drug therapy for nausea and vomiting Flashcards
vomiting is a ____ reflex
central
where is the vomiting center located
medulla
the CTZ can be triggered by…
-emetogenic drugs
-anticipatory
-motion sickness
give and example of phenothiazines
promethazine
what are phenothiazines used for
-prevent and treat nausea
-changes responsiveness of CTZ
-IV, IM, PO, suppository
what are some contraindications of phenothiazines
-black box warning to avoid in children under 2
-black box warning to avoid giving SQ bc it is really tough on tissue
-CNS depression
-liver failure with long term use
what are some adverse effects of phenothiazines
-severe drowsiness, dizziness
-dry mouth, urinary retention
what are some nursing implications for phenothiazines
-avoid giving with other CNS depressants
-IV administration can cause tissue injury
describe pateint teaching for phenothiazines
-take lowest dose possible
-do not take with other CNS depressants
-works best as preventative
-do not drive while taking this med
-lying down may hep nausea
give and example of antihistamines
hydroxyzine
describe the use of antihistamines
-relieve nausea, vomiting, and motion sickness
-block action of histamine of CTZ
-PO, IV, IM
what are some adverse effects of antihistamines
-drowsiness, dizziness
-dry mouth, urinary retention
what are some nursing considerations for antihistamines
-avoid giving with other CNS depressants
-IV admin can cause tissue injury
-not all histamines work as antiemetics
describe patient teaching for antihistamines
-take lowest dose possible
-do not take with other CNS depressants
-works best as a preventative
-do not drive while taking this med
-lying down may help nausea
give an example of 5-HT3 receptor blockers
ondansetron
what are 5-HT3 receptor blockers used for
-prevent nausea and vomiting (chemo, radiation, post op)
-block receptors in CTZ
-PO, IV
what are some adverse effects of 5-HT3 receptor blockers
-diarrhea
-headache
-prolonged QT interval
describe patient teaching for 5-HT3 receptor blockers
-take lowest dose possible
-works best as a preventative
-do not drive while taking this med
-lying down may help nausea
give and example of substance P/neurokinin 1 antagonists
aprepitant
what are substance P/neurokinin 1 antagonists used for
-used in combo with 5-HT3 receptor anatgonist and corticosteroid
-treat delayed nausea and vomiting
-works in CNS to block N/V receptors
-IV, PO
-given with chemotherapy
what are some adverse effects of substance P/neurokinin 1 antagonists
-fatigue
-weakness
-heart arrhythmias
what are some nursing considerations for substance P/neurokinin 1 antagonists
-take 1hr pre chemo
-take to prevent nausea
-may need rescue antiemetic
describe patient teaching for substance P/neurokinin 1 antagonists
-works best as a preventative
-do not drive while taking this med
-lying down may help with nausea
what does metoclopramide do
increases bowel motility
what does dronabinol do
contains cannabis, used for N/V in chemo
what does scopolamine do
prevents N/V in motion sickness
name some OTC antiemetics
antacids, diphenhydramine, peppermint, ginger
what does acupuncture do
treats and prevents N/V
true or false
all antihistamines can be used as antiemetics
false
not all antihistamines affect the CTZ in the brain
