Antiemetic and Antinausea Drugs Flashcards

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0
Q

Meclizine (Dramamine)

Chemical Classification

A

H1-receptor antagonist, piperazine derivative

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1
Q

Meclizine (Dramamine)

Functional Classification

A

Antiemetic, antihistamine, anticholinergic

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2
Q

Meclizine (Dramamine)

Mechanism of Action

A

Acts centrally by blocking chemoreceptor trigger zone, which in turn acts on vomiting center

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3
Q

Meclizine (Dramamine)

Uses

A

Vertigo, motion sickness

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4
Q

Meclizine (Dramamine)

Contraindications

A

hypersensitivity to cyclizines, shock

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5
Q

Meclizine (Dramamine)

Side Effect

A

CNS: Drowsiness, fatigue, restlessness, headache, insomnia
CV: hypotension
EENT: dry mouth, blurred vision
GI: nausea, anorexia, constipation, increased appetite
GU: urinary retention

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6
Q

Meclizine (Dramamine)

Nursing Considerations

A

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
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7
Q

Metoclopramide (Reglan)

Functional Classification

A

Cholinergic, antiemetic

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8
Q

Metoclopramide (Reglan)

Chemical Classification

A

Central DOPamine receptor antagonist

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9
Q

Metoclopramide (Reglan)

Mechanism of Action

A

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

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10
Q

Metoclopramide (Reglan)

Uses

A

Prevention of nausea, vomiting induced by chemotherapy, radiation, delayed gastric emptying, gastroesophageal reflux

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11
Q

Metoclopramide (Reglan)

Contraindications

A

Hypersensitivity to this product, procaine, or procainamide; seizure disorder, pheochromocytoma, breast cancer (Prolactin dependent), GI obstruction

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12
Q

Metoclopramide (Reglan)

Side Effects

A

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

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13
Q

Metoclopramide (Reglan)

Nursing Considerations

A

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
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14
Q

Ondansetron (Zofran)

Functional Classification

A

Antiemetic

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15
Q

Ondansetron (Zofran)

Chemical Classification

A

5-HT3 receptor antagonist

16
Q

Ondansetron (Zofran)

Mechanism of Action

A

Prevents nausea, vomiting by blocking serotonin peripherally, centrally, and in the small intestine

17
Q

Ondansetron (Zofran)

Uses

A

Prevention of nausea, vomiting associated with cancer chemotherapy, radiotherapy; prevention of postoperative nausea, vomiting

18
Q

Ondansetron (Zofran)

Contraindications

A

Hypersensitivity; phenylketonuric hypersensitivity (oral disintegrating tab), torsades de pointes

19
Q

Ondansetron (Zofran)

Side Effects

A

CNS: Headache, Dizziness, Drowsiness, Fatigue, EPS
GI: Diarrhea, Constipation, abdominal pain, dry mouth
MISC: rash, BRONCHOSPASM (rare), Musculoskeletal Pain, Wound Problems, Shivering, Fever, Hypoxia, Urinary Retention

20
Q

Ondansetron (Zofran)

Nursing Considerations

A

ASSESS:

  • Absence of nausea, vomiting during chemotherapy
  • Hypersensitivity reaction: rash, bronchospasm (rare)
  • EPS: shuffling gait, tremors, grimacing, rigidity periodically
21
Q

Prochlorperazine

Functional Classification

A

Antiemetic, antipsychotic

22
Q

Prochlorperazine

Chemical Classification

A

Phenothiazine, piperazine derivative

23
Q

Prochlorperazine

Mechanism of Action

A

Decreases dopamine neurotransmission by increasing dopamine turnover through the blockade of the D2 somatodendritic autoreceptor in the mesolimbic system

24
Q

Prochlorperazine

Uses

A

Nausea, Vomiting, Psychotic Disorders

25
Q

Prochlorperazine

Contraindications

A

Hypersensitivity to phenothiazines, coma; infants, neonates, children <2yr; surgery

26
Q

Prochlorperazine

Side Effects

A

CNS: NEUROLEPTIC MALIGNANT SYNDROME, Extrapyramidal Reactions, Tardive Dyskinesia, Euphoria, DEPRESSION, Drowsiness, restlessness, tremor, dizziness, headache
CV: CIRCULATORY FAILURE, TACHYCARDIA, hypotension, ECG changes
EENT: blurred vision
GI: nausea, vomiting, anorexia, dry mouth, diarrhea, constipation, weight loss, metallic taste, cramps
HEMA: AGRANULOCYTOSIS
MISC: impotence
RESP: RESPIRATORY DEPRESSION

27
Q

Prochlorperazine

Nursing Considerations

A

ASSESS:

  • EPS: abnormal movement, tardive dyskinesia, akathisia
  • VS, BP; check patients with cardiac disease more often
  • NEUROLEPTIC MALIGNANT SYNDROME: seizures, hypo/hypertension, fever, tachycardia, dyspnea, fatigue, muscle stiffness, loss of bladder control; notify prescriber immediately
  • CBC, LFTs during course of treatment; blood dyscrasias, hepatotoxicity may occur
  • Respiratory status before, during, after administration of emetic; check rate, rhythm, character; respiratory depression can occur rapidly among geriatric or debilitated patients