Antiemetic popcorn Flashcards
What 4 receptors are involved in the “Chemoreceptor trigger zone”
D2 (dopamine)
opioid
5-HT3 (serotonin)
NK1 (neurokinin)
Which 2 receptors are involved in the vestibular system
M1 and H1
Involved in motion sickness
(“Meghan Markle and Prince Harry get motion sickness”)
Which receptor is in the vagal and spinal afferent nerves in the GI tract
5-HT3
(so not involved in motionsickness)
T/F: complex N/V is resolved with antiemetics
false
What are the 4 Selective Serotonin 5-HT3 receptor antagonists?
- Granisetron
- Ondansetron
- Dolasetron
- Palonosetron
(“Palo GOD”)
Which Selective Serotonin 5-HT3 receptor antagonist causes QT prolongation
Dolasetron
Which Selective Serotonin 5-HT3 receptor antagonist do you have to decrease in liver problems
Ondansetron
What are the 2 uses of Selective Serotonin 5-HT3 receptor antagonists? What is it not useful for (2)?
- Uses: Chemo, post-op
- NOT FOR MOTION SICKNESS
- NO use for N/V 24hrs after chemo
Is dose reduction of Selective Serotonin 5-HT3 receptor antagonists required in geriatric patients with renal insufficiency?
no
How do you increase efficacy of Selective Serotonin 5-HT3 receptor antagonists?
add corticosteroid
What are the 2 ADEs of Selective Serotonin 5-HT3 receptor antagonists
HA
constipation (slow GI motility)
What are the 2 Substance P/NK1 receptor antagonist meds?
Aprepitant
Rolapitant
What are Substance P/NK1 receptor antagonists used for?
Delayed emesis
How do you treat acute and delayed emesis?
Substance P/NK1 receptor antagonists + Selective seretonin receptor blocker
= Netupitant + Palonosetron
Which group of meds have hiccups as a SE?
Substance P/NK1 receptor antagonists
(Aprepitant, Rolapitant)
Which antihistaminic/anticholinergic should not be used in elderly
Dimenhydrinate
What are the 2 uses of Meclizine
Vertigo
Motion sickness
What med should be used for motion sickness on a cruise?
(KNOW)
Scopolamine
What are the 2 ADEs of Prochlorperazine?
Prolonged QT
Tardive Dyskinesia
2 ADEs of Promethazine
Sedation
Drowsiness
What is the main ADE of Chlorpromazine?
Tardive Dyskinesia
Which med should you be careful giving to patients in extremely hot/cold climates due to the Difficulty regulating body temp
Chlorpromazine
What is the MOA of Chlorpromazine
Hypothalamus depression affecting basal metabolism, body temp, wakefulness, ,emesis
What receptor does Haloperidol and Droperidol block?
D2
(Group= Butyrophenones)
Which Butyrophenon (D2 blocker) causes QT prolongation/Torsades, requires EKG to monitor but has limited use outside trials
Droperidol
What 2 Benzos are used to tx anticipatory N/V?
What schedule drug?
- Alprazolam, Lorazepam
- Schedule IV
(“You get anticipatory N/V when you go to LA for 4 weeks
Main SE of Alprazolam?
memory impairment
What schedule are Cannabinoids?
Schedule III
What is the main SE of Dronabinol (cannabinoid) that most patients don’t like
euphoria
What are the 3 SEs of Nabilone (cannabinoid)
Somnolence
Vertigo
Xerostomia
Which med is good for Diabetic gastroporesis
Metoclopramide
Which med has asthenia as a SE?
Metoclopramide
T/F: Olanzapine causes sedation and you should take caution with prescribing to elderly
true
