Decontamination Agents and Antiemetics Flashcards

1
Q

What are 3 classes of stimulation that cause vomiting?

A

Mechanical
Blood born
Higher center

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2
Q

Where are Chemoreception Trigger Zone (CTZ) and Vomiting center located?

A

CTZ = Oustide of BBB in 4th ventricle

Vomiting Center = IN BBB, medulla

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3
Q

What receptors are present in CTZ?

A
Serotonin
Histamine
Muscarinic
Opioid
Dopamine
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4
Q

What portion/area of the vomiting signal do 5HT inhibitors act on?

A

5HT receptors in the GI tract

i.e. sensory signalling from vagal afferents

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5
Q

What portion/area of the vomiting signal do DA and opioid inhibitors act on primarily?

A

CTZ

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6
Q

What portion/area of the vomiting signal do Muscarinic, histamine, NK, and cannabinoid inhibitors act on?

A

Inside the BBB

  • Central Centers
  • Vomiting Center
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7
Q

Dolasetron
Granisertron
Ondansetron
Palonosetron MOA and use?

A

5HT3 R antagonists

Used for chemotherapy anti-emesis

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8
Q

SE of 5HT3 antagonists?

A

Mild headache, dizziness, constipation

Prolonged QT

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9
Q

Scopolamine MOA and use?

A

Anti-muscarinic

Motion sickness

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10
Q

How is scopolamine administered?

A

Trans-dermal patch

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11
Q

Aprepitant/Fosaprepitant MOA and use?

A

NK1 antagonists (Sub P usually binds)

Used with –serton + dexamethasone to relieve chemotherapy emesis

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12
Q

How are aprepitant and fosaprepitant administered?

A
aprepitant = Oral
fosaprepitant = IV
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13
Q

SE of Aprepitant/Fosaprepitant ?

A

CYP3A4 metabolism

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14
Q

Dimenhydrinate
Diphenhydramine
Meclizine MOA?

A

Histamine antagonists, likely due to sedation, possibly acts on H1R in vestibulocerebellar pathway

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15
Q

SE of Dimenhydrinate, Diphenhydramine, Meclizine?

A

Anticholinergic
Teratogenic
Macrolide interactions

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16
Q
Droperidol
Metoclopramide
Prochlorperazine
Promethazine
Thiethylperazine MOA?
A

DA2 Antagonists

17
Q

Dronabinol

Nabilone MOA?

A

Marijonaz

18
Q

Activated Charcoal MOA?

A

Large surface area absorbs many drugs and poisons

19
Q

What DOESN’T charcoal bind?

A

Iron
Lithium
Potasium

20
Q

When SHOULDN’t you use activated charcoal?

A

Poisoning due to corrosive mineral acids or alkalis

21
Q

Polyetheylene glycol MOA?

A

Hasten removal or toxins

22
Q

Ipecac MOA?

A

Local irritant + CTZ stimulation