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Antiemetic Drugs Flashcards

1
Q 
Serotonin Receptor Antagonists?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

ondansetron

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2
Q 
Dopamine Antagonists
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

phenothiazines- promethazine, prochloperazine

Metoclopramide (also a prokinetic)

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3
Q 
Cannabinoids?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

dronabinol

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4
Q 
Anticholinergic Drugs?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Scopolamine

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5
Q 
Antihistamines?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

meclizine (Antivert®), dimenhydrinate, hydroxyzine

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6
Q 
Herbal?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Ginger

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7
Q 
Morning Sickness
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Doxylamine + Vitamin B6 (Pyridoxine)

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8
Q 
Substance P/Neurokinin 1 Antagonist:?
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Aprepitant

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9
Q 
EXTRA
Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Lorazepam, dexamethasone

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10
Q

Anti-emeticsTHREE MAIN STAGES OF EMESIS

Nausea, Refraction, Retching, Emesis (vomiting), Hemophrage.

A

Nausea
Retching
Emesis (vomiting)

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11
Q

Forcible emptying of gastric, and occasionally, intestinal contents

Retching, Emesis (vomiting), Nausea

A

Emesis (vomiting)

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12
Q

Diaphragm, chest/abdominal wall contractions

Retching, Emesis (vomiting), Nausea

A

Retching

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13
Q

Unpleasant feeling that often precedes vomiting

Retching, Emesis (vomiting), Nausea

A

Nausea

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14
Q

Treat:
CINV (chemotherapy induced N/V)
Post-Op N/V
radiation/anesthesia N/V

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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15
Q

MECHANISM OF ACTION
antagonist at serotonin/5-HT3 receptors located in the CTZ as well as in the G.I. tract.

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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16
Q

ADVERSE EFFECTS
Headache (sort of the opposite of our “triptans”
Otherwise, pretty mild- diarrhea, dizziness

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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17
Q

Headache (sort of the opposite of our “triptans”
Otherwise, pretty mild- diarrhea, dizziness

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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18
Q

Nursing Considerations
EKG in patients with history of cardiac issues

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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19
Q

Also, make sure to give early (premed) for exposure (such as for chemo or for surgery)

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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20
Q

Administration
GIVE 1 HOUR PRIOR TO CHEMOTHERAPY

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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21
Q

!SLOW IV INFUSION- Remember the QT risk

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Serotonin Receptor Antagonists- Ondansetron

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22
Q

Treat:
Surgery
Toxins
CINV

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Dopamine Antagonists:Phenothiazines> Promethazine, Prochlorperazine

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23
Q

MECHANISM OF ACTION

1) antagonist at D2 receptors in the brain (CTZ)
2) Antagonism at H1 receptors and M1receptors

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Dopamine Antagonists:Phenothiazines> Promethazine, Prochlorperazine

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24
Q

ADVERSE EFFECTS
extrapyramidal symptoms
anticholinergic properties
drowsiness

Aprepitant
Metoclopramide (also a prokinetic)
dronabinol 
Ginger
Scopolamine
phenothiazines- promethazine, prochloperazine
meclizine (Antivert®), dimenhydrinate, hydroxyzine
Doxylamine + Vitamin B6 (Pyridoxine)
ondansetron 
Lorazepam, dexamethasone
A

