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Pharmacology and Therapeutics 2 Y2 > Anti-Emetics > Flashcards

Anti-Emetics Flashcards

1
Q

4 main classes of anti-emetics?

A

5-HT receptor antagonists
Histamine receptor antagonists
Muscarinic receptor antagonists
Dopamine receptor antagonists

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2
Q

How does cisplatin result in 5-HT release

A

Toxic to enterochromaffin cells, causes them to apoptose, releases free radicals as well as 5-HT

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3
Q

Enterochromaffin cells apoptosis results in release of what

A

free radicals as well as 5-HT

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4
Q

Where do the emetic nerve fibres from the stomach go to in the brain

A

nucleus tractus solitarius, vomiting centre, and CTZ

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5
Q

Where is the vomiting centre in the brain

A

Medulla oblongata

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6
Q

What part of the brain has emetic fibres to the stomach

A

The vomiting centre in the medulla oblongata

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7
Q

Vomiting centre AKA

A

Area postrema

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8
Q

Area postrema AKA

A

Vomiting centre

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9
Q

How is the positioning of the chemoreceptor trigger zone useful to its function?

A

Outside BBB so can detect shit in blood

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10
Q

How does the stomach induce vomiting

A

Serotonin stimulates 5-HT receptors, which have nerves projecting up to the NTS, VC and CTZ, when then have fibres to the VC, which then triggers emesis

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11
Q

Treatment for stomach induced emesis?

A

Ondansteron - 5HT antagonist

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12
Q

Example of 5HT antagonist/

A

Ondansteron

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13
Q

Ondansteron iss an example of?

A

5HT antagonist

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14
Q

Main use of a 5HT receptor antagonist?

A

Chemotherapy induced nausea and vomiting

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15
Q

Main use of a histamine H1 receptor antagonist?

A

Motion sickness

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16
Q

Main use of a muscarinic receptor antagonist?

A

Motion sickness

17
Q

Main use of a dopamine receptor antagonist?

A

Gastroperesis induced N&V

18
Q

Treatment for Chemotherapy induced nausea and vomiting

A

5HT receptor antagonist

19
Q

Treatment for motion sickness?

A

muscarinic receptor antagonist

20
Q

Treatment for Gastroperesis induced N&V

A

dopamine receptor antagonist

21
Q

Role of the nucleus tractus solitarius?

A

Innervates the vomiting centre

22
Q

Role of the CTZ?

A

communicates with the VC

23
Q

Mechanistic triggers of emesis?

A

Cytotoxic drugs, motion sickness, GI problems

24
Q

Why do we get motion sickness?

A

Visual/neural mismatch

25
Q

What receptors connect the labyrinth and vestibular systems

A

Muscaronic M1-5

26
Q

What receptors connect the vestibular systems and VC

A

Muscarinic M1-5

27
Q

What receptors connect the hypothalamus and CTZ

A

Histamine H1-receptor

28
Q

Where does promethazine act

A

H1 receptor antagonist, blocks signals from hypothalamus to CTZ

29
Q

Where does hyoscine act

A

Muscarinic receptor for neurons from labyrinth to vestibular system, and vestibular system to VC

30
Q

What is promethazine

A

H1 receptor antagonist

31
Q

What is hyoscine

A

Muscarinic receptor antagonist

32
Q

How does gastroparesis trigger emesis (2)

A

Reduced stomach contraction activates 5HT receptors in stomach which sends signals directly to VC and releases dopamine to stimulate its D2 receptors

There are also fibres to the CTZ

33
Q

What is the treatment for gastroparesis induced N&V

A

Metoclopramide - D2 receptor antagonist

And 5HT receptor antagonist to inhibit activation of CTZ

34
Q

Effects of metoclopramide (2)

A

Prokinetic - stimulates gastric emptying
Inhibits D2 receptors in VC
Slight 5HT receptor antagonist to inhibit activation of CTZ

35
Q

Example of a D2 receptor antagonist

A

Metaclopramide

36
Q

Side effects of 5HT receptor antagonism (2)

A
  • Headaches

- Constipation

37
Q

Side effects of histamine H1 receptor antagonism

A
  • Drowsiness
38
Q

Side effects of dopamine D2 receptor antagonism

A
  • Extrapyramidal side-effects
39
Q

Side effects associated with MUSCARINIC RECEPTOR ANTAGONISM:

A
  • Drowsiness
  • Dry mouth
  • Constipation

Pharmacology and Therapeutics 2 Y2 (24 decks)

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