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Pharmacology > Antiemetics > Flashcards

Antiemetics Flashcards

0
Q

True or false, cyclizine is a D2 antagonist used to treat motion sickness

A

False

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1
Q

True or false, aprepitant is a substance P agonist which has anti-emetic properties

A

False

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2
Q

Dexamethasone may be used in combination with D2 or 5HT3 antagonists to treat CINV, true or false

A

True

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3
Q

Ondansetron is considered the drug if choice for CINV, true or false

A

True

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4
Q 
Which of the following chemicals act on the chemoreceptor trigger zone;
Acetylcholine
Serotonin
Bradykinin 
Dopamine
A

Acetylcholine
Serotonin
Dopamine

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5
Q

Cyclizine, cinnarizine and promethazine are what type of anti emetic

A

Histamine H1 receptor antagonists

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6
Q

What type of antiemetic is ondansetron

A

Serotonin receptor antagonist

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7
Q

What type of antiemetic is hycosine and scopolamine

A

Muscarinic receptor antagonist

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8
Q

What type of antiemetics are phenothiazines, chloropromazine and perphenazine?

A

D2 receptor antagonists

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9
Q

What type of antiemetic is nabilone

A

Cannabinoid

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10
Q

What type of antiemetic is aprepitant

A

Neurokinin-1 antagonist

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11
Q

What percentage of cancer patients treated with anti-neoplastic agents experience emesis?

A

70-80%

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12
Q

Which clinically used drugs are often associated with high levels of emesis

A

Anti cancer agents
Anaesthetics
Opioids

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13
Q

The vomiting reflex is regulated by which part of the CNS

A

Medulla

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14
Q

Where is the chemoreceptor trigger zone located

A

Dorsal Vagal complex

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15
Q

Which pathway inputs into the dorsal Vagal complex causes nausea and vomiting in pregnancy

A

The Vagal pathway

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16
Q

Which pathway inputs into the dorsal Vagal complex causes nausea and vomiting from motion/height

A

The vestibular pathway

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17
Q

Where is the main site of action of antiemetic drugs

A

Chemoreceptor trigger zone

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18
Q

Which emesis pathway is linked to sensory input, stimuli from the pharynx and stimuli from the GI tract

A

Vagal pathway

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19
Q

True of false, antiemetics are agonists

A

False, they are antagonists

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20
Q

Antiemetic H1 antagonists inhibit the release of what substance

A

Histamine

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21
Q

Antiemetic H1 antagonists work less well where?
A. Chemoreceptor trigger zone
B. Vagal pathway
C. Vestibular pathway

A

Chemoreceptor trigger zone

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22
Q

Which H1 antagonists could be given for motion sickness?
A. Cyclizine
B. Cinnarizine
C. Promethazine

A

Cyclizine and cinnarizine

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23
Q

What are the side effects of antiemetic H1 antagonists?

A

Drowsiness and sedation

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24
Q

What is the drug of choice for severe morning sickness in pregnancy
A. Cinnarizine
B. Cyclizine
C. Promethazine

A

Promethazine

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25
Q

When you the antiemetic H1 antagonist cinnarizine be prescribed

A

Motion sickness

Vestibular disorders

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26
Q

When would you use the H3 receptor agonist betahistine hydrochloride?

A

Vertigo

27
Q

Which antiemetics are good “general purpose” antiemetics

A

Muscarinic Rs antagonists; hyoscine, scopolaimine

28
Q

True or false, hyoscine, scopolamine is the drug of choice for motion sickness

A

True

29
Q

How are the antiemetics Muscarinic Rs antagonists hyoscine/scopolamine administered

A

Oral and/or transdermal patch

30
Q

Where do antiemetic D2 receptor antagonists work strongly

A

Chemoreceptor trigger zone

31
Q

True or false, antiemetic D2 Rs antagonists have a powerful antiemetic action and will antagonise Muscarinic and histamine receptors too

A

True

32
Q

Phenothiazines, metoclopramide and domperidone are all examples of what type of antiemetic

