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Phamacology Summer > Antiemetic Drugs > Flashcards

Antiemetic Drugs Flashcards

1
Q

▪Serotonin Receptor Antagonists

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
d. dronabinol (Marinol®)
e. scopolamine
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

a. ondansetron (Zofran®)

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2
Q

▪Dopamine Antagonists

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
d. dronabinol (Marinol®)
e. scopolamine
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

b. phenothiazines- promethazine, prochloperazine

c. Metoclopramide (also a prokinetic

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3
Q

▪Cannabinoids

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
d. dronabinol (Marinol®)
e. scopolamine
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

d. dronabinol (Marinol®)

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4
Q

▪Anticholinergic Drugs

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
d. dronabinol (Marinol®)
e. scopolamine
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

e. scopolamine

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5
Q

▪Antihistamines

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
d. dronabinol (Marinol®)
e. scopolamine
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine

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6
Q

▪Morning Sickness

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

g. Ginger

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7
Q

▪ ? (also a prokinetic)

b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide

A

c. Metoclopramide

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8
Q

Unpleasant feeling that often precedes vomiting

Nausea
Retching
Emesis (vomiting)

A

▪ Nausea

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9
Q

Diaphragm, chest/abdominal wall contractions

Nausea
Retching
Emesis (vomiting)

A

▪ Retching

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10
Q

Forcible emptying of gastric, and occasionally, intestinal
contents

Nausea
Retching
Emesis (vomiting)

A

▪ Emesis (vomiting)

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11
Q

Which is three stages of Emesis

Nausea
Retching
Emesis (vomiting)
Hypertension

A

Nausea
Retching
Emesis (vomiting)

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12
Q 
USED TO TREAT
Chemotherapy induced N/V)
Post-Op
Radiation/anesthesia N/V
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

a. ondansetron (Zofran®)

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13
Q

ADVERSE EFFECTS
▪ QT prolongation-meaning risk for torsades de pointes (remember
this is an additive effect with other drugs)
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

a. ondansetron (Zofran®)

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14
Q

▪ QT prolongation
▪ Diarrhea
▪ Headache (fairly common!) and Dizziness!
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

a. ondansetron (Zofran®)

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15
Q

GIVE 1 HOUR PRIOR TO CHEMOTHERAPY!

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

a. ondansetron (Zofran®)

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16
Q

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

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

a. ondansetron (Zofran®)

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17
Q

Ondastreton
Chemotherapy
PRE-MEDICATE!
? hour prior to start of chemotherapy
FOLLOW UP!
Give another round ? hours after chemotherapy
Give another round ? hours after chemotherapy

A

PRE-MEDICATE!
1 hour prior to start of chemotherapy
FOLLOW UP!
Give another round 4 hours after chemotherapy
Give another round 8 hours after chemotherapy

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18
Q 
MECHANISM OF ACTION:
1) Primary mechanism: antagonist
at D2 receptors in the brain (CTZ)
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

b. phenothiazines- promethazine, prochloperazine

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19
Q 
ADVERSE EFFECTS
▪Extrapyramidal Symptoms (EPS)
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

b. phenothiazines- promethazine, prochloperazine

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20
Q

◦ BOXED WARNING: tissue injury- extravasation

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

b. phenothiazines- promethazine, prochloperazine

c. Metoclopramide (also a prokinetic

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21
Q

◦ BOXED WARNING: respiratory depression
resulting in death in pediatric patients (<2 years)
◦ Compounding effect with other meds, such as???
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

b. phenothiazines- promethazine, prochloperazine

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22
Q

Respiratory depression
resulting in death in pediatric patients (<2 years)
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

b. phenothiazines- promethazine, prochloperazine

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23
Q

Caution
◦ Benzos, Barbiturates, Booze (alcohol), Benadryl
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

b. phenothiazines- promethazine, prochloperazine

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24
Q

CNS sedation, avoid with other depressants

(opioids) and avoid in children
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

b. phenothiazines- promethazine, prochloperazine

25
Q 
Always DILUTE to avoid tissue damage
(recommended as IVPB)
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

b. phenothiazines- promethazine, prochloperazine

26
Q

USED TO TREAT- “prokinetic”

