Drugs for Nausea and Vomiting

Question 1

GIT motility mediator that stimulates excitatory neurons or muscle cells directly

Answer 1

motilin

Question 2

Stimulation of these receptors enhance release of CGRP (calcitonin gene-related peptide) or ACh

Answer 2

5-HT1p and 5-HT4 (on IPANs – intrinsic primary afferent nerves)

Question 3

Serotonin receptor stimulating nausea, vomiting, abdominal pain

Answer 3

5-HT3

Question 4

Neurotransmitter than inhibits GIT –> decrease intensity of esophageal/gastric contractions

Answer 4

dopamine

causes constipation

Question 5

M3 agonist formerly used for GERD and gastroparesis

Answer 5

bethanecol

Question 6

M3 agonist given IV for acute large bowel distention

Answer 6

neostigmine

Question 7

M3 receptors located where in GIT

Answer 7

myenteric plexus synapses

Question 8

Enhance gastric emptying, increase LES pressure, and potent antinausea and antiemetic

Answer 8

D2 antagonist

Question 9

D2 receptors are located at the

Answer 9

chemoreceptor trigger zone / area postrema

vomiting/nausea center

Question 10

For emesis (CTZ) or refractory heartburn (LES pressure)

Answer 10

D2 antagonist

Question 11

Causes elevated prolactin levels

Answer 11

D2 antagonist

Question 12

Directly stimulate motilin receptors in GI smooth muscle

Answer 12

macrolides

Question 13

When oral intake of food is restarted after emesis, avoid foods with _____

Answer 13

fat and indigestible residues

since lipids delay gastric emptying time and prolong gastric retention

Question 14

Tumor near vagal nerve causing vomiting. What drug?

Answer 14

anti-serotonergics (ondansetron)

vagus nerve has 5-HT3 receptors

Question 15

CTZ contains these receptors

Answer 15

5-HT
M1
H1
D2

Question 16

Antibiotics that stimulate gastric motility

Answer 16

macrolides

Question 17

Anti-emetic drugs affecting vestibular system

Answer 17

antimuscarinics (scoplamine)

antihistamine (meclizine)

Question 18

D2 Antagonists we learned (2)

Answer 18

phenothiazine

butyrophenone

Question 19

5-HT blocker approved for patients with severe irritable bowel syndrome

Answer 19

alosetron (prototype)

ondansetron

Question 20

Indicated in acute upper GI hemorrhage (promotes gastric emptying of blood prior to endoscopy)

Answer 20

macrolides

Question 21

Used in chemotherapy-induced vomiting and nausea and diarrhea-prominent IBS

Answer 21

ondansetron

Question 22

Clinically indicated in radiation-induced emesis

Answer 22

ondansetron

Question 23

Treatment for cardiac causes of nausea/vomiting

Answer 23

ondansetron

Question 24

Better than anti-emetics for anticipatory nausea

Answer 24

anxiolytics (valium)

Question 25

1) Vomiting due to bacterial infection in children due to:

2) Treat with:

Answer 25

1) Probably staph aureus or bacillus cereus

2) methicillin group
lincosamide (clindamycin)
vancomycin (MRSA)

Question 26

Antidepressants with antiemetic properties

Answer 26

TCA

works on IBS

Question 27

Combined 5-HT4 agonist and D2 antagonist

Answer 27

Metoclopramide

mixed serotonin agonist/antag
5-HT3 antagonist but 5-HT4 agonist

Question 28

Macrolide most useful when given IV to inpatients with refractory gastroparesis

Answer 28

erythromycin

Question 29

D2 antagonist with prokinetic and entiemetic effects.

Answer 29

domperidone