Antiemetics Flashcards
Ondansetron/Zofran, Zuplenz
- MOA
- Side effects
MOA: 5-HT3 Receptor Antagonist
- blocks 5-HT3 receptors peripherally (vagal nerve terminals) and centrally (CTZ)
Side effects:
- headache (most common)
- prolongs QTc
- constipation or diarrhea
- weakness/fatigue
Ondansetron/Zofran, Zuplenz
- Dose
- Onset
- Peak
- Duration
Dose:
- 4-8 mg IV at the end of surgery
- max 16 mg
Onset: ?
Peak:
- IV: 10 mins
- IM: 41 mins
- PO: 1.2 hrs
Duration:
- IV half life: 3-6 hours
- Oral half life: 4.79 hours
Ondansetron/Zofran, Zuplenz
- Metabolism/Excretion
- Characteristics/observations
Metabolism/Excretion: hepatic/renal, fecal
Characteristics/observations: structurally related to serotonin - can cause serotonin syndrome with other medications
Metaclopramide/Reglan
- MOA
- Side effects
MOA: Dopamine antagonist, GI prokinetic
- dopamine blockade in CTZ
- promotes upper GI motility by sensitizing tissues to action of acetylcholine
Side effects:
- drowsiness
- tardive dyskinesia
- altered taste
- fluid retention
Metaclopramide/Reglan
- Dose
- Onset
- Peak
- Duration
Dose: 10-20 mg
Onset: 1-3 minutes
Peak: 15 minutes
Duration: half-life 5-6 hours
All of the above are related to IV administration
Metaclopramide/Reglan
- Metabolism/Excretion
- Characteristics/observations
Metabolism/Excretion: hepatic/renal
Characteristics/observations:
- contraindicated in total bowel obstruction
- risk of seizures in epilepsy
Droperidol/Inapsine
- MOA
- Side effects
MOA: Dopamine antagonist in CTZ
Side effects:
- BLACK BOX QTc prolongation & arrhythmias
- vasodilation → hypotension (alpha-adrenergic blockade)
- drowsiness
- tardive dyskinesia
Droperidol/Inapsine
- Dose
- Onset
- Peak
- Duration
Dose: 0.625-1.25 mg IV at the end of surgery
Onset: 3-10 minutes
Peak: 30 minutes
Duration: 2-4 hours (may persist up to 12)
All of the above are related to IV administration
Droperidol/Inapsine
- Metabolism/Excretion
- Characteristics/observations
Metabolism/Excretion: hepatic/renal
Characteristics/observations:
- use cautiously in patients with parkinsons or other diseases related to dopaminergic activity
Prochlorperazine/Compazine
- MOA
- Side effects
MOA: Dopamine antagonist in CTZ
Side effects:
- Anticholinergic effects
- vasodilation → hypotension (alpha-adrenergic blockade)
- drowsiness
- QTc prolongation
- tardive dyskinesia
Prochlorperazine/Compazine
- Dose
- Onset
- Peak
- Duration
Dose: 2.5-10 mg IV slowly (not to exceed 5 mg/min)
Onset: 10-20 minutes
Peak: 2-4 hours
Duration: 3-4 hours
All of the above are related to IV administration
Prochlorperazine/Compazine
- Metabolism/Excretion
- Characteristics/observations
Metabolism/Excretion: hepatic/fecal
- active metabolites
Characteristics/observations:
- avoid if there is suspicion of Reye’s syndrome in pediatric patients
DimenhyDRINATE/Dramamine
- MOA
- Side effects
MOA: antihistamine, anticholinergic
- blocks histamine in GI tract & CTZ, diminishes vestibular stimulation
- depresses labyrinthine function via central anticholinergic effects
Side effects:
- drowsiness
- dry mouth
- urinary retention
DimenhyDRINATE/Dramamine
- Dose
- Onset
- Peak
- Duration
Dose: 50-100 mg (oral or IV) q 4-6 hrs PRN
Onset:
- IV: immediate
- oral: 15-30 minutes
Peak: unknown?
Duration:
- oral: 4-6 hours
DimenhyDRINATE/Dramamine
- Metabolism/Excretion
- Characteristics/observations
Metabolism/Excretion: hepatic/renal
Characteristics/observations:
- crossover hypersensitivity with diphenhydramine
