Anti emetics Flashcards

1
Q

Give the important points in a nausea Hx?

A
  1. Triggers, Volume + Pattern
  2. Exacerbating + Reliving Factors
  3. Drugs Tried
  4. Bowel Habit
  5. Other medications
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2
Q

Give the important points in a vommiting Hx?

A
  1. Triggers, volumes + patterns
  2. Exacerbating+ Relieving Factors
  3. Medications Tried
  4. Constipation
  5. Other medications
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3
Q

List some medications that can contribute to N+V

A
Opiates
Sugary Sweet Medications
Antibiotics
Antidepressants
Antiepileptics
NSAIDS
Alcohol
Digoxin
Chemo
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4
Q

You go to examine a patient with N+V. What particular things are you looking for?

A

General- dehydration, sepsis, drug tox
Neuro Exam
Abdo Exam- organomeagly, bowel sounds

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5
Q

A patient on the wards has nausea and vomiting. What investigations would you do?

A
U+E
LFTs
Calcium
Glucose
\+ urinalysis to exclude inf
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6
Q

What are the 2 peripheral pathways causing N+V? How are they transmitted?

A
  1. Mechanoreceptors- stretch eg./ obstruction
  2. Chemoreceptors- mets, chemo, local toxins
    Transmit via- vagus, splanchnic, glossopharyngeal and sympathetic ganglia
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7
Q

What system is activated to cause N+V by motion?

A

Vestibular System

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8
Q

What receptors are present in the Chemoreceptor Trigger Zone? What are these sensitive to?

A

Dopamine Agonists + 5HT3 Antagonists
They react to Raised ICP, Toxins and metabolites (ketoacidosis, uraemia, addisons, hypercalcemia, hyponatremia) in both fluid and CSF

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9
Q

What receptors are present in the cortex? What are they sensitive to?

A

Sensory Receptors

They react to anxiety, raised ICP and meningeal irritation

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10
Q

What type of drugs are metaclopramide and domperidone? What is their use? Is there any major SE?

A

Prokinetics used for motility disorders and migraines.
Metaclopramide is also used for clinical toxicity
Have EPSE

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11
Q

What type of drug is Haloperidol? What is its use? Any major SE’s?

A

Clinical toxicity , antipsychotic, hiccups.

EPSE, hyperprolactinaemia

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12
Q

What type of drug in Ondansetron? What is its use? Any major SE’s?

A

Chemo + post op

Contraindated in prolonged QT and BBs

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13
Q

What type of drug is Cyclizine? What is its use? Any major SE’s?

A

Raised ICP, Vesitbular causes

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14
Q

What are the indications of use for Levopromazine?

A

Multifactoral N+V

Can cause: hypotension, neuroepileptic malignant syndrome, EPSE, respiratory depression, prolonged QT

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15
Q

What are the 2 classes of Bromides and what is their use?

A
  1. Hydrobromide- motion sickness

2. Butylbromide- colic, inc in secretions

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16
Q

What is the use of benzodiazepines?

A

Alcohol withdrawal, Seizure termination, insomnia, anxiety