Antiemetic & Antinausea Drugs

Question 1

Chemoreceptor trigger zone (CTZ) and vomiting center (VC)

Answer 1

• both located in the brain
• cause vomiting reflex

Question 2

Acetylcholine - N/V

Answer 2

• vomiting center
• inner ear

Question 3

Dopamine - N/V

Answer 3

• GI tract
• CTZ

Question 4

Histamine - N/V

Answer 4

• vomiting center
• inner ear

Question 5

Prostaglandins - N/V

Answer 5

• GI tract

Question 6

Serotonin - N/V

Answer 6

• GI tract
• CTZ
• VC

Question 7

Substance - N/V

Answer 7

• brainstem
• neurokinin antagonists
• prokinetics

Question 8

Scopolamine MOA

Answer 8

• anticholinergic
• block nausea signals
• for motion sickness

Question 9

Scopolamine implications

Answer 9

• transdermal patch, leaves residue
• contraindicated in glaucoma

Question 10

Scopolamine SE

Answer 10

• grogginess
• drowsiness
• blurred vision
• worsen motor skills

Question 11

Meclizine (Antivert) MOA

Answer 11

• motion sickness prophylaxis
• antihistamine

Question 12

Meclizine (Antivert) implications

Answer 12

• contraindication in shock, lactation, glaucoma
• possible paradoxical rxn in kids
• CNS symptoms in eldery
• monitor BP

Question 13

Meclizine (Antivert) SE

Answer 13

• blurred vision
• dry mouth
• constipation
• dizziness
• drowsiness
• headache
• vomiting
• tiredness

Question 14

Antidopaminergics examples

Answer 14

• Promethazine (Phenergran)
• Prochlorperazine (Compazine)

Question 15

Antidopaminergics MOA

Answer 15

• prevent and treat N/V
• also used for antipsychotic effects

Question 16

Promethazine implication

Answer 16

• not for kids under 2
• orthostatic hypotension

Question 17

Neurokinin Blockers example

Answer 17

Aprepitant (Emend)

Question 18

Aprepitant (Emend) MOA

Answer 18

• used with serotonin blockers and glucosteroids
• chemo-related emesis

Question 19

Aprepitant (Emend) implications

Answer 19

• check INR if on warfarin
• contraindicated if taking primozide

Question 20

Aprepitant (Emend) SE

Answer 20

• tiredness
• hiccups
• GI effects

Question 21

Prokinetic Drugs MOA

Answer 21

• control acid reflux
• strengthen lower esophageal sphincter
• content of stomach empty faster
• less time for acid reflux to occur

Question 22

Prokinetic Drugs example

Answer 22

Metochlopramide (Reglan)

Question 23

Metochlopramide (Reglan) MOA

Answer 23

• block dopamine receptors
• promote peristalsis
• also for chemo/radiation therapy

Question 24

Metochlopramide (Reglan) SE/AE

Answer 24

• depression
• GI effects
• bone marrow suppression
• EPS effects

Question 25

EPS effects

Answer 25

extrapyramidial symptoms and tardive dskyinesia

Question 26

Tardive dyskinesia

Answer 26

jerky motor movements, rigid muscle movements, mimic Parksinson’s

Question 27

Serotonin blockers MOA

Answer 27

• block serotonin peripherally and centrally
  (GI nerves and chemoreceptors)

Question 28

Serotonin blockers example

Answer 28

Ondansetron (Zofran)

Question 29

Ondansetron (Zofran) implications

Answer 29

• often for chemo, radiation, post op
• S/S of dehydration
• risk of dhysrhythmias

Question 30

Tetrahydrocannabinols example

Answer 30

Dronabinol

Question 31

Dronabinol MOA

Answer 31

• used for loss of apetite that causes weight loss in AIDS patients
• also severe N/V due to chemo

Question 32

Dronabinol implications

Answer 32

• dehydration and electrolytes
• CNS assessment (altered mental state)
• orthostatic hypotention
• brain fog