Antiemetics and Diuretics Flashcards
Odansetron Class
5-HT3 receptor antagonist
Odansetron Use
postop nausea and vomiting, chemotherapy n/v, carcinoid syndrome
Odansetron MOA
inhibits serotonin both peripherally on the vagus nerve terminals and centrally in the medulla’s chemoreceptor trigger zone
Odansetron Dose
4 - 8 mg IV
Odansetron Pharmacokinetics
Onset = rapid
DOA = 6 - 12 hours
Metabolism: liver (CYP450)
Elimination: kidney
Odansetron Contraindications
Can prolong QT interval, do not admin with known prolongation or severe electrolyte abnormalities
Odansetron Considerations
Side effects = headache, drowsiness, constipation
Dexamethasone Class
Synthetic glucocorticoid steroid
Dexamethasone Use
decreasing risk for postop n/v, edema, postop pain
Dexamethasone MOA
↓ inflammation by inhibiting prostaglandin synthesis
Dexamethasone Dose
4 - 12 mg IV
Dexamethasone Pharmacokinetics
Onset = 10 - 30 min
DOA up to 72 hours
Metabolism: liver
Elimination: renal
Dexamethasone Contraindications
systemic fungal infections, hypersensitivity
Dexamethasone Considerations
Side effects = delayed wound healing, HPA axis suppression, hyperglycemia
Best to give at start of case
Furosemide Class
loop diuretic
Furosemide Use
treatment for hypertension, heart failure, peripheral and pulmonary edema, ICP and renal failure
Furosemide MOA
inhibits reabsorption of sodium, chloride, and potassium in the ascending loop of Henle
Furosemide Dose
Start with 5mg and up titrate as needed
Furosemide Pharmacokinetics
Onset = 5 min DOA = 2 hours Metabolism = hepatic Elimination = renal
Furosemide Contraindications
Hypersensitivity, severe dehydration, anuria
Furosemide Considerations
Hypotension
Electrolyte abnormalities, low potassium, magnesium and chloride
Ototoxic
Potentiates neuromuscular blockers
Mannitol Class
Osmotic diuretic
Mannitol Use
treat increased ICP, and increase renal perfusion
Mannitol MOA
- increases osmolarity of plasma that draws fluid in from the ICF and ECF and out of the brain
- Increased plasma mannitol is filtered, not reabsorbed, and draws fluids and electrolytes into the urine, increasing urine output
Mannitol Dose
0.25 - 1g/kg over 30-60min
Mannitol Pharmacokinetics
Onset = 15 min DOA = 3 - 6 hours Metabolism = not metabolized Elimination = renal (100% unchanged)
Manntiol Contraindications
Severe renal disease, active head bleed and severe dehydration
Mannitol Considerations
Risk for hypovolemia, electrolyte abnormalities, pulmonary edema
