Chapter 4 BNF (Nausea and Labyrinth Disorders) Flashcards

1
Q

What are the causes of N and V?

A
Drugs
Labyrinthitis (inner ear infection)
Motion
Gut irritation
Higher stimuli
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2
Q

How dose nausea occur?

A

vomiting centre triggered by chemoreceptor trigger zone?

antiemetics antagonise the CTZ

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3
Q

What dopamine antagonists are used in N and V?

A

Metoclopramide
Domperidone (parkinson’s)
Prochloperazine (migraine)
haloperidol, levopromazine (palliative )

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4
Q

which antihistamines are used in n and v?

A

Cinnarizine
cyclizine
promethazine (vertigo)

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5
Q

what antimuscarinc is used in n and v?

A

hyoscine hydrobromide (most effective in motion)

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6
Q

what 5ht3 antagonists are used in n and v?

A

ondansetron
granisetron
palonsetron

chemo, post op,

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7
Q

what other drugs are used in n and v?

A

dexamethasone
nabilone
aprepitant

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8
Q

When drug treatment is necessary, what medication can be used in N and V in pregnancy?

A

promethazine short term
prochloperazine
metoclopramide

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9
Q

What antiemetics can be used in prevention of post op N and V?

A

5HT3 Antagonists
Dexamethasone
Phenothiazines
cyclizine

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10
Q

How does Metoclopramide work?

A

D2 receptors on the CTZ

acts in the gut to promote emptying, prokinetic

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11
Q

what are the risks with Metoclopramide?

A

EPSEs (MHRA)

Max use 5 days, 18+, 10mg TDS

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12
Q

What are the side effects with Metoclopramide?

A

Acute dystonic reactions especially in young girls and elderly

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13
Q

Whats the difference between Metoclopramide and Domperidone?

A

Domperidone doesnt cross the BBB, no dystonia

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14
Q

Whats the risk with Domperidone?

A

serious cardiac reactions (MHRA) QT prolongation

max use 1 week 10mg TDS

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15
Q

What are the hallmarks of 5HT3 antagonists interactions?

A
QT prolongation
serotonin syndrome 
hypokalemia drugs (causes torsades)
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