drugs for nausea and vomiting

Question 1

vomiting

Answer 1

this is the forceful expulsion of stomach contenets and the contents of the proximal small intestine

Question 2

potassium deficiency, sodium depletion, alkalosis, malnutrition, differential diagnosis, esophageal and gastric injury, dnetal injury are all consequences of what

Answer 2

vomiting

Question 3

what does the act of vomiting not include

Answer 3

regugriation and rumintation

Question 4

what is regurgitation

Answer 4

this is the return of previously swallowed food or secretions into the mouth

Question 5

what is the return of previously swallowed food or secretions into the mouth

Answer 5

regurgitation

Question 6

what is rumination

Answer 6

this is the repetitive, effortless regurgitation of recently ingested food into the mouth followed by rechewing and re swallowing

Question 7

what is the effortless regurgitation of recently ingested food into the mouth followed by rechewing and re swallowing

Answer 7

rumintation

Question 8

what is nausea associated with (3)

Answer 8

decreased gastric motility, increased small intestine, reverse proximal small intestin peristalisis

Question 9

what are the three distinct units that control vomiting

Answer 9

vomiting centres, nucleus tractus solitarius, chemoreceptor trigger zones

Question 10

vomiting canters, nucleus tractus solitarius, chemoreceptor trigger zones - are what?

Answer 10

3 units in the braisntem that control vomiting

Question 11

where are the bilateral vomiting centres found

Answer 11

found in the reticular formation of the medulla

Question 12

bilateral vomiting centres - role, what do they integrate signals from, what does this activation trigger

Answer 12

they integrate signals from a large number of outlying sources - the activation tirggers vomiting

Question 13

where do the vomiting centres receive afferent signals from

Answer 13

CTZ and NTS

visceral afferants from the GI tract and outside the gi tract

Question 14

visceral afferents from the Gi tract

Answer 14

vagus or sympathetic nerves, mucosal irritation

Question 15

visceral afferents from outside the GI tract

Answer 15

bile ducts, peritoneum, heart, and a variety of other organs

Question 16

afferents from the extramedullary centers in the brain

Answer 16

odors, fear, vestibular disturbance, cerebral trauma

Question 17

where do afferent signals come from that attricbute to fear

Answer 17

the extramedullary center

Question 18

where do vistubular disturbances come from - motion sickness

Answer 18

the extra medullary center

Question 19

chemoreceptor trigger zones (heart)

Answer 19

these are bilateral centres in the brainstem that are located under the floor of the fourth ventricle

Question 20

does electrical stimulation cause vomiting

Answer 20

no, however, an emetic drug would

Question 21

what does noxious stimuli cause

Answer 21

vomiting

Question 22

what does the CTz act as

Answer 22

acts as an emetic chemoreceptors for the VC

Question 23

what do CTZ detect

Answer 23

detect chemical abnormailities

Question 24

What signals does the CTZ send

Answer 24

they send excitatory signals

Question 25

what would be described as a chemical abnormaility

Answer 25

diabetic ketoacidosis, antiemetic drugs, hypoxia

Question 26

vomiting pathways - absorbed toxic chemicals and drugs in the blood go where

Answer 26

ctz --> vomiting centre

Question 27

vomiting pathways - where do mechanical stimuli within the GI tract go

Answer 27

vagal afferents --> VC

Question 28

where do inputs from the vestibular system go

Answer 28

vestibular nuclei --> ctz --> vomiting centre

Question 29

stimuli within the CNS how do they get to the vomiting center

Answer 29

cerebral cortex --> limbic system --> vomiting centre

Question 30

why does chemotherapy make people vomit/nausea

Answer 30

because the drugs directly stimulate the CTZ

Question 31

what does chemotherapy stimulate what cells to release what

Answer 31

chemotherapy stimulates cells in the Gi tract to release serotonin

Question 32

what does the release of serotonin stimulates what

Answer 32

the release stimulates the 5ht3 receptors in 3 areas

Question 33

what areas do the serotonin activate 5-HT3 receptors

Answer 33

NTs | CTZ and vagal afferents in the GI

Question 34

NTS, CTZ, and vagal afferents are stimulated by what in chemotherapy

Answer 34

serotonin

Question 35

anticipatory nausea and vomtiing

Answer 35

triggered by specific odours, tastes, objects that pt associates with treatment

Question 36

what vomiting occurs within 24 hours after cancer treatment

Answer 36

acute

Question 37

delayed onset nausea and vomiting

Answer 37

occurs more than 24 hours after cancer treament and may continue for several days

Question 38

anticholinergics

Answer 38

they are a muscainic receptor antagonist in the NTS and CTZ

Question 39

side effects of anticholinergics

Answer 39

sedation, dry mouth, constipation, urinary retention

Question 40

antihistamines

Answer 40

targetr the H1 receptors in the NTs and CTZ

Question 41

cannabinoids

Answer 41

CB1 receptor in he cortex and VC

Question 42

what are cannabinoids used for

Answer 42

to increase appetite

Question 43

what are dopamine antagonists good for

Answer 43

good for drug induced nausea and vomiting

Question 44

what do the dopamine antagonists target

Answer 44

the D2 receptors in the CTZ and MTS

Question 45

serotonin antagonists

Answer 45

are more important for drug induced and chemotherapy induced

Question 46

what do the serotonin antagonists do

Answer 46

they trigger the 5ht3 receptors in the CTZ and the NTS

Question 47

glucocorticoids

Answer 47

they inhibit serotonergic tone

Question 48

what are glucocorticoids helpful for

Answer 48

chemotherapy

Question 49

what does the inhibition of serotinergic tone do

Answer 49

stops the 5ht3 release and the receptor density, thus stopping the signal from going to the ctz, nts

Question 50

what drugs have direct central action within the CNS

Answer 50

glucocorticoids

Question 51

what are glucocorticoids commonly combined with

Answer 51

5HT antagonists and NK1 antagonists

Question 52

neurokinin receptor antagonists (NK1)

Answer 52

blokc the binding of substance p at the NK1 receptor

Question 53

what block the binding of substance p at the NK1 receptor

Answer 53

NK1 receptor antagonists

Question 54

what are some adverse effects of NK1 receptor antagonists

Answer 54

it inhibits the CYP3A4 enzymes

Question 55

when should benzos be prescribed

Answer 55

for ptsd, chemo panic

Question 56

motion sickness (CTZ) - prescribe

Answer 56

histamine or muscarinic antagonists

Question 57

chemo meds and opiods

Answer 57

NK1, histamine, cannabinoid

Question 58

Chemo

Answer 58

serotinergic