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Study cards 2 > Antiemetic and Antinausea Drugs > Flashcards

Antiemetic and Antinausea Drugs Flashcards

1
Q

Nausea

Vomiting

Antiemetic drugs

A

Nausea
Sensation often leading to the urge to vomit

Emesis (vomiting)
Forcible emptying of gastric and, occasionally, intestinal contents

Antiemetic drugs
Used to relieve nausea and vomiting

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2
Q

Vomiting Centre and Chemoreceptor Trigger Zone

  1. Location
  2. What happens when its stimulated?
A

Vomiting centre

Chemoreceptor trigger zone (CTZ)
-Both located in the brain
-Once stimulated, cause the vomiting reflex

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3
Q

3 Types of Nausea and Vomiting

A

Chemotherapy induced
Postoperative
General

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4
Q

7 Antiemetics and Antinausea Drugs

A

Anticholinergic drugs

Antihistamines (histamine 1 [H1] receptor blockers)

Antidopaminergic drugs

Neurokinin ANTAGONISTS

Prokinetic drugs

Serotonin BLOCKERS

Tetrahydrocannabinoids

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5
Q

Antiemetics and Antinausea Drugs: Mechanism of Action

A

Many different mechanisms of action

Most work by blocking one of the vomiting pathways, thus blocking the stimulus that induces vomiting.

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6
Q

Site of action of Antinausea drugs

A

Labyrinth (inner ear)
-Anticholinergics
-Antihistamine
-Neuroleptics
-Prokinetic

GI Tract
-Prokinetic
-Serotonin Blockers

Cerebral Cortex
-Tetrahydrocannabinol (THC)
-Corticosteroids
-Benzodiazepines

Vomiting Centre (Medulla)
-Serotonin Blockers

Chemoreceptor Trigger Zone (CTZ)
-Neuroleptocs
-Prokinetic
-Serotonin Blockers

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7
Q

Antiemetic Indications

A

Specific indications vary per class of antiemetics.

General use for each type: prevention and reduction of nausea and vomiting

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8
Q

Anticholinergic drugs (acetylcholine blockers)

  1. 1 medication
  2. Mechanism of action
A

scopolamine

Bind to and block acetylcholine receptors in the inner ear labyrinth

Block transmission of nauseating stimuli to CTZ

Also block transmission of nauseating stimuli from the reticular formation to the vomiting centre

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9
Q

Antihistamine drugs (H1 receptor blockers)

  1. 2 medications
  2. Mechanism of action
  3. Also used for? (4)
A

dimenhydrinate (Gravol®)
diphenhydramine (Benadryl®)

Inhibit acetylcholine by binding to H1 receptors

Prevent cholinergic stimulation in vestibular and reticular areas, thus preventing nausea and vomiting

Also used for motion sickness, nonproductive cough, allergy symptoms, sedation

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10
Q

Antidopaminergic drugs

  1. 1 medication
  2. Mechanism of action
A

prochlorperazine (Proclorazine®)

Block dopamine receptors in the CTZ
Also used for psychotic disorders, intractable hiccups

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11
Q

Neurokinin receptor antagonists

  1. 1 medication
  2. Mechanism of action
  3. Used in conjuction with _____ and _______
  4. Use augments the? why?
A

aprepitant (Emend®)

Inhibit substance P/neurokinin 1 receptors in the brain stem

Used in conjunction with serotonin blockers and glucocorticoids

Use augments the serotonin blockers and glucocorticoids to inhibit acute and delayed phases of chemotherapy-induced emesis

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12
Q

Prokinetic drugs

  1. 1 medication and its long term use effect
  2. Mechanism of action
  3. Also stimulates
  4. Also used of
A

metoclopramide (Metonia®)
-Long-term use may cause irreversible tardive dyskinesia (movement disorder)

Block dopamine receptors in the CTZ

Cause CTZ to be desensitized to impulses it receives from the gastrointestinal tract

Also stimulate peristalsis in gastrointestinal tract, enhancing emptying of stomach contents

Also used for gastroesophageal reflux disease, delayed gastric emptying

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13
Q

Serotonin blockers

  1. 1 medication
  2. Mechanism of action
A

ondansetron (Zofran®)

Block serotonin receptors in the gastrointestinal tract, CTZ, and vomiting centre

Used for nausea and vomiting in patients receiving chemotherapy and for postoperative nausea and vomiting

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14
Q

Tetrahydrocannabinoids

  1. Major psychoactive substance in ________
  2. Mechanism of action
  3. 1 medication
  4. Used for nausea and vomiting associated with?
A

Major psychoactive substance in marihuana

Inhibitory effects on reticular formation, thalamus, cerebral cortex

Alter mood and body’s perception of its surroundings, which may help relieve nausea and vomiting

Medical marihuana

Used for nausea and vomiting associated with chemotherapy and for anorexia associated with weight loss in (AIDS) patients

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15
Q

2 Miscellaneous Antinausea Drugs

A

aprepitant

doxylamine succinate

pyridoxine hydrochloride

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16
Q

doxylamine succinate

pyridoxine hydrochloride

A

doxylamine succinate- (used for morning sickness with pregnancy)

Pyridoxine hydrochloride (combination known as Diclectin – used for morning sickness – N & V - during pregnancy)

17
Q

Antiemetic Adverse Effects

A

Vary according to drug used

Stem from their nonselective blockade of various receptors

18
Q

Ginger

  1. Used for
  2. Adverse effects
  3. Drug interactions
A

Used for nausea and vomiting, including that caused by chemotherapy, morning sickness, and motion sickness

Adverse effects

Anorexia, nausea and vomiting, skin reactions

Drug interactions

May increase absorption of oral medications

Increase bleeding risk with anticoagulants

19
Q

Nursing Implications

A

Assess complete nausea and vomiting history, including precipitating factors.

Assess current medications.

Assess for contraindications and potential drug interactions

Monitor therapeutic effects.

Watch for and monitor adverse effects.

20
Q

Important to teach?

A

Many of these drugs cause severe drowsiness; warn patients about driving or performing any hazardous tasks.

Taking antiemetics with alcohol may cause severe central nervous system depression.

Teach patients to change positions slowly to avoid hypotensive effects.

For chemotherapy, antiemetics are often given 30 to 60 minutes before chemotherapy begins.

21
Q

IV antiemetic schedule

A

30 minutes before chemo

22
Q

prokinetic drugs are also used for?

A

delayed gastric emptying

23
Q

aprepitant

A

this drug may not help more severe nausea caused by chemo

24
Q

marihuana therapy

A

useful for N & V due to chemo

stimulate apetite due to nutritional wasting

may cause drowsiness and euphoria

25
Q

transdermal patch for nausea

A

apply patch 4 hrs before travelling

26
Q

aprepitant interaction

A

warfarin, oral contraceptives, corticosteroids

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