Dopamine Antagonists:Phenothiazines> Promethazine, Prochlorperazine

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25
BOXED WARNING respiratory depression (pediatrics especially) tissue injury Dopamine Antagonists: Phenothiazines Promethazine Prochlorperazine
Dopamine Antagonists: | PROMETHAZINE
26
Narrow Therapeutic Index Dopamine Antagonists: Phenothiazines Promethazine Prochlorperazine
Dopamine Antagonists: | PROMETHAZINE
27
? Injection Dangers- gangrene Dopamine Antagonists: Phenothiazines Promethazine Prochlorperazine
Dopamine Antagonists: | PROMETHAZINE
28
Nursing Considerations Dilute the drug prior to administration (IVPB) Monitor for S/S of EPS Monitor for respiratory depression ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Dopamine Antagonists:Phenothiazines> Promethazine, Prochlorperazine
29
Administration GIVE 1 HOUR PRIOR TO CHEMOTHERAPY! MEDICATION MUST BE DILUTED! (Normal Saline is a default diluent for most medications) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Dopamine Antagonists:Phenothiazines> Promethazine, Prochlorperazine
30
Treat: diabetic gastroparesis N/V- CINV, Post-Op off label- hiccups ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
31
Treat: PROKINETIC ``` Aprepitant Metoclopramide dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
32
MECHANISM OF ACTION Blocks dopamine receptors in the CTZ, when doses are increased, also blocks 5-HT3receptors ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
33
ADVERSE EFFECTS Diarrhea/ Abdominal Cramping ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
34
CONTRA-IDNICATION: Not to be used in Bowel Obstruction, GI perforation/hemorrhage ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
35
``` BOXED WARNING Tardive Dyskinesia ( a sub type of EPS) ``` ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
36
Nursing Considerations Assess for any bowel obstructions ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
PROKINETIC/Dopamine Antagonists: Metoclopramide
37
Treat: Nausea/Vomiting (CINV) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
38
Appetite stimulant (patients w/ AIDS and muscle wasting/anorexia) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
39
MECHANISM OF ACTION Agonist at cannabinoid receptors in the brain (CB1 and CB2 ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
40
``` ADVERSE EFFECTS Sedation Tachycardia euphoria, addictive?- SUD Mental changes/dysphoria hallucinations ``` ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
41
Nursing Considerations Not recommended in hx of mental health disorders ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
42
Not recommended in cardiac disorder ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Cannabinoids: Dronabinol
43
Treat: motion sickness Post op N/V ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
44
Pre-op to decrease saliva ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
45
MECHANISM OF ACTION Block ACh receptors in the vestibular nuclei and reticular formation ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
46
ADVERSE EFFECTS Our usual Anticholinergic ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
47
Contraindication- Narrow Angle Glaucoma ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
48
Metal in the patch-must remove patch prior to MRI ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
49
Nursing Considerations Educate patients about sedation (avoid activities that require alertness) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
50
Educate patients about anticholinergic profile (constipation, xerostomia, mydriasis) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
51
Apply at least 4 hours prior to travel or surgery Change patch every 3 days, placed behind the ear ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
52
General Patch Considerations ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Anticholinergics:Scopolamine
53
Anticholinergics:Scopolamine General Patch Considerations ``` Dry/Hairless Part of Body Wet/Hairless Part of Body Wash with Soap, Water and Alcohol Wash with Soap and Water (not alcohol) Rotate sites to prevent skin irritation if frequently using ```
Dry/Hairless Part of Body Wash with Soap and Water (not alcohol) Rotate sites to prevent skin irritation if frequently using
54
Anticholinergics:Scopolamine General Patch Considerations You can cover Patch Don’t cover patch Don’t get patch wet (don’t bathe/shower with patch) Get patch wet (bathe/shower with patch) PATCHES MAY CONTAIN METAL- MRI RISK!Any other patches you remember?- Fentanyl- flush them!
Don’t cover patch Don’t get patch wet (don’t bathe/shower with patch) PATCHES MAY CONTAIN METAL- MRI RISK!Any other patches you remember?- Fentanyl- flush them!
55
General Patch Considerations | PATCHES MAY CONTAIN METAL- ? RISK!
MRI
56
General Patch Considerations | Any other patches you remember?- Fentanyl- flush them!
Yes
57
Anticholinergics:Scopolamine Administration Apply at least ? hours prior to event (some recommend ? before!) Behind the ?
4 Hours night ear
58
Treat: Motion sickness Vertigo Nausea and vomiting ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
59
MECHANISM OF ACTION Block H1 receptors from the inner ear to the vomiting center, also has anticholinergic properties ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
60
ADVERSE EFFECTS Sedation◦No driving Avoid the B’s (benzos, barbiturates, booze, opioids, Benadryl) Anticholinergic ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
61
Avoid the B’s (benzos, barbiturates, booze, opioids, Benadryl) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
62
Nursing Considerations Educate patients about sedation (avoid activities that require alertness) Educate patients about anticholinergic profile (constipation, xerostomia) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
63
Cautious with other CNS sedating agents◦No alcohol, benzos, opioids etc.! ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
64
PRE-MEDICATE ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamines: Meclizine, hydroxyzine, dimenhydrinate
65
Treat: Motion Sickness Morning Sickness ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Ginger
66
ADVERSE EFFECTS Anorexia, nausea and vomiting, skin reactions ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Ginger
67
Nursing Considerations May increase absorption of oral medications Increase bleeding risk with anticoagulants (WARFARIN!) ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Ginger
68
Treat: nausea/vomiting associated with Pregnancy ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamine + Water soluble Vitamin Diclegis®Doxylamine + Vitamin B6 (Pyridoxine)
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ADVERSE EFFECTS Typical antihistamine effects ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamine + Water soluble Vitamin Diclegis®Doxylamine + Vitamin B6 (Pyridoxine)
70
Administration TAKE SCHEDULED, NOT AS NEEDED ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Antihistamine + Water soluble Vitamin Diclegis®Doxylamine + Vitamin B6 (Pyridoxine)
71
Treat For CIN anticipatory nausea ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Benzodiazepines- ◦Lorazepam◦
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For CINV- ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Glucocorticoids Dexamethasone and Methylprednisolone
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Treat Used exclusively for Operative/ Chemotherapy induced Nausea ``` Aprepitant Metoclopramide (also a prokinetic) dronabinol Ginger Scopolamine phenothiazines- promethazine, prochloperazine meclizine (Antivert®), dimenhydrinate, hydroxyzine Doxylamine + Vitamin B6 (Pyridoxine) ondansetron Lorazepam, dexamethasone ```
Substance P/ Neurokinin Antagonist◦Aprepitant

Phamacology (13 decks)

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