Clinical Pharm - Antiemetics and Growth Factors

Question 1

3 neurotransmitters primarily responsible for chemo-induced N/V

Answer 1

1. serotonin
2. substance P/NK-1
3. dopamine

Question 2

3 classes of drugs that help prevent chemo-induced N/V

Answer 2

1. 5-HT3 receptor antagonists
2. NK-1 receptor antagonists
3. dopamine receptor antagonists

Question 3

examples of 5-HT3 receptor antagonists

Answer 3

*“trons”:
-ondansetron
-granisetron
-palonosetron

Question 4

examples of NK-1 receptor antagonists

Answer 4

*aprepitant
*fosaprepitant
*rolapitant
*netupitant/palonosetron

Question 5

examples of dopamine receptor antagonist antiemetics

Answer 5

*prochlorperazine
*promethazine
*metoclopramide
*haloperidol
*droperidol

Question 6

side effects of 5-HT3 receptor antagonists

Answer 6

*headaches
*constipation > diarrhea
*prolonged QTc
*note - NOT sedating!

Question 7

side effects of NK-1 receptor antagonists

Answer 7

*fatigue
*hiccups
*diarrhea
*SEDATING
*CYP3A4 interactions

Question 8

side effects of dopamine receptor antagonists

Answer 8

*SEDATING
*extrapyramidal effects

Question 9

important drugs available to manipulate the hematopoietic system in chemo patients

Answer 9

*granulocyte colony-stimulating factor (filgrastim - helps promote white cell production, primarily neutrophils)

*erythropoietin stimulating agents (epoetin - helps promote red cell production)

Question 10

pegfilgrastim

Answer 10

*longer-acting version of filgrastim (a granulocyte colony-stimulating factor)
*only requires one dose, rather than multiple daily shots

Question 11

filgrastim - drug class

Answer 11

granulocyte colony-stimulating factor

Question 12

side effect of filgrastim/pegfilgrastim (G-CSFs)

Answer 12

*bone pain (esp in lumbar, sternal, and pelvic areas, the main locations where bones have cells that participate in hematopoiesis)
*possibly fever