Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia Pharm II > Antiemetics ppt Micky Dees > Flashcards

Antiemetics ppt Micky Dees Flashcards

josh's guide to no vomit

1
Q

what is the incidence of postop N/V

A

10-60%

average 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

post-op factors that influence PONV

A 
pain
dizziness
first movement
first oral intake
opioids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 top surgical procedures that influence PONV

A

gyn
abd
ENT
opthalmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

anesthetic factors that influence PONV

A

premedications
anesthetic agents
gastric distention
duration and depth of anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

patient factors that influence PONV

A 
age
gender
obesity
HX of PONV or motion sickness
Anxiety
gastroparesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

medical consequences of PONV

A 
patient discomfort
interruption in oral intake
wound dehiscence
electrolyte inbalance
dehydration
aspiration of vomitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

5 classes of antiemetic agents with ex in each

wait don’t forget the one he did here there is 6

A 
PHENOTHIAZINES
-chlorpromazine, chlorpromethazine
BUTYROPHENONES
-droperedol, haloperidol
BENZAMINES
- Metaclopromide
Anticholinergic
- Scopolamine
ANTIHISTAMINES
-hydroxyzine
5-HT3 receptor antagonist
- ondansetron
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SE of PHENOTHIAZINES

-chlorpromazine, chlorpromethazine

A 
sedation
hypotension
extrapyramidal reactions
dry mouth
urinary retention
tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SE of BUTYROPHENONES

-droperedol, haloperidol

A 
Sedation
dystonic reactions
hypotension
tachycardia
extrapyramidal reactions
anxiety
restlessness arrythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SE of BENZAMINES

- Metaclopromide

A 
drowsiness
restlessness
fatigue
anxiety
extrapyramidal reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SE of Anticholinergic

- Scopolamine

A 
sedation
dry mouth
visual disturbances
 memory loss
confusion
hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SE of ANTIHISTAMINES

-hydroxyzine

A 
sedation 
blurred vision
dry mouth
urinary retention
tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SE of 5-HT3 receptor antagonist

A 
Headache
dizziness
mild drowsiness
constipation
arrhythmia's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

why do 5-HT3 receptor antagonist avoid dystonic reactions?

A

not associated with dopamine blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

where are 5-HT3 receptors located

A

peripheral
-GI tract
Central
-medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ondansetron intactions with narcotics and NMBDs

A

none

17
Q

Ondansetron recommended dose

for PONV

A

immediately prior to induction
adults 4 mg undiluted over 30 sec (prefer 2-5 min)
peds 0.1mg/kg

18
Q

Ondansetron recommended dose

for further episodes of nausea/ vomiting

A

same
adults 4 mg undiluted over 30 sec (prefer 2-5 min)
peds 0.1mg/kg

19
Q

Ondansetron special concerns for:
elderly?
Renal impairment?
Hepatic insufficiency?

A

NONe
NOne
None

20
Q

4 main predictors for PONV

A

female
Hx of motion sickness. PONV
NON-smoker
postop opioids

21
Q

PONV video cards

A

from the young man himself

22
Q

Causes of PONV

A 
PREMEDS
-opioids
GASTRIC DISTENTION
-ventilation
-full stomach
-DM
DEPTH AND LENGTH OF SX
-longer sx higher risk
SURGICAL PROCEDUES
- gyn
-eyes
-ABD
- ENT
POST-OP FACTORS
-pain
-opioids
-dizziness
- movement
- 1st oral intake
PATIENTS AT RISK
- age (peds higher)
- gender (female higher)
- obese
-hx of PONV
- anxiety
- motion sickness
23
Q

Consequences of PONV

A 
discomfort
oral drug disruption
wound dehisence
aspiration
electrolyte disturbances
24
Q

Now on to RTFF’s highlights from EVERs

A

rudy rudy rudy (thats me cheering you on)

25
Q

vomiting is acomplex process coordinated by the vomiting center in the ???????

A

lateral reticular formation of the medula

26
Q

explain the process of n/v go deep

A
  • the lateral reticular formation of the medulla receives input from (1) the chemoreceptor trigger zone of the area of POSTREMA in the floor of the fourth ventricule
    (2) the vestibular apparatus threough the nucleus vestibularis and cerebellum
    (3) higher brain stem and cortical structures
    (4) afferents from the GI tract (mainly serotoni-nergic, pharynx, and mediastinum
27
Q

_____ is an important emetic transmitter in the afferent pathway from the GI tract terminating in the cheorecptor trigger zone and in the nucleus tractus solitarius

A

Serotoin (5-hydroxytryptamine)

5-HT3

28
Q

____, _____, _______, and _______ are also implicated in emetic signaling at the chemoreceptor trigger zone and in the nucleus tractus solitarius

A

dopamine (D2)
acetylcholine
histamine substance P (NK1)

29
Q

as 5-HT is rapidly removed from plasma by platelets, endothelium, and the liver, peripheral 5-HT release is reflected by analyzing its major metabolite what???

A

5-hydroxyindole acetic acid (5-HIAA)

30
Q

The 5-HT3 receptor is a ____-_____ ____ channel and therby differes from other serotonin receptors whose ace=tions are mediated via G-proteins

A

ligand-gated ion

31
Q

four 5-HT3 antagonist are now available in the US for PONV what are they

A

ondansetron
dolaseron
granisetron
palonosetron

32
Q

which 5-HT3 is available in Europe

A

tropisetron

33
Q

5 factors that predispose you to PONV

A 
female sex
non-smoking
previous PONV
hx of motion sickness
duration of sx >60 min
34
Q

the presence of one of these symptoms (female sex, non-smoking, previous PONV, hx of motion sickness,duration of sx >60 min) increased the risk of nausea from 17% to

A

18, 42, 54, 74 and finialy 87% when all 5 are present

35
Q

the presence of one of these symptoms (female sex, non-smoking, previous PONV, hx of motion sickness,duration of sx >60 min) increased the risk of vomiting from 7% to

A

7%, 17%, 25%, 38% and 61% for all 5 factors

Anesthesia Pharm II (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions