drugs for vertigo, hearing loss, and N/v

Question 1

produce dose-dependent ototoxicity

Answer 1

aminoglycosides, NSAIDs, salicylates, loop diuretics (can be irreversible), cytotoxic drugs (irreversible)

Question 2

produce ototoxicity that is not dose dependent

Answer 2

erythromycin, minocycline, fluoroquinolones, antimalarials

Question 3

Rx for vertigo

Answer 3

meclizine hcl, diphenhydramine, scopolamine trasdermal patch, promethazine, diazepam

Question 4

H1 and M1 block

Answer 4

diphenhydramine, meclizine, promethazine

Question 5

M1 block only

Answer 5

scopolamine

Question 6

serotonin antagonists (drugs)

Answer 6

dolasteron, granisetron, ondansetron, palonosetron

Question 7

serotonin antagonists adverse effects

Answer 7

OT prolongation, headache, constipation, and diarrhea; cyp interactions

Question 8

D2 receptor antagonists (drugs)

Answer 8

prochlorperazine, chlorpromazine

Question 9

D2 receptor antagonists adverse effects

Answer 9

QT prolongation and torsade de pointes; co-administration with antipsychotics may increase CNS adverse effects

Question 10

aprepitant and fosaprepitant moa

Answer 10

substance P (NK1) receptor antagonist; central action in the solitary tract

Question 11

substance p inhibitors metabolism

Answer 11

cyp 3A4 inhibition

Question 12

dronabinol moa

Answer 12

cannabinoid receptor agonist; g protein coupled decrease in neuronal activity in medullary vomiting center and solitary tract nucleus;
opposes 5-HT3 mediated stimulation from vagal afferents
appetite stimulation via CB receptors in lateral hypothalamus

Question 13

schedule III drug

Answer 13

dronabinol

Question 14

dronabinol pharmacokinetics

Answer 14

slow and gradual onset,

Question 15

treatment of choice for prophylaxis of emesis in chemo

Answer 15

serotonin receptor antagonist + corticosteroid, possible an NK-1 antagonist (prepitants)

Question 16

benzodiazepine for antiemesis

Answer 16

diazepam