Antiemetics

Question 1

Name the antiemetics and their class

Answer 1

Metoclopramide, Domperidone = dopamine antagonist
Dexamethasone = corticosteroid
Ondansetron = 5HT3 antagonist

Question 2

Indications for Metoclopramide and Domperidone

Answer 2

Nausea and vomiting

Question 3

Indication for dexamethasone (NTL MOD 1)

Answer 3

Nausea and vomiting induced postoperatively, by chemotherapy, and radiotherapy

Question 4

Indication for ondansetron

Answer 4

Nausea and vomiting (radiation therapy, chemotherapy, post operative)

Question 5

Ondansetron Adverse Effects

Answer 5

Common = constipation, headache, dizziness
Rare = transient visual disturbances, hypersensitivity, ECG changes, seizures

Question 6

Precautions for Ondansetron

Answer 6

Elderly (prolonged QT interval), hepatic impairment

Question 7

Metoclopramide Adverse Effects

Answer 7

Common= headache, dizziness, drowsiness, akathisia
Rare = hyperaldosteronism, agranulocytosis, arrhythmias

Question 8

Metoclopramide Contraindications

Answer 8

Parkinson’s = will worsen symptoms
Depression = will worsen symptoms
Pheochromocytoma

Question 9

Domperidone Adverse Effects

Answer 9

Common = headache, dry mouth
Rare - prolonged QT interval, allergic reactions, drowsiness, EPSE

Question 10

Which dopamine antagonist antiemetic is best suited for Parkinson’s Disease?

Answer 10

Domperidone

Question 11

Domperidone contraindications

Answer 11

GI obstruction, drugs that increase QT interval, prolactinaemia, cardiac disease

Question 12

Dexamethasone Adverse Effects

Answer 12

Common = hypokalaemia, hyperglycaemia, adrenal suppression, skin atrophy, weight gain, mood disturbances, transient itching

Rare = peptic ulcerations, hypersensitivity reactions, fat deposits around spinal cord

Question 13

Dexamethasone Precautions

Answer 13

Breastfeeding = limited data, try prednisolone instead

Question 14

Metoclopramide Precautions

Answer 14

Worsen Parkinson and depression symptoms