Antiemetic and Antinausea Drugs Flashcards
Meclizine (Dramamine)
Chemical Classification
H1-receptor antagonist, piperazine derivative
Meclizine (Dramamine)
Functional Classification
Antiemetic, antihistamine, anticholinergic
Meclizine (Dramamine)
Mechanism of Action
Acts centrally by blocking chemoreceptor trigger zone, which in turn acts on vomiting center
Meclizine (Dramamine)
Uses
Vertigo, motion sickness
Meclizine (Dramamine)
Contraindications
hypersensitivity to cyclizines, shock
Meclizine (Dramamine)
Side Effect
CNS: Drowsiness, fatigue, restlessness, headache, insomnia
CV: hypotension
EENT: dry mouth, blurred vision
GI: nausea, anorexia, constipation, increased appetite
GU: urinary retention
Meclizine (Dramamine)
Nursing Considerations
ASSESS:
- VERTIGO/MOTION SICKNESS: nausea, vomiting after 1hr; assess vertigo periodically
- Signs of toxicity of other products, masking of symptoms of disease: brain tumor, intestinal obstruction
- Observe for drowsiness, dizziness, level of consciousness
Metoclopramide (Reglan)
Functional Classification
Cholinergic, antiemetic
Metoclopramide (Reglan)
Chemical Classification
Central DOPamine receptor antagonist
Metoclopramide (Reglan)
Mechanism of Action
Enhances response to acetylcholine of tissue in upper GI tract, which causes the contraction of gastric muscle; relaxes pyloric, duodenal segments; increases peristalsis without stimulating secretions; blocks dopamine in chemoreceptor trigger zone of CNS
Metoclopramide (Reglan)
Uses
Prevention of nausea, vomiting induced by chemotherapy, radiation, delayed gastric emptying, gastroesophageal reflux
Metoclopramide (Reglan)
Contraindications
Hypersensitivity to this product, procaine, or procainamide; seizure disorder, pheochromocytoma, breast cancer (Prolactin dependent), GI obstruction
Metoclopramide (Reglan)
Side Effects
CNS: Sedation, Fatigue, Restlessness, Headache, Sleeplessness, Dystonia, dizziness, drowsiness, SUICIDAL IDEATION, SEIZURES, EPS, NEUROLEPTIC MALIGNANT SYNDROME; TARDIVE DYSKINESIA (>3MO, HIGH DOSES)
CV: hypotension, supraventricular tachycardia
GI: dry mouth, constipation, nausea, anorexia, vomiting, diarrhea
GU: decreased libido, prolactin secretion, amenorrhea, galactorrhea
HEMA: NEUTROPENIA, LEUKOPENIA, AGRANULOCYTOSIS
INTEG: urticaria, rash
Metoclopramide (Reglan)
Nursing Considerations
ASSESS:
- EPS, tardive dyskinesia; more likely to occur in geriatric patients
- NEUROLEPTIC MALIGNANT SYNDROME: hyperthermia, change in BP, pulse, tachycardia, sweating, rigidity, altered consciousness
- Mental status: depression, anxiety, irritability
- GI complaints: nausea, vomiting, anorexia, constipation
Ondansetron (Zofran)
Functional Classification
Antiemetic