and efferent pathways and the role that each plays in the different types of nausea and vomiting 2. List the prototype anti-emetic agents used to control the different types of nausea and vomiting, describe their mechanism of action, and list their significant adverse effects
efferent pathway of n/v
vomiting center –> nucleus tractus solitarious –> cranial nerves to M1, H1 D2 serotinin receptors
location of vomiting center
lateral medullary reticular formation
afferent inputs ti vomitingc center
chemorecptor in area postrema vestibular system via CN VIII gag reflex via CN X 5 HT receptors in GI mucosa cerebral cortex
ondansetron, granisetron, dolasetron
5-HT3 antagonists
5-HT3 antagonists action restricted to
emesis casued by vagal stimulation
use of 5-HT3 antagonosts
acute chemo, surgery, radiation induced vomiting
5-HT3 antagonosts metabolism
hepatic
5-HT3 antagonosts SE
headache, dizzinness, constipation
metoclpramide MOA
D2 receptor antagonists
metoclopramide SE
extrpyramidal effectes, restlessness, dystonia
prochloroperazine MOA
inhibition of dopaminergic, muscarinuc and histaminergic receptors
seditive antiemetic
prochloroperazine, droperidol
antipsychotic and sedative antiemetic
droperidol
can cause hypotension
droperidol
MOA of droperidol
central sopaminergic blockade
