Anti-emetics In brief Flashcards

1
Q

Ondansetron significant concepts

A
Ondansetron- 4 mg IV before case ends, potential QT prolongation, adjust for hepatic impairment (phase 1 and 2 in the liver) 
Modulates vagal (stomach) and CTZ in NTS (ion channels)
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2
Q

Palonsetron

A

0.75 mg, for chemo N/v because half life is 40 hours

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3
Q

Dolasetron

A

Serotonin antagonist, 12.5 mg IV, liver and KIDNEY, administer 15 minutes before end of case, QT prolongation

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4
Q

Scopolamine

A

1.5 mg transdermal patch behind the ear
many CNS side effects can be reversed with physostigmine
Muscarinic antagonist- competitively bonds and blocks Ach

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5
Q

Droperidol

A

Dopaminergic (D2)
QT prolongation have to monitor! And causes sedation
“Drop it like it’s hot”

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6
Q

Compazine/ prochlorperazine

A

Malignant neoplastic syndrome is a large concern, 5-10 mg IV before induction
Acts on histaminergic, muscarinic, dopaminergic, can cause extrapyramidal and anticholinergic effects

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7
Q

Metoclopramide

A

Dopaminergic receptor antagonist
Centrally acting as dopamine receptor anatagonist in the CTZ
Contraindicated in pheochromocytoma
10 mg over 1-2 minutes
Ineffective at lower doses unless used in combo

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8
Q

Midazolam

A

Give 2 mg IV

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9
Q

Ephedrine

A

Sympthamimetic agent 10-25 mg IV for N/v associated with postural hypotension in PACU

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10
Q

Promethazine

A

Histamine antagonist
Phenegran-risk for significant sedation
12.5-25 mg IM q4-q6

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11
Q

Dexamethasone

A

Corticosteroid- 4-10 mg .2-.5 mg/Kg children, given at the beginning of a case
Can cause perineal priorities
Don’t give with uncontrolled infections, cerebral malaria, fungal infection, or current treatment with a live virus

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12
Q

Aprepitant

A

Neurokinin 1 receptor antagonist (inhibits substance P at central and peripheral receptors)
40-80 mg PO period
If administered with dexamethasone reduce dose by half to maintain dexamethasone plasma concentrations

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13
Q

Dimenhydrinate

A

Dramamine-histamine antagonist
Competes with histamine and blocks CTZ and vestibular stimulation
50-100 mg IV/IM Q4
Commonly causes sedation.

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