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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Antiemetic drugs - Ch. 84 > Flashcards

Antiemetic drugs - Ch. 84 Flashcards

1
Q

What are antiemetic drugs used for?

A

Used to relieve nausea and vomiting
-More difficult to control nausea

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2
Q

What are the brain regions responsible for vomiting?

A

Vomiting centre (VC) -coordinates muscles
Chemoreceptor trigger zone (CTZ) -leads to reflex

-Both in the medulla oblongata

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3
Q

What neurotransmitters are involved in the vomitting reflex?

A

Histamine (H1 receptors)
ACh (muscarinic receptors)
5-HT (5-HT3 receptors)
Dopamine (DA2 receptors)
Substance P (neurokinin 1 receptors)

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4
Q

What are some causes of N&V that antiemetics are used for?

A

Cancer chemotherapy-induced (CINV)
Post op with general anesthesia
motion sickness

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5
Q

What is the mechanism of action of 5-HT (serotonin) antagonist antiemetics?

A

Block 5-HT3 (serotonin) receptors in CTZ and VC and GI

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6
Q

Examples of 5-HT (serotonin) antagonists?

A

Odansetron
Dolasetron
Granisetron
Palonosetron

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7
Q

What types of N&V are 5-HT (serotonin) antagonists used for?

A

CINV
Post op N and V

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8
Q

What is the mechanism of action of dopamine (DA) receptor antagonists?

A

Block DA receptors in the CTZ

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9
Q

What type of N&V is DA receptor antagonists used for?

A

Severe vomiting
e.g, CINV, radiation therapy

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10
Q

What are the other indications that DA receptor antagonists are used for?

A

Antipsychotic (neuroleptic) agents
Prokinetic agents (increase GI motility)

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11
Q

Examples of DA receptor antangonists?

A

Chlorpromazine (antipsychotic)
metoclopramide

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12
Q

What is the mechanism of action of anticholinergic agents (ACh blockers)?

A

Block ACh receptors in the inner ear labyrinth
Block transmission of nauseating stimuli to VC
Block transmission of nauseating stimuli from the reticular formation to the VC

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13
Q

Example of ACh blocker?

A

Scopolamine

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14
Q

What is Scopolamine used for?

A

Motion sickness
-Patch behind ear

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15
Q

What is the mechanism of action of antihistamine agents (H1 receptor antagonists)?

A

Block H1 receptors
Prevent cholinergic stimulation in vestibular and reticular areas

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16
Q

Example of antihistamine antiemetic?

A

Dimenhydrinate (Gravol)
= diphenhydramine + 8-Chlorotheophylline

Diphenhydramine
Cyclizine

17
Q

What adverse effects are associated with Odansetron?

A

Dysrhythmia (long Q-T)

18
Q

What adverse effects are associated with DA antagonists?

A

Movement disorders

19
Q

What adverse effects are associated with Scopolamine?

A

Typical anticholinergic effects

20
Q

What adverse effects are associated with antihistamines?

A

Sedation
Typical anticholinergic effects

21
Q

What is the mechanism of action of glucocorticoids as antiemetics?

A

Unknown mechanism of action as antiemetic

22
Q

Examples of antiemetics glucocorticoids?

A

methylprednisolone
dexamethasone

23
Q

What are antiemetic glucocorticoid commonly used fro?

A

Suppress cancer chemotherapy N&V

24
Q

Example of substance P/neurokinin1 receptor antagonist?

A

Aprepitant

25
Q

What is the mechanism of action of substance P/neurokinin1 receptor antagonist: Aprepitant?

A

Blocks neurokinin1-type receptors in CTZ

-Prolonged duration of action

26
Q

What is aprepitant used for?

A

Postoperative and CI N and V

27
Q

What are Tetrahydrocanabinoids? (THC)

A

Synthetic derivatives of psychoactive substance in marijuana

28
Q

What antiemetics were withdrawn in Canada?

A

Nabilone
Dronabinol

29
Q

What were Nabilone and dronabinol used for?

A

N&V associated with chemotherapy
-second-line drug

30
Q

How should antiemetic drugs be taken?

A

Prophylactically when appropriate

Chemo= 30 min to 3 hours prior to chemo

Motion sickness:
dimenhydrinate = 1h before travel
Scopolamine patch applied 4h before travel

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

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