drug therapy for nausea and vomiting

Question 1

vomiting center includes

Answer 1

medulla, chemoreceptor trigger zone (CTZ), emetogenic drugs, anticipatory, motion sickness

Question 2

drug classes for N/V

Answer 2

phenothiazine antiemetics, anticholinergic antiemetics, 5-HT3 receptor blockers, substance P/neurokinin 1 receptor antagonist

Question 3

example meds of phenothiazines

Answer 3

promethazine

Question 4

uses of phenothiazines

Answer 4

prevent and treat nausea, changes responsiveness of CTZ, given IV/ IM/ PO/ suppository

Question 5

contraindications of phenothiazines

Answer 5

BLACK BOX TO AVOID IN CHILDREN UNDER 2, BLACK BOX TO AVOID SUBQ, CNS depression, liver failure

Question 6

adverse effects of phenothiazines

Answer 6

drowsiness, dizziness, dry mouth, urinary retention

Question 7

nursing implications for phenothiazine

Answer 7

avoid giving with other CNS depressants, don’t give IV or subs because it can cause tissue damage

Question 8

patient teaching when taking phenothiazine

Answer 8

take lowest dose possible, don’t take with other CNS depressants works best as a preventative, do not drive while taking this medication, lying down may help nausea

Question 9

example meds of antihistamine

Answer 9

hydroxyzine

Question 10

uses of antihistamine

Answer 10

relieve N/V/ motion sickness, block action of histamine on CTZ, given PO/IV/IM

Question 11

adverse effects of histamines

Answer 11

drowsiness, dizziness, dry mouth, urinary retention

Question 12

nursing considerations for antihistamines

Answer 12

avoid giving with other CNS depressants, IV administration can cause tissue damage, not all antihistamines work as antiemetics

Question 13

patient teaching on antihistamines

Answer 13

take lowest dose possible, do not take with other CNS depressants, works best as a preventative, do not drive while taking this medication, lying down may help nausea

Question 14

example meds of 5-HT3 receptor blockers

Answer 14

ondansetron

Question 15

uses of 5-HT3 receptor blockers

Answer 15

prevent N/V (chemo, radiation, post-op), block receptors in CTZ, given PO or IV

Question 16

adverse effects of 5-HT3 receptor blockers

Answer 16

diarrhea, headache,***prolonged QT interval

Question 17

patient teaching for 5-HT3 receptor blockers

Answer 17

take lowest dose possible, works best as a preventative, do not drive while taking this medication, lying down may help nausea

Question 18

example meds of substance P/ neurokinin 1 antagonists

Answer 18

aprepitant

Question 19

uses of substance P/ neurokinin 1 antagonists

Answer 19

used in combo with 5-HT3 receptor antagonists & corticosteroids, ***treat delayed N/V, works in CNS to block N/V receptors, given IV/ PO

Question 20

adverse effects substance P/ neurokinin 1 antagonists

Answer 20

fatigue, weakness, heart arrhythmias

Question 21

nursing considerations for substance P/ neurokinin 1 antagonists

Answer 21

take 1 hr pre chemo, take to prevent nausea, may need ‘rescue’ antiemetic

Question 22

patient teaching for substance P/ neurokinin 1 antagonists

Answer 22

works best as preventative, do not drive while taking this medication, lying down may help nausea

Question 23

use of metoclopramide: antiemetic

Answer 23

increases bowel motility

Question 24

use of dronabinol: antiemetics

Answer 24

contains cannabis, used for N/V in chemo

Question 25

use of scopolamine: antiemetic

Answer 25

prevents N/V in motion sickness

Question 26

OTC antiemetics

Answer 26

antacids, diphenhydramine, peppermint, ginger

Question 27

acupuncture: antiemetics

Answer 27

treats and prevents N/V

Question 28

T or F. All histamine can be used as antiemetics

Answer 28

false, not all affect the CTZ in the brain