A

D2 Rs antagonist

33
Q

Perphenazine, prochloropramazine and phenothiazines are examples of which antiemetic

A

D2 Rs antagonist

34
Q 
Which D2 Rs antagonist antiemetic is indicated for severe morning sickness of pregnancy 
A. Domperidone 
B. Metoclopramide 
C. Trifluoperazine 
D. Phenothiazines
A

Phenothiazines

35
Q

How is the D2 Rs antagonist antiemetic phenothiazines administered

A

Orally
IV
Suppository

36
Q

Which D2 Rs antagonist anti emetic penetrates the blood-brain barrier

A

Metoclopramide

37
Q

How is the drug metoclopramide administered

A

Oral

IV/IM

38
Q

Which D2 Rs antagonist anti emetic is used for migraine and cytotoxic therapy-induced emesis and emesis due to emergency hormonal contraception

A

Domperidone

39
Q

Does the antiemetic domperidone penetrate the blood brain barrier?

A

No

40
Q

True or false, D2 Rs antagonists have an effect on chemoreceptor trigger zone, Vagal pathway and the vestibular pathway

A

False, they do not effect the vestibular pathway

41
Q

What type of antiemetic is ondansetron, granisetron, palonosetron and tropisetron?

A

5HT3 antagonist

42
Q

What is the drug if choice for chemotherapy induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV)

A

Ondansetron

43
Q

How can the antiemetic ondansetron be administered

A

Oral
Suppositories
IV
IM

44
Q

What are the side effects of the antiemetic ondansetron

A

Gastrointestinal disturbances

Headache

45
Q

Which two types of antiemetics work on the vestibular pathway?

A

Muscarinic Rs antagonists

H1 Rs antagonists

46
Q

Which 3 antiemetics work on the Vagal pathway?

A

5HT3 antagonists
D2 Rs antagonists
H1 Rs antagonists

47
Q

Which 3 types of antiemetics work on the chemoreceptor trigger zone

A

5HT3 antagonists
D2 Rs antagonists
M antagonists

48
Q

The antiemetic aprepitant is an antagonist of what?

A

Substance P NK1R

49
Q

What is active in late phase emesis with cytotoxic drugs?

A

Neurokinin 1 (substance P)

50
Q

What is the substance P antagonist used for

A

CINV

PONV

51
Q

What is the route of administration of aprepitant

A

Oral

IV

52
Q

Fosaprepitant is a pro drug of what antiemetic

A

Aprepitant

53
Q

Casopitant, maropritant, aprepitant and Fosaprepitant are all examples of what kind of anti emetic?

A

Neurokinin 1 (substance P) antagonists

54
Q

The antiemetics nabilone and marinol are examples of what

A

Cannabinoids

55
Q

Antiemetic cannabinoids mimetic the main chemical componant of cannibis - which is?

A

HTC

56
Q

Which antiemetic is used adjunct to chronic pain management

A

Nabilone - cannabinoid

57
Q

How is it thought the antiemetic nabilone works?

A

Act via opioid receptors in the chemoreceptor trigger zone

58
Q

Corticosteroids such as Dexamethasone can be used for what kind of emesis

A

Vomiting caused by cytotoxics

59
Q

Dexamethasone is used in combination with which 2 other antiemetics to improve their actions

A

D2 and 5HT3 antagonists

60
Q

Which drugs would you use for anticipatory emesis?

A

Benzodiazepines

61
Q

Which two antiemetics are most suitable for emesis causes by opioids?

A

Haloperidol

Metoclopramide

62
Q

Which antiemetic is most suitable for emesis caused by gastroenteritis

A

Metoclopramide

63
Q

Apomorphine is what kind of drug?

A

Emetic

64
Q

How is the emetic apomorphine administered?

A

IM

Subcut

65
Q

How long does it take for the emetic apomorphine to act

A

5-10mins

66
Q

Which is the most commonly used emetic?
A. Ipecacuanha
B. Apomorphine
C. Activated charcoal

A

Activated charcoal

Pharmacology (13 decks)

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