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Pharmacology Exam 2 > Antiemetic Agents > Flashcards

Antiemetic Agents Flashcards

1
Q

What is vomiting?

A

Complex reflex reaction to various stimuli

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2
Q

What are the most common complaints regarding a patient being uncomfortable.

A

Nausea and vomiting

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3
Q

Name an example where it is productive to vomit

A

Food poisoning.

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4
Q

When do we taken agents to prevent vomiting?

A

When the reflex rejection is not beneficial.

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5
Q

What does Emetics do?

A

Cause vomiting, however they are no longer recommended for at home poison control because the fluid could get into the lung and the vomiting could harm the trachea and mucous membrane. May be used in rare emergency situations.

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6
Q

What does Antiemetics do?

A

Decrease or prevent nausea and vomiting.
Centrally or locally acting.
Varying degrees of effectiveness.

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7
Q

What should a parent do if they suspect that their child have ingested something that is toxic/poisonous?

A

Call their healthcare provider or poison control and wait for instructions which will depend on what the child ingested.

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8
Q

Are Antiemetic used in children?

A

Yes, but there should be heightened caution due to increased risk of CNS effects as well as fluid and electrolyte imbalances.

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9
Q

What should we remember is Adults are taking Antiemetic agents?

A

They could have a CNS effect and so performing daily activities may put them in risk of injury.

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10
Q

Have safety regarding Antiemetic Agents been established in pregnancy/lactation?

A

No, should only be used when benefit outweighs the risk.

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11
Q

what adverse effects are older people most likely to experience when taking antiemetic agents?

A

Confusion, dizziness, Fluid imbalance and cardiac effects. Safety measures are critical.
Patients with hepatic or renal impairment should start on a lower dose then adjust accordingly.

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12
Q

Is it recommended to give children syrup of ipecac to children?

A

Its advised to call the healthcare provider or poison control before giving the child anything.

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13
Q

What does Phenothiazines do?

A

Depress various areas of the central nervous system.

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14
Q

What are the 3 drug classes we need to remember for the drug category Phenothiazines?

A

Prochlorperazine
Perphenazine
Chlorpromazine

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15
Q

Why would we give Prochlorperazine?

A

For Nausea and vomiting. Prochlorperazine is a Phenothiazine.

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16
Q

What are the contraindications when considering prescribing Phenothiazines to a patient?

A

CNS depression: coma, brain damage or injury
Severe hypotension or hypertension
Severe liver dysfunction

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17
Q

What should we be cautious of when prescribing Chlorpromazine to a patient?

A

Renal dysfunction
Moderate liver impairment
Active peptic ulcer

Chlorpromazine is a Phenothiazine.

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17
Q

What are the Drug-Drug interactions with Phenothiazines?

A

CNS depressants incl Alcohol.

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18
Q

What other drug class is Phenothiazines also a part of?

A

Antipsychotics

19
Q

What type of antipsychotic is Phenothiazines?

A

1st generation antipsychotic

20
Q

What are the most serious adverse effects of Chlorpromazine?

A

Side effects are higher the longer the drug is used.

Chlorpromazine is a Phenothiazines (1st generation antipsychotic) and the most serious adverse effects are

Neuroleptic Malignant Syndrome : Muscle stiffness, high fever, tachycardia and diaphoresis. ( No treatment)

Extrapyramidal symptoms/effects: Abnormal movement of the body - includes tardive dyskinesia
Abnormal movement of face and mouth.

21
Q

What are the more common side effects of Prochlorperazine?

A

Prochlorperazine is a Phenothiazine and most common side effects are

CNS - Drowsiness, dizziness, weakness and dry mouth
Cardiac - Hypotension and Dysrhythmias
Endocrine - Menstrual disorders and Gynecomastia
Other - Photosensitivity (skin and eyes sensitive to the sun) and pink to reddish brown urine.

22
Q

What is the drug we need to know for the drug category Nonphenothiazines?

A

Metoclopramide

23
Q

What does Metoclopramide do?

A

Block dopamine receptors affecting the chemo trigger zone. Works on the parasympathetic system as well by increasing the movement of food through the GI system.

It is also a part of the drug category ‘GI stimulants’

Metoclopramide is a Nonphenothiazined

24
Q

Why would we give Metoclopramide?

A

For nausea and vomiting associated with chemotherapy as well as post-operative nausea and vomiting.

25
Q

What are two common side effects of Metoclopramide?

A

Fatigue and Weakness

26
Q

What are the drug classes we need to know for the drug category 5-HT3 Receptor Blockers (Serotonin Receptor Blockers) and the suffixes

A

“setron”
Granisetron
Palonosetron
Ondansetron

27
Q

What does Ondansetron do?

