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Exam 3 - Pharmacology > Chapter 52 - Antiemetic and Antinausea Drugs > Flashcards

Chapter 52 - Antiemetic and Antinausea Drugs Flashcards

1
Q

What is nausea?

A

Unpleasant feeling preceding vomiting

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2
Q

What is Emesis?

A

Vomiting.

Forcible emptying of gastric/intestinal contents

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3
Q

What drugs are used to relieve nausea/vomiting?

A

Antiemetic drugs

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4
Q

6 pharmacologic managemetn of nausea/vomiting?

A
  1. Dopamine antagonists
  2. Antihistamines
  3. Anticholinergics
  4. Prokinetic agents
  5. Serotonin blockers
  6. Tetrahydrocannabinoids (THC)
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5
Q

Causes of nausea/vomiting? (11, and they literally all start with M)

A 
Metastases
Meningeal irritation
Movement
Mental anxiety
Medications
Mucosal irritation
Mechanical obstruction
Motility
Metabolic
Microbes
Myocardial
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6
Q

What is the MOA of anticholinergic drugs?

MOA = Mechanism of Action

A
  1. bind to and block ACh receptors in inner ear labyrinth
  2. block transmission of nauseating stimuli to CTZ
  3. also block transmission of nauseating stimula from reticular formation to the VC
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7
Q

Indications of anticholinergic drugs?

A

motion sickness, pre-surgical secretion reduction, N/V

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8
Q

What is scopolamine and what is it used for?

A

Anticholinergic drug in transdermal patch form used for motion sickness

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9
Q

What is the MOA of antihistamine drugs (H1 receptor blockers)?

A
  1. inhibit ACh by binding to H1 receptors

2. prevent cholinergic stimulation in vestibular/reticular areas, preventing N/V

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10
Q

Indications of antihistamine drugs?

A

motion sickness, nonproductive cough, allergy symptoms, sedation, N/V

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11
Q

3 Antihistamine drugs

ADDM

A
  1. dimenhydrinate (Dramamine(
  2. diphenhydramine (Benadryl)
  3. meclizine (Antivert)

Antihistamines Don’t Deliver Madness

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12
Q

MOA of antidopaminergic drugs

A

block dopamine receptors on the CTZ

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13
Q

Indications of antidopaminergic drugs?

A

used for psychotic disorders, intractable hiccups (i find this funny), N/V

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14
Q

3 antidopaminergic drugs, and which is controversial/why?

A
  1. prochlorperazine (Compazine)
  2. promethazine (Phenergan)
  3. droperidol (Inapsine): controversial use b/c associated cardiac dysrhythmia
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15
Q

MOA of prokinetic drugs

A
  1. block dopamine in the CTZ
  2. cause CTZ to be desensitized to ipulses it receives from the GI tract
  3. stimulates peristalsis in GI tract, enhancing emptying of stomach contents
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16
Q

Indications of prokinetic drugs

A

GERD, delayed gastric emptying, N/V

17
Q

Example of a prokinetic drug

A

metoclopramide (Reglan)

long term use may cause irreversible tardive dyskinesia

18
Q

MOA of serotonin blockers

A

block serotonin receptors in the GI tract, CTZ, and VC

19
Q

Indication of serotonin blockers

A

N/V in pt’s receiving chemotherapy and for postoperative n/v

20
Q

4 examples of serotonin blocker drugs

A
  1. dolasetron (Anzemet)
  2. granisetron (Kytril)
  3. ondansetron (Zofran)
  4. palonosetron (Aloxi)
21
Q

MOA of tetrahydrocannabinoids (THC)

A
  1. major psychoactive substance in marijuana
  2. inhibitory effects on reticular formation, thalamus, cerebral cortex
  3. alter mood and body’s perception of its surroundings
22
Q

Indications of tetrahydrocannabinoids

A

N/V associated with chemo, and anorexia associated with weight loss in AIDS/cancer pts
-may also stimulate appetite

23
Q

Example of tetrahydrocannabinoid drug

A

dronabinol (Marinol)

24
Q

Common adverse effects

A
  1. dizziness, h/a
  2. drowsiness, sedation, fatigue
  3. disorientation, confusion
  4. dry mouth, blurred vision, dilated pupils, urinary retention

for other specific adverse effects, use table 52-5 on page 831. btw there’s a lot.

25
Q

Ginger: used for, adverse effects, and interactions

A

used for: n/v, caused by chemo, morning sickness, and motion sickness

adverse: anorexia, n/v, skin reactions

drug interactions: increase absorption of oral meds, increase bleeding risk with anticoagulants, not recommended during pregnancy

26
Q

Nursing implications: what to assess?

A

N/V history, including causes

assess allergies, current meds (everything, literally everything), contraindications, potential drug interactions

27
Q

Do antidiabetic/antiemetic drugs cause drowsiness?

A

Many of them do!

Warn pt’s about driving

28
Q

Taking antiemetics with alcohol can cause __________

A

severe CNS depression

29
Q

When are antiemetics given for chemo?

A

30-60 minutes before chemo begins

30
Q

What must we monitor for?

A

therapeutic and adverse effects

31
Q

What must be taught to pts?

A

change position slowly (avoid hypotensive effects) and VS frequently

Exam 3 - Pharmacology (4 decks)

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