Antiemetics & Gut Motility Disorder Treatment Flashcards
Example of an anti-muscarinic.
Hyoscine hydrobromide
Name three anti-histamines.
- Cinnarizine
- Cyclizine
- Promethazine
What are side effects of anti-histamines?
Drowsiness
Antimuscarinic effects
What type of emesis are anti-muscarinics used to treat?
Motion sickness
What are side effects of anti-muscarinics?
Constipation
Transient bradycardia
Dry mouth
What type of emesis are anti-histamines used to treat?
Motion sickness
Vestibular disorders
Which histamine receptors do the anti-histamines act as antagonists at?
H1 Histamine receptor
How can anti-muscarinics be administered?
Orally
Topically via a patch
Upon which region of the brain do the dopamine antagonists act?
Chemoreceptor trigger zone
What are the three sub-classes of dopamine antagonists?
Phenothiazines
Domperidone
Metoclopramide
Give 4 examples of phenothiazine dopamine antagonists.
Chlorpromazine
Perphenazine
Prochlorperazine
Trifluoperazine
What type of emesis are the dopamine antagonists active against and which in particular are they not active against?
Active against CTZ triggered vomiting
Not active against stomach induced vomiting
What are the phenothiazines also known as?
Antipsychotics
Neuroleptics
Give a primary example of a 5HT3 antagonist.
Ondansetron
Under what circumstances are 5HT3 antagonists used?
To treat N/V in postoperative patients and those receiving cytotoxins. Also used on cancer patients suffering from N/V as a side effect of their treatment
Give 2 examples of neurokinin 1 receptor antagonists.
Aprepitant
Fosaprepitant
When are neurokinin 1 receptor antagonists advised for use?
In chemotherapy associated N/V
Give an example of a synthetic cannabinoid.
Nabilone
When is nabilone used?
When a patient has been found to be resistant to primary antiemetic treatment; i.e. used second line
What are common side effects of nabilone?
Drowsiness
Dizziness
Give an example of a type of steroid used in anti-emesis.
Dexamethasone
What are indications for the use of dexamethasone?
Cancer chemotherapy associated N/V
What does dexamethasone cause when used in palliative care associated with cancer development?
Shrinkage of everything, including a metaplasia for example
Name 2 other neuroleptics.
Haloperidol
Levomepromazine
Outline the function of neuroleptics.
Reduction of nervous tension by depressing nervous function
What type of laxative is (WTLI): Methylcellulose
Bulk
WTLI: Bisacodyl
Stimulant
WTLI: Dantron
Stimulant
WTLI: Lactulose
Osmotic
WTLI: Liquid paraffin
Softener
WTLI: Arachis oil
Softener
WTLI: Methylnaltrexone bromide
Peripheral opioid receptor antagonist
WTLI: Ispaghula husk
Bulk
WTLI: Macrogols
Osmotic
If a patient presents to you with painful acute diarrhoea, what should you consider prescribing them?
ORT for diarrhoea Hyoscine butylbromoide (aka buscopan) or mebeverine - iow antispasmodics for pain If ORT doesn't work, anti motility drugs may be indicated
What are the three pharmacological options considered for the treatment of chronic diarrhoea?
Anti motility agents
Adsorbents
Bulk forming drugs
Give 4 examples of anti motility agents.
Codeine
Co-phenotrope
Loperamide (imodium)
Morphine
What is a contraindication of adsorbents?
Acute diarrhoea
What are the indications for use of bulk forming drugs?
Control of diarrhoea associated with diverticular disease
Give 3 examples of bulk forming drug.
Ispaghula
Methyl cellulose
Sterculia
What is common practice on the treatment of gallstones?
Laparoscopy - lap chole
What drug can be used to dissolve gallstones?
Ursodeoxycholic acid
Name another drug that reduces the amount of free flowing billirubin.
Cholestyramine - reduces itch
What type of drug is cinnarizine?
Anti-histamine
What type of drug is chlorpromazine?
Phenothiazine dopamine antagonist
What type of drug is hyoscine hydrobromide?
Anti-muscarinic
What class of drug does ondansteron belong to?
5HT3 antagonists