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

c. Metoclopramide (also a prokinetic

27
Q 
USED TO TREAT
◦ diabetic gastroparesis
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

c. Metoclopramide (also a prokinetic

28
Q 
MECHANISM OF ACTION:
blocks dopamine and enhances actions of
acetylcholine
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

c. Metoclopramide (also a prokinetic

29
Q 
BOXED WARNING
▪ Extrapyramidal Symptoms
▪ Specifically Tardive Dyskinesia
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

c. Metoclopramide (also a prokinetic

30
Q 
BOXED WARNING
▪ Extrapyramidal Symptoms
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

b. phenothiazines- promethazine, prochloperazine

c. Metoclopramide (also a prokinetic

31
Q 
▪Not to be used in Bowel Obstruction, GI
perforation/hemorrhage
a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic
A

c. Metoclopramide (also a prokinetic

32
Q

▪Cholinergic adverse effects- diarrhea

a. ondansetron (Zofran®)
b. phenothiazines- promethazine, prochloperazine
c. Metoclopramide (also a prokinetic

A

c. Metoclopramide (also a prokinetic

33
Q 
USED TO TREAT
▪Nausea/Vomiting (CINV)
▪ appetite stimulant
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

d. dronabinol (Marinol®)

34
Q 
USED TO TREAT-
appetite stimulant (patients w/ AIDS and
muscle wasting/anorexia)
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

d. dronabinol (Marinol®)

35
Q 
ADVERSE EFFECTS-
Sedation
Tachycardia
 euphoria, addictive?- SUD
Mental changes/dysphoria
 hallucinations
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

d. dronabinol (Marinol®)

36
Q 
ADVERSE EFFECTS 
euphoria
Tachycardia
• Mental Status Changes
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

d. dronabinol (Marinol®)

37
Q 
USED TO TREAT-
▪motion sickness
▪ Post op N/V
▪ Pre-op to decrease saliva
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

e. scopolamine

38
Q

USED TO TREAT-
▪motion sickness
d. dronabinol (Marinol®)
e. scopolamine

A

e. scopolamine

39
Q 
Contraindication- Narrow
Angle Glaucoma
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

e. scopolamine

40
Q 
▪Metal in the patch-must
remove patch prior to MRI
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

e. scopolamine

41
Q 
Educate patients about sedation (avoid
activities that require alertness)
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

e. scopolamine

42
Q 
Educate patients about anticholinergic
profile (constipation, xerostomia,
mydriasis)
d. dronabinol (Marinol®)
e. scopolamine
f.  meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

e. scopolamine

43
Q

e. scopolamine

Apply at least ? hours ? to travel or surgery

A

e. scopolamine

Apply at least 4 hours prior to travel or surgery

44
Q

e. scopolamine
Change patch every ? days, placed
? the ear

A

e. scopolamine
Change patch every 3 days, placed
behind the ear

45
Q

General Patch Considerations

  • Dry/Hairless Part of Body
  • Wash with Soap and Water (not alcohol)
  • Rotate sites to prevent skin irritation if frequently using
  • Don’t cover patch
  • Patches can get wet
46
Q

PATCHES MAY CONTAIN METAL- MRI RISK!

47
Q

Any other patches you remember?- Fentanyl- flush them!

48
Q 
USED TO TREAT-
▪motion sickness
▪Vertigo
▪Nausea and vomiting
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

meclizine (Antivert®), dimenhydrinate, hydroxyzine

49
Q 
USED TO TREAT-
▪Vertigo
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine

50
Q 
USED TO TREAT-
▪motion sickness
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine

51
Q 
anticholinergic
◦ Brain
◦ Eyes
◦ Mouth
◦ GI Tract
◦ Bladder
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine

52
Q

USED TO TREAT
nausea/vomiting associated with Pregnancy
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

A

h. Doxylamine + Vitamin B6 (Pyridoxine)

53
Q 
ADVERSE EFFECTS
Typical antihistamine effects
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

h. Doxylamine + Vitamin B6 (Pyridoxine)

54
Q 
ADMINISTRATION
TAKE SCHEDULED, NOT AS NEEDED
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
A

h. Doxylamine + Vitamin B6 (Pyridoxine)

55
Q 
USED TO TREAT
Motion Sickness
Morning Sickness
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h.  Doxylamine + Vitamin B6 (Pyridoxine)
56
Q

ADVERSE EFFECTS
Anorexia, nausea and vomiting, skin reactions
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

57
Q

NURSING CONSIDERATIONS
May increase absorption of oral medications
Increase bleeding risk with anticoagulants
f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

58
Q

Morning Sickness

f. meclizine (Antivert®), dimenhydrinate, hydroxyzine
g. Ginger
h. Doxylamine + Vitamin B6 (Pyridoxine)

Phamacology Summer (48 decks)

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