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CPT Drugs > Antiemetics > Flashcards

Antiemetics Flashcards

1
Q

How do we vomit?

A
  1. Vomiting centre in medulla signals to vomit
  2. Take deep breath
  3. Glottis closes to protect airway
  4. Abdo muscles contract
  5. LOS relaxes
  6. Retrograde peristalsis
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2
Q

What are the 4 inputs to the Chemoreceptor trigger zone?

A

Vestibular nuclei - motion sickness
Visceral afferents from gut - bowel obstrction/GORD
Higher cortical centres - smells, pain, phobia
Direct triggers - chemo, srugs

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3
Q

Muscuranic Antagonist - ADRs?

A

Hyoscine hydrobromide

MOTION SICKNESS

Blocks Ach Receptors in vestibular nuclei + CTZ

Sedation
Constipation
Dry mouth

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4
Q

H1 Antagonist

A

Cyclizine
Levomepromazine (D2 antagonist too!)
Dihenhydramine (benadryl)

Inhibits histamenergic signals (H1) from vestibular nuclei to CTZ

Sedation
Anti-muscarinic ADRs (dry mouth, constipation)

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5
Q

5-HT3 Antagonist

A

Ondansetron

Inhibits CTZ centrally
Reduced GI motility peripherally
(serotonin - usually ^motility)

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6
Q

Domperidone - ADRs?

A

Central dopamine antagonist

Dry mouth
Galactorrhea
Long QT interval
Parkisonism

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7
Q

Metoclopramide - ADRs?

A

Central dopamine antagonist
Peripheral cholinergic agonist

^LOS tone / ^gastric contractions (^peristalsis)

Depression
Diarrhoea
Drowsiness
Galactorrhea (^prolactin)
Parkisonism

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8
Q

Anti-psychotic -ADRs?

A

Haloperidol

D2 receptor antagonist at CTZ

Parkinsonism
Long QT

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9
Q

NK-1 Receptor Antagonist

A

Aprepitant

Delayed N+V (chemo)

Prevents excitatory action of substrate P

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10
Q

Corticosteroids

A

Dexamethasone, Methylprednisolone

D2 antagonists

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11
Q

Cannaboids - ADRs?

A

Nabilone

Acts on CTZ

Depression/Psychosis
Drowsiness

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12
Q

Post op N+V?

A

Metoclopramide

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13
Q

Pregnancy induced N+V?

A

Cyclizine (anti-histamine)

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14
Q

General N+V?

A

Ondansetron

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15
Q

Motion Sickness?

A

Hyoscine hydrobromide
Cyclizine

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16
Q

^ICP N+V?

A

Haloperidol
(sedative too)

17
Q

Chemo induced N+V?

A

Ondansetron
Aprepitant (delayed)
Metoclopramide (delayed)

18
Q

Pre-med constipation?

A

High fibre
High fluid intake
Exercise

19
Q

Osmotic Laxatives?

A

Lactulose (draws fluid into bowel)

Macrogol (limits loss of fluid into bowel)

20
Q

Loperamide?

A

Mu receptor agonist in myenteric plexis
Increases segmental contractions
Reduces peristalsis

21
Q

Anti-diarrhoea?

A

Opioids - codeine
Mu receptor agonist

CPT Drugs (19 decks)

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