Antiemetic popcorn

Question 1

What 4 receptors are involved in the “Chemoreceptor trigger zone”

Answer 1

D2 (dopamine)

opioid

5-HT3 (serotonin)

NK1 (neurokinin)

Question 2

Which 2 receptors are involved in the vestibular system

Answer 2

M1 and H1

Involved in motion sickness

(“Meghan Markle and Prince Harry get motion sickness”)

Question 3

Which receptor is in the vagal and spinal afferent nerves in the GI tract

Answer 3

5-HT3

(so not involved in motionsickness)

Question 4

T/F: complex N/V is resolved with antiemetics

Answer 4

false

Question 5

What are the 4 Selective Serotonin 5-HT3 receptor antagonists?

Answer 5

1. Granisetron
2. Ondansetron
3. Dolasetron
4. Palonosetron

(“Palo GOD”)

Question 6

Which Selective Serotonin 5-HT3 receptor antagonist causes QT prolongation

Answer 6

Dolasetron

Question 7

Which Selective Serotonin 5-HT3 receptor antagonist do you have to decrease in liver problems

Answer 7

Ondansetron

Question 8

What are the 2 uses of Selective Serotonin 5-HT3 receptor antagonists? What is it not useful for (2)?

Answer 8

• Uses: Chemo, post-op
• NOT FOR MOTION SICKNESS
• NO use for N/V 24hrs after chemo

Question 9

Is dose reduction of Selective Serotonin 5-HT3 receptor antagonists required in geriatric patients with renal insufficiency?

Answer 9

no

Question 10

How do you increase efficacy of Selective Serotonin 5-HT3 receptor antagonists?

Answer 10

add corticosteroid

Question 11

What are the 2 ADEs of Selective Serotonin 5-HT3 receptor antagonists

Answer 11

HA

constipation (slow GI motility)

Question 12

What are the 2 Substance P/NK1 receptor antagonist meds?

Answer 12

Aprepitant

Rolapitant

Question 13

What are Substance P/NK1 receptor antagonists used for?

Answer 13

Delayed emesis

Question 14

How do you treat acute and delayed emesis?

Answer 14

Substance P/NK1 receptor antagonists + Selective seretonin receptor blocker

= Netupitant + Palonosetron

Question 15

Which group of meds have hiccups as a SE?

Answer 15

Substance P/NK1 receptor antagonists

(Aprepitant, Rolapitant)

Question 16

Which antihistaminic/anticholinergic should not be used in elderly

Answer 16

Dimenhydrinate

Question 17

What are the 2 uses of Meclizine

Answer 17

Vertigo

Motion sickness

Question 18

What med should be used for motion sickness on a cruise?

(KNOW)

Answer 18

Scopolamine

Question 19

What are the 2 ADEs of Prochlorperazine?

Answer 19

Prolonged QT

Tardive Dyskinesia

Question 20

2 ADEs of Promethazine

Answer 20

Sedation

Drowsiness

Question 21

What is the main ADE of Chlorpromazine?

Answer 21

Tardive Dyskinesia

Question 22

Which med should you be careful giving to patients in extremely hot/cold climates due to the Difficulty regulating body temp

Answer 22

Chlorpromazine

Question 23

What is the MOA of Chlorpromazine

Answer 23

Hypothalamus depression affecting basal metabolism, body temp, wakefulness, ,emesis

Question 24

What receptor does Haloperidol and Droperidol block?

Answer 24

D2

(Group= Butyrophenones)

Question 25

Which Butyrophenon (D2 blocker) causes QT prolongation/Torsades, requires EKG to monitor but has limited use outside trials

Answer 25

Droperidol

Question 26

What 2 Benzos are used to tx anticipatory N/V? What schedule drug?

Answer 26

* Alprazolam, Lorazepam * Schedule IV ("You get **anticipatory N/V** when you go to **LA** for **4** weeks

Question 27

Main SE of Alprazolam?

Answer 27

memory impairment

Question 28

What schedule are Cannabinoids?

Answer 28

Schedule III

Question 29

What is the main SE of Dronabinol (cannabinoid) that most patients don't like

Answer 29

euphoria

Question 30

What are the 3 SEs of Nabilone (cannabinoid)

Answer 30

Somnolence **Vertigo** Xerostomia

Question 31

Which med is good for **Diabetic gastroporesis**

Answer 31

Metoclopramide

Question 32

Which med has **asthenia** as a SE?

Answer 32

Metoclopramide

Question 33

T/F: Olanzapine causes sedation and you should take caution with prescribing to elderly

Answer 33

true