Antiemetic & Antinausea Drugs Flashcards
Ch. 7 GI
Chemoreceptor trigger zone (CTZ) and vomiting center (VC)
- both located in the brain
- cause vomiting reflex
Acetylcholine - N/V
- vomiting center
- inner ear
Dopamine - N/V
- GI tract
- CTZ
Histamine - N/V
- vomiting center
- inner ear
Prostaglandins - N/V
- GI tract
Serotonin - N/V
- GI tract
- CTZ
- VC
Substance - N/V
- brainstem
- neurokinin antagonists
- prokinetics
Scopolamine MOA
- anticholinergic
- block nausea signals
- for motion sickness
Scopolamine implications
- transdermal patch, leaves residue
- contraindicated in glaucoma
Scopolamine SE
- grogginess
- drowsiness
- blurred vision
- worsen motor skills
Meclizine (Antivert) MOA
- motion sickness prophylaxis
- antihistamine
Meclizine (Antivert) implications
- contraindication in shock, lactation, glaucoma
- possible paradoxical rxn in kids
- CNS symptoms in eldery
- monitor BP
Meclizine (Antivert) SE
- blurred vision
- dry mouth
- constipation
- dizziness
- drowsiness
- headache
- vomiting
- tiredness
Antidopaminergics examples
- Promethazine (Phenergran)
- Prochlorperazine (Compazine)
Antidopaminergics MOA
- prevent and treat N/V
- also used for antipsychotic effects
Promethazine implication
- not for kids under 2
- orthostatic hypotension
Neurokinin Blockers example
Aprepitant (Emend)
Aprepitant (Emend) MOA
- used with serotonin blockers and glucosteroids
- chemo-related emesis
Aprepitant (Emend) implications
- check INR if on warfarin
- contraindicated if taking primozide
Aprepitant (Emend) SE
- tiredness
- hiccups
- GI effects
Prokinetic Drugs MOA
- control acid reflux
- strengthen lower esophageal sphincter
- content of stomach empty faster
- less time for acid reflux to occur
Prokinetic Drugs example
Metochlopramide (Reglan)
Metochlopramide (Reglan) MOA
- block dopamine receptors
- promote peristalsis
- also for chemo/radiation therapy
Metochlopramide (Reglan) SE/AE
- depression
- GI effects
- bone marrow suppression
- EPS effects
EPS effects
extrapyramidial symptoms and tardive dskyinesia
Tardive dyskinesia
jerky motor movements, rigid muscle movements, mimic Parksinson’s
Serotonin blockers MOA
- block serotonin peripherally and centrally
(GI nerves and chemoreceptors)
Serotonin blockers example
Ondansetron (Zofran)
Ondansetron (Zofran) implications
- often for chemo, radiation, post op
- S/S of dehydration
- risk of dhysrhythmias
Tetrahydrocannabinols example
Dronabinol
Dronabinol MOA
- used for loss of apetite that causes weight loss in AIDS patients
- also severe N/V due to chemo
Dronabinol implications
- dehydration and electrolytes
- CNS assessment (altered mental state)
- orthostatic hypotention
- brain fog
