CPT ANTIEMETICS

Question 1

1. name Muscarinic receptor antagonist
2. MOA
3. indications
4. SE and exploitation

Answer 1

1. hyoscine hydrobromide
2. competitive blocker of acetylcholine receptors in the vesitubular neucli and the CTZ
3. motion sickness, cant take pills, bowel obstruction
4. sedation, dry mouth, gloaucoma and memory problems, exploit by using in ppl with nerological problems e.g dry mouth.

Question 2

1. name one H1 receptor antagonist
2. MOA
3. SE
4. Indication
5. CI

Answer 2

1. Cyclizine
2. inhibit histamenergic signals from the VN to the CTZ
3. sedation, excitation, antimuscurinic ( UR, C, and DM), cardiac toxicity
4. promethazine for morning sickness and cyclizine for motion sickness
5. no cyclizine for old ladies and children

Question 3

2 classes of drugs that act on the vesicular nuclei

Answer 3

muscurinic receptor antagonists

H1 receptor antagonists

Question 4

2 classes of drugs that act on visceral afferents

Answer 4

seratonin 5HT3 receptor antagonist

D2 receptor antagonist

Question 5

1. seratonin receptor antaganist eg
2. SE
3. MOA
4. indications

Answer 5

1. ondansetron
2. headache, constipation, dystonia and parkinsonism,elevated liver enzymes, long QT syndrome
3. seratonin normally relased in response to PSS, excites enteric system so effect is reduced GI motility and secretions
4. 1st line treatment for everyone( eg bowel obstruction )

Question 6

1. D2 receptor antagonist
2. reason for dystonia and parkinsonism as SE
3. the zines indications and haliperidol indication
4. the zines MOA
5. the zines side effects
6. SE of metoclopramide and domperidone each

Answer 6

1. metoclopramide and domperidone, promote gastric emptying bc inc Ach in M recdeptors in gut.
2. M crosses BBB inhibit D2 receptor
3. zines D are antipsychotics and prochlorperazine used for morning sickness
4. act directly on the CTZ
5. dystonia and P, sedation and hypotension
6. M=galactorrhoea and D and P
   D=galactorrhoea and sudden cardiac death

Question 7

1. corticosteroids 2 eg
2. SE
3. MOA
4. Indications

Answer 7

dexamethasone and methylprednisalone

2. inc glucose and apetite and insomnia
3. properites of D2 antagonist and act on CTZ
4. 1st drug to give with chemotherapy, perioperative nausea, and palliation

Question 8

1. cannabinoid eg
2. SE
3. indications

Answer 8

1. nabilone
2. drowsiness and dizziness
3. chemo, last line

Question 9

1. neurokinin 1 receptor antagonist (1)

2. MOA

Answer 9

1. aprepitant
2. inc effect of seratonin antagonists
   chemotherapy

Question 10

1. drugs to use in motion sickness
2. prokinetics eg and when to use and not use
3. what to use in bowel obstruction (3)

Answer 10

1. hyoscine hydrobromide
2. metoclopramide and domperidone dont use in bowel obstruction , use in GORD and ileus
3. ondansteron and or cyclizine and then dexamethasone

Question 11

1. what to use in hyperemesis gravidarum( 4 steps)

Answer 11

promethazine( histamine receptor antagonist) or prochloperazine and then add metoclolramide then add ondansteron

Question 12

1. management for perioperative nausea

Answer 12

ondansterone ( inhitbit mot) and or cyclizine then add dexamethasone

Question 13

1. opioid receptor antagonist used for diarrhea
2. MOA
3. SE

Answer 13

2. L acts on mew recp and C and M act on gamma and mew receptors of myenteric plexus
   decreases tone of longitudinl and circular SM but inc segmental contractions
3. addiction, nausea and vomting, paralytic ileus

Question 14

2 osmotic laxitives

MOA difference

Answer 14

lactulase and movicol
L draws water in
movicol retains water

Question 15

3 stimulant laxitives

MOA

Answer 15

senna, bisacodyl, docusate sodium

DS is a stimulant and a stool softener

Question 16

Bulk forming laxitives (2)

2 stool softners and MOA

Answer 16

methylcellulose and ispaghula husk

docusate sodium and glycerine suppository (dec surface tension and inc fluid penetration)