A

Blocks specific receptor sites associated with nausea and vomiting,
peripherally and in the CTZ (Chemoreceptor trigger zone in the medulla)

28
Q

What are the adverse effects of Palonosetron?

A

Palonosetron is a 5-HT3 Receptor Blocker and the most common adverse effects are related to the CNS. Dizziness, Myalgia, Constipation and headaches.

29
Q

What are the drug drug interactions with Granisetron?

A

Granisetron is a 5-HT3 Receptor Blocker and would interact with any other serotonin receptor blocker because this can increase the risk of serotonin syndrome/toxicity.

30
Q

What drug classes and suffixes do we need to remember for the drug category Substance P/Neurokinin 1
Receptor Antagonists ?

A

“pitant”
Aprepitant
Rolapitant
Fosaprepitant

31
Q

What does Aprepitant do?

A

Aprepitant is a Substance P/Neurokinin 1 Receptor Antagonists and act directly in the CNS to block receptors associated with nausea and vomiting.

32
Q

Who do we give Rolapitant to ?

A

Rolapitant is a Substance P/Neurokinin 1 Receptor Antagonists and is given for nausea and vomiting to patients who are undergoing chemotherapy.

33
Q

What are the drug-drug interactions to Fosaprepitant?

A

Fosaprepitant is a Substance P/Neurokinin 1 Receptor Antagonists and may have an adverse reaction when given with other medications such as Warfarin and Hormonal contraceptives.

It decreases warfarin levels and decreases effectiveness in the hormonal contraceptive.

34
Q

What are the adverse effects of Aprepitant?

A

Aprepitant is a Substance P/Neurokinin 1 Receptor Antagonists

CNS - Headache and Fatigue
GI - Diarrhea or Constipation, Nausea and Anorexia
Blood - Neutropenia (decrease in neutrophil count) , Amenia (Decrease in red blood cell count), Leukopenia (Decrease in WBC count)

35
Q

What are the Miscellaneous Agents that we need to know in the Antiemetic Agents category?

A

Cannabinoids
Antihistamines
Scopolamine

36
Q

What do we need to know about Cannabinoids?

A

Drug classes : Dronabinol & Nabilone
Contain active ingredients of cannabis
Given for nausea and vomiting in chemotherapy and stimulate appetite for patients with AIDS

Miscellaneous Agent

37
Q

What do we need to know about Antihistamines?

A

Drug classes: Hydroxyzine & Meclizine
Blocks histamine and muscarinic receptors.
Given for nausea, vomiting and motion sickness

Miscellaneous Agent

38
Q

What do we need to know about Scopolamine

A

Drug class : Anticholinergic
Given for Nausea and vomiting due to motion sickness
Adverse effects include sedation and anticholinergic effects

Miscellaneous Agent

39
Q

What would be the nursing assessment for all drug classes when looking at history?

A

Allergy, Pregnancy/lactation.
Impaired renal or hepatic function
Underlying neuro conditions (especially CNS conditions) or active peptic ulcer.

40
Q

What physical nursing assessment would you do for all drug classes?

A

CNS: Baseline neuro exam assessing for orientation, affect and reflexes
Cardiac: baseline pulse and blood pressure
Abdominal: including bowel sounds and emesis ( note color, amount and frequency of vomiting episodes so that we can tell if there is an improvement after drugs are given)
Skin: any rashes or lesions

41
Q

What Labs would you do for all drug classes?

A

Liver function and Kidney function

42
Q

What would be the nursing conclusion for all drug classes?

A

Impaired comfort related to adverse effects
Injury risk related to the CNS effect
Altered cardiac output related to the cardiac effect
Knowledge deficit related to drug regimen

43
Q

What implementations would you do for all drug classes?

A

Assure that the route of administration is appropriate for each patients to make sure the get the effectiveness that they need and to decrease adverse effects ex if patient is vomiting they should take the drug orally.

Prevention vs treatment

Provide other measures to help the patient cope with the discomfort of nausea and vomiting and drug effects - make sure they’re close to the bathroom, have an emesis basin, giving them ice chips.

Patient teaching- avoid CNS depressant incl alcohol. When to notify provider or noticing side effects.

44
Q

What is special about some of the pills in this category regarding how they’re designed for patients that are vomiting?

A

Some dissolve under the tongue to try to decrease the vomiting reflex.

45
Q

What is a prophylactic administration?

A

When you foresee that the there might be a triggering effect happening in the patients body and you tailor the administration of the drug to that reaction. For example giving the drugs prior to chemotherapy.

Pharmacology Exam 2 (10 decks)

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