Antiemetics

Question 1

H2 blockers

uses

Answer 1

Reduce preoperative risk of aspiration pneumonia
GERD
Duodenal and gastric ulcers

Question 2

H2 blockers

drug examples

Answer 2

Ranitidine

Famotidine

Question 3

H1 blockers

uses

Answer 3

Antianxeity
Decrease GI motility
Sedation
W/ H2 blocker=good for allergic rxn

Question 4

H1 blocker

drug example

Answer 4

Diphenhydramine

Question 5

Proton Pump inhibitor PPI

MOA

Answer 5

Bind to the K+ H+ pump and block release of H+

Question 6

Proton Pump inhibitor PPI

Uses

Answer 6

treatment of duodenal ulcer, GERD, stress ulcer prophylaxis

Question 7

Proton Pump inhibitor PPI

drug exampes

Answer 7

Pantoprazole
Lansoprazole
Omeprazole

Question 8

Metoclopramide

MOA

Answer 8

Central dopamine receptor antagonist

Question 9

Metaclopramide

uses

Answer 9

Increases low esophageal sphincter tone

Increase GI motility-diabetic gastroparesis

Question 10

PONV risk factors

Answer 10

General prevalence 20-30%
duration of anesthesia
type of surgery
4 main: female, non-smoker, HX of PONV, opioid use in surgery

Question 11

5HT3 receptor antagonists

MOA

Answer 11

blocks receptors in 2 areas:

• GI tract=blocks vagal stimulation in post-op and chemo
• CTZ outside blood brain barrier

Question 12

5HT3 receptor antagonists

Uses and Risks

Answer 12

no sedative effects
hepatic metabolism
Risk of prolonged QT interval

Question 13

Dexamethasone

uses and risks

Answer 13

steroid
slower onset
may cause puritis and genital burning
impaired glucose tolerance

Question 14

Scopolamine

MOA

Answer 14

Antimuscarinic

transdermal long acting patch

Question 15

Scopolamine

Adverse effecs

Answer 15

typically mild: dry mouth, blurred vision

old ppl=agitation and cognitive impairment

Question 16

Dopamine receptor antagonist

MOA

Answer 16

D2 receptor blockers in the CTZ

Question 17

Dopamine receptor antagonist

drug examples

Answer 17

Droperidol
Haloperidol
Promethazine

Question 18

Dopamine receptor antagonist

Adverse effects

Answer 18

Droperidol-QT prolongation risk, arrhythmias, not for kids

Acute dystonic rxn=oculogyric crisis, toricollis, treat w/ antimuscarinic

Question 19

Neurokinin receptor antagonist

MOA

Answer 19

Inhibit at both central and peripheral receptors

blocks substance P at the NK-1 receptors

Question 20

Neurokinin receptor antagonist

drug example

Answer 20

Aprepitant

Question 21

Neurokinin receptor antagonist

Uses

Answer 21

Helpful in preventing delayed PONV

good for ENT and eye surgeries

Question 22

Rescue therapy

Answer 22

always include a antiemetic from a diff class than the one used for prophylaxis 
if small dose of prophylaxis, just give more

Question 23

Metoclopramide

Uses

Answer 23

Upper GI stimulant

Effectiveness controversial