Chapter 3 CNS - antiemetic/antivertigo drugs

Question 1

prochlorperazine (compazine)
* including triflupromazin, chlorpormazine, and trifluperazine

Answer 1

• all phenothiazine antipsychotics
• agents control vomiting by blocking D2 dopamine receptors in the chemoreceptor trigger zone (CTZ) of the brainstem

Question 2

promethazine (phenergan)

Answer 2

• D2 dopamine antgonist and H1 histamine antagonist which is used to control motion sickness +n/v
• useful post sx d/t it reducing anesthesia-related nausea, induces light sleep and reduces apprephension

Question 3

metoclopramide (reglan)

Answer 3

dopamine (d2) antagonist
* useful for reducing chemotherapy induced nausea
* clinically used as GI stimulant to improve gastric emptying
* RISK OF TARDIVE DYSKINESIA

Question 4

scopolamine (transderm-scop)

Answer 4

• anticholinergic available as a transdermal preparation to prevent motion sicknes — It works on the central nervous system (CNS) to create a calming effect on the muscles in the stomach and bowels (gut). [also n/v caused by motion sickness]

Question 5

anticholinergics/antihistamines

Answer 5

• diphenhydramine, dimenhydrinate, meclizine are antihistamines w/ anticholinergic effects; anticholinergic drugs reduce motion sickness as well as emesis (agents that block muscarinic receptors and inhibit cholinergic transmission from the vestibular nuclei to the vomiting center. Anticholinergic antiemetics are mainly used to prevent or treat motion sickness.)

Question 6

ondansetron (zofran)
granisetron (kytril)
dolastetron (anzemet)
alsetron (lotronex)
palanosetron (aloxi)

Answer 6

• blocks serotonin (5-ht3) receptors, but not dopamine receptors
• used to control chemotherapy-induced nausea
• REMARKABLY more effective than other agents in patients receiving chemotherapy