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pharmacology > drugs for nausea and vomiting > Flashcards

drugs for nausea and vomiting Flashcards

1
Q

vomiting

A

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

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2
Q

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

A

vomiting

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3
Q

what does the act of vomiting not include

A

regugriation and rumintation

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4
Q

what is regurgitation

A

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

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5
Q

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

A

regurgitation

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6
Q

what is rumination

A

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

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7
Q

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

A

rumintation

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8
Q

what is nausea associated with (3)

A

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

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9
Q

what are the three distinct units that control vomiting

A

vomiting centres, nucleus tractus solitarius, chemoreceptor trigger zones

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10
Q

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

A

3 units in the braisntem that control vomiting

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11
Q

where are the bilateral vomiting centres found

A

found in the reticular formation of the medulla

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12
Q

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

A

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

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13
Q

where do the vomiting centres receive afferent signals from

A

CTZ and NTS

visceral afferants from the GI tract and outside the gi tract

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14
Q

visceral afferents from the Gi tract

A

vagus or sympathetic nerves, mucosal irritation

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15
Q

visceral afferents from outside the GI tract

A

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

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16
Q

afferents from the extramedullary centers in the brain

A

odors, fear, vestibular disturbance, cerebral trauma

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17
Q

where do afferent signals come from that attricbute to fear

A

the extramedullary center

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18
Q

where do vistubular disturbances come from - motion sickness

A

the extra medullary center

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19
Q

chemoreceptor trigger zones (heart)

A

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

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20
Q

does electrical stimulation cause vomiting

A

no, however, an emetic drug would

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21
Q

what does noxious stimuli cause

A

vomiting

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22
Q

what does the CTz act as

A

acts as an emetic chemoreceptors for the VC

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23
Q

what do CTZ detect

A

detect chemical abnormailities

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24
Q

What signals does the CTZ send

A

they send excitatory signals

25
Q

what would be described as a chemical abnormaility

A

diabetic ketoacidosis, antiemetic drugs, hypoxia

26
Q

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

A

ctz –> vomiting centre

27
Q

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

A

vagal afferents –> VC

28
Q

where do inputs from the vestibular system go

A

vestibular nuclei –> ctz –> vomiting centre

29
Q

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

A

cerebral cortex –> limbic system –> vomiting centre

30
Q

why does chemotherapy make people vomit/nausea

A

because the drugs directly stimulate the CTZ

31
Q

what does chemotherapy stimulate what cells to release what

A

chemotherapy stimulates cells in the Gi tract to release serotonin

32
Q

what does the release of serotonin stimulates what

A

the release stimulates the 5ht3 receptors in 3 areas

33
Q

what areas do the serotonin activate 5-HT3 receptors

A

NTs

CTZ and vagal afferents in the GI

34
Q

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

A

serotonin

35
Q

anticipatory nausea and vomtiing

A

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

36
Q

what vomiting occurs within 24 hours after cancer treatment

A

acute

37
Q

delayed onset nausea and vomiting

A

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

38
Q

anticholinergics

A

they are a muscainic receptor antagonist in the NTS and CTZ

39
Q

side effects of anticholinergics

A

sedation, dry mouth, constipation, urinary retention

40
Q

antihistamines

A

targetr the H1 receptors in the NTs and CTZ

41
Q

cannabinoids

A

CB1 receptor in he cortex and VC

42
Q

what are cannabinoids used for

A

to increase appetite

43
Q

what are dopamine antagonists good for

A

good for drug induced nausea and vomiting

44
Q

what do the dopamine antagonists target

A

the D2 receptors in the CTZ and MTS

45
Q

serotonin antagonists

A

are more important for drug induced and chemotherapy induced

46
Q

what do the serotonin antagonists do

A

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

47
Q

glucocorticoids

A

they inhibit serotonergic tone

48
Q

what are glucocorticoids helpful for

A

chemotherapy

49
Q

what does the inhibition of serotinergic tone do

A

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

50
Q

what drugs have direct central action within the CNS

A

glucocorticoids

51
Q

what are glucocorticoids commonly combined with

A

5HT antagonists and NK1 antagonists

52
Q

neurokinin receptor antagonists (NK1)

A

blokc the binding of substance p at the NK1 receptor

53
Q

what block the binding of substance p at the NK1 receptor

A

NK1 receptor antagonists

54
Q

what are some adverse effects of NK1 receptor antagonists

A

it inhibits the CYP3A4 enzymes

55
Q

when should benzos be prescribed

A

for ptsd, chemo panic

56
Q

motion sickness (CTZ) - prescribe

A

histamine or muscarinic antagonists

57
Q

chemo meds and opiods

A

NK1, histamine, cannabinoid

58
Q

Chemo

A

serotinergic

pharmacology (26 decks)

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