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Drug Of The Day > Antiemetics > Flashcards

Antiemetics Flashcards

1
Q

What class of drug is Metoclopramide?

A

Dopamine 2 receptor antagonist

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2
Q

metoclopramide is also involved with serotonin

A

5HT4 (increases peristalsis, increase smooth muscle contraction, increase gut secretion) AGONIST
5HT3 (causes N+V) ANTAGONIST

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3
Q

What are the common indications for Metoclopramide?

A

Post operative nausea, vomiting and certain digestive disorders.

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4
Q

What is the mechanism of action of Metoclopramide?

A

Central dopamine antagonist
Blocks messages from the CTZ (chemoreceptor trigger zone) and the vomiting centre
Peripheral cholinergic agonist. Increases tone and motility of the stomach and intestines, speeding up digestion (5HT4) - why it is good for GORD

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5
Q

why is metocloperamide known as a pro kinetic drug

A
  • increases the tone of the LOS and causes gastric emptying and increases the gut motility
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6
Q

What are the adverse effects of Metoclopramide?

A

Depression, diarrhoea, drowsiness, hypotension and galactorrhoea

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7
Q

What are the drug-drug interactions of Metoclopramide?

A

Anti-psychotic drugs, dopamine agonists
- can give parkinsonian effects as it can cross the BBB

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8
Q

if a patient is on metocloperamide and is suffering from parkinsonian effects what other medication could you switch them too?

A

Domperidone
It does not cross the BBB and is metabolised peripherally

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9
Q

How can you remember Metoclopramide?

A
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10
Q

What class of drug is Ondansetron?

A

Serotonin antagonist
5Ht3 receptor antagonist

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11
Q

What are the common indications of Ondansetron?

A

To prevent nausea and vomiting in chemotherapy

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12
Q

What is the mechanism of action of Ondansetron?

A

Blocks (vagal) afferent signals from the gut to the CTZ
Peripherally reduces GI motility and reduces GI secretions

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13
Q

What are the adverse effects of Ondansetron?

A

Constipation, headache, elevated liver enzymes
Extra-pyramidal effects- dystonia, parkinsonism

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14
Q

What are the warnings with Ondansetron?

A

Subacute abdominal obstruction, susceptible to long QT

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15
Q

What are the drug-drug interactions of Ondansetron?

A

Serotonin agonists, drugs that prolong the QT interval (Tramadol)

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16
Q

How can you remember Ondansetron?

A
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17
Q

what class is hyoscine hydrobromide

A

muscarinic receptor blocker at the vestibular nuclei
blocks acetylcholine

18
Q

how does hyoscine hydrobromide work

A

competitive blockade of the myscarinic acetylcholine receptors in the CTZ

19
Q

what are some side effects of hyoscine hydrobromide

A

glaucoma and dry mouth as it blocks the muscarinic receptors

20
Q

what is a condition in which you shouldn’t prescribe hyoscine hydrobromide

A

myasthenia graves as it blocks the muscarinic receptors

21
Q

what class of drug is ranitidine

A

Anti histamine (H2)

22
Q

how does Ranitidine work

A

It is a competitive reversible inhibitor of histamine in the gastric parietal cells
= stops the gastric acid secretion and reduces H conc

23
Q

when would you prescribe ranitidine

A

when someone has high stomach acid

24
Q

what class of drug is cyclizine

A

H1 receptor blocker

25
Q

how does cyclizine work

A

acts at the vestibular nuclei and inhibits histaminergic signals from vestibular system to CTZ

26
Q

What are some uses of cyclizine

A

motion sickness

27
Q

what is promethazine used for

A

morning sickness

28
Q

what is the first line medication for bowel obstruction

A

cyclizine then give dexamethasone

29
Q

what are two anti-emetic drugs that can be given to pregnant women who are feeling morning sickness

A

promethazine and prochlorperazine

30
Q

what class of drug is haloperidol

A

D2 receptor antagonist

31
Q

how does haloperidol work

A

acts on the CTZ
causes the LOS to close
increases gastric contraction
and reduces the pylorus tone so it opens

32
Q

haloperidol is an anti-emetic but it can also be classed into what other drug type

A

anti-psychotic
can be used to treat schizophrenia

33
Q

what is an ADR of haloperidol

A

it is a D2 antagonist so can cause prolonged QT
DO NOT give to someone who has Parkinson’s

34
Q

what are some side effects of haloperidol

A

sedation
hypotension

35
Q

Chlorpromazine and levomepromazine are both from which drug class

A

D2 receptor antagonist

36
Q

Dexamethasone is what class of drug

A

corticosteroid

37
Q

when is dexamethasone used

A

in chemo when people feel Sick and nauseous
GIVE ondansetron too of not strong enough

38
Q

what is a side effect of dexamethasone

A

HIGH SUGAR
all steroids increase sugar levels
increased weight

39
Q

Aprepitant and fosaprepitant are class of what drug

A

neurokinin-1 receptor antagonist

40
Q

how does Aprepitant work

A

prevents the action of substance P at CTZ and peripheral nerves
boosts the effect of the 5HT3 receptor antagonist

41
Q

what other drug class can aprepitant be in

A
  • anti anxiety
    anti-psychotic

Drug Of The Day (16 decks)

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