Anti emetics Flashcards
Give the important points in a nausea Hx?
- Triggers, Volume + Pattern
- Exacerbating + Reliving Factors
- Drugs Tried
- Bowel Habit
- Other medications
Give the important points in a vommiting Hx?
- Triggers, volumes + patterns
- Exacerbating+ Relieving Factors
- Medications Tried
- Constipation
- Other medications
List some medications that can contribute to N+V
Opiates Sugary Sweet Medications Antibiotics Antidepressants Antiepileptics NSAIDS Alcohol Digoxin Chemo
You go to examine a patient with N+V. What particular things are you looking for?
General- dehydration, sepsis, drug tox
Neuro Exam
Abdo Exam- organomeagly, bowel sounds
A patient on the wards has nausea and vomiting. What investigations would you do?
U+E LFTs Calcium Glucose \+ urinalysis to exclude inf
What are the 2 peripheral pathways causing N+V? How are they transmitted?
- Mechanoreceptors- stretch eg./ obstruction
- Chemoreceptors- mets, chemo, local toxins
Transmit via- vagus, splanchnic, glossopharyngeal and sympathetic ganglia
What system is activated to cause N+V by motion?
Vestibular System
What receptors are present in the Chemoreceptor Trigger Zone? What are these sensitive to?
Dopamine Agonists + 5HT3 Antagonists
They react to Raised ICP, Toxins and metabolites (ketoacidosis, uraemia, addisons, hypercalcemia, hyponatremia) in both fluid and CSF
What receptors are present in the cortex? What are they sensitive to?
Sensory Receptors
They react to anxiety, raised ICP and meningeal irritation
What type of drugs are metaclopramide and domperidone? What is their use? Is there any major SE?
Prokinetics used for motility disorders and migraines.
Metaclopramide is also used for clinical toxicity
Have EPSE
What type of drug is Haloperidol? What is its use? Any major SE’s?
Clinical toxicity , antipsychotic, hiccups.
EPSE, hyperprolactinaemia
What type of drug in Ondansetron? What is its use? Any major SE’s?
Chemo + post op
Contraindated in prolonged QT and BBs
What type of drug is Cyclizine? What is its use? Any major SE’s?
Raised ICP, Vesitbular causes
What are the indications of use for Levopromazine?
Multifactoral N+V
Can cause: hypotension, neuroepileptic malignant syndrome, EPSE, respiratory depression, prolonged QT
What are the 2 classes of Bromides and what is their use?
- Hydrobromide- motion sickness
2. Butylbromide- colic, inc in secretions