Drugs Used for Nausea

Question 1

What kind of receptors are in the chemo-receptor trigger zone of nausea and vomitting?

Answer 1

5-HT3
D2
M1
CB1
NK1

Question 2

What neurotransmitters are important in the vomiting relfex?

Answer 2

M1- muscarinic
D2- dopamine
5 HT-3- serotonin
NK1- substance P
H1- histamine

Question 3

Scopolamine: drug class

Answer 3

anticholinergic: M1 muscarinic antagonist

Question 4

Scopolamine MOA

Answer 4

anticholinergic: blocks parasympatheric impulses, thereby relaxing smooth muscle and reducing intestinal contractions

Question 5

What are side effects of Scopolamine?

Answer 5

Dry mouth
drowsiness
vision disturbances

Caution with: CNS depressant, liver renal failure

Question 6

Scopolamine clinical usage

Answer 6

motion sickness

transdermal patch

Question 7

Name the drug class:
diphenhydramine (benadryl)
dimenhydrinate (darmamine)
meclizine (antivert)
promethazine (phenergan)

Answer 7

Antihistamines

Question 8

Antihistamine MOA

Answer 8

blocks histamine (H1) receptors within the vestibular nucleus

Question 9

Antihistamine ADE

Answer 9

sedation
thickens bronchial secretions
dry mouth
urinary retention

Question 10

Antihistamine usage

Answer 10

weak anti-emetic,

good for motion sickness

Question 11

Name the drug class:
Prochlorperazine (Compazine)
Chlorpromazine (Thorazine)

Answer 11

Phenothiazines

Dopamine Receptor Blockers

Question 12

Compazine MOA

Answer 12

inihibits dopamine and muscarinic (M1) receptors in the chemo trigger zone

Question 13

Compazine side effects

Answer 13

extra-pyramidal (tardive dyskinesia)
orthostatic hypotension
elevation in prolactin

Caution: with etoh, CNS depressants

Question 14

Compazine uses

Answer 14

severe N/V

Chlorpromazine is for intractable hiccups (Hannah)

Question 15

Name the drug class:

droperidol

Answer 15

butyrophenone

Question 16

Droperidol MOA

Answer 16

central dopamine blockade

Question 17

Droperidol uses

Answer 17

post-op N/V, sedation

IM or IV only

Question 18

Droperidol ADE

Answer 18

extrapyramidal symptoms
drowsy
dizzy
PROLONGS QT

Question 19

Metaclopramide Drug Class

Answer 19

Benzamides

Question 20

Metaclopramide (Reglan) MOA

Answer 20

antiemetic acts centrally as a dopamine and 5-HT3 antagonist

Question 21

Metaclopramide uses

Answer 21

N/V, gastroparesis

Question 22

Metaclopramide ADE

Answer 22

tardive dyskinesia

Question 23

Name the drug class:
Ondansetron (Zofran)
Granisetron (Topotecan, Kytril)
DOlasetron (Anzemet)
Palonosetron (Lexicomp)

Answer 23

Serotonin Antagonists

Question 24

Zofran MOA

Answer 24

block 5-HT3 receptors peripherally on intestinal vagal efferents and centrally block chemoreceptor trigger zone

Question 25

Serotonin antagonists ADE

Answer 25

headache, dizzzy, constipated

dolasetron is associated with prolonged QT interval

Question 26

Name the drug class:

Aprepitant (Emend)

Answer 26

Neurokinin-1 receptor antagonist

Question 27

Aprepitant MOA

Answer 27

blocks substance P and NK-1 receptor

Question 28

Aprepitant uses

Answer 28

chemo induced N/V, usually given with 5-HT3 antagonists and a corticosteroid

given PO with chemo

Question 29

Aprepitant side effects

Answer 29

fatigue, drowsiness

reduces coumadin and birth control pill effectiveness

Question 30

Name the drug class:
Nabilone
dronabinol

Answer 30

cannabinoids

Question 31

Glucocorticoid and benzos can also have __________ effects

Answer 31

antiemetic