Emesis Related Drugs

Question 1

Activated Charcoal

Answer 1

Adsorbs drugs and poisons due to its large surface area. Must be given in a ratio of 10:1 by weight, does nto bind iron, lithium or potassium, binds alcohols and potassium poorly not useful in cases of poisoning due to corrosive mineral acids or alkalis

Question 2

Ipecac

Answer 2

Local irritant as well as acting on the chemoreceptive trigger zone. Only useful if given within 1 hour of ingestion. oral dose takes 30 min to take effect.

Question 3

Polyethylene Glycol Solution

Answer 3

Hastens removal of toxins and reduces absorption. Whole bowel irrigation can enhance decontamination. Useful for iron tablets, enteric coated medicines, illicit drug packets, and foriegn bodies.

Question 4

Dolasetron

Answer 4

5HT3 antagonist on primary affarent fibers. also in chemoreceptive zone and vomiting center. Used in the prevention and treatment of the acute phase (<24H) chemo induced N&V if given w/in 30 min of chemo start, used for post op and post radiation
AE: well tolerated, constipation, dizzyness and headache

Question 5

Granisetron

Answer 5

5HT3 antagonist on primary affarent fibers. also in chemoreceptive zone and vomiting center. Used in the prevention and treatment of the acute phase (<24H) chemo induced N&V if given w/in 30 min of chemo start, used for post op and post radiation
AE: well tolerated, constipation, dizzyness and headache

Question 6

Ondansetron

Answer 6

5HT3 antagonist on primary affarent fibers. also in chemoreceptive zone and vomiting center. Used in the prevention and treatment of the acute phase (<24H) chemo induced N&V if given w/in 30 min of chemo start, used for post op and post radiation
AE: well tolerated, constipation, dizzyness and headache

Question 7

Palonosetron

Answer 7

5HT3 antagonist on primary affarent fibers. also in chemoreceptive zone and vomiting center. Used in the prevention and treatment of the acute phase (<24H) chemo induced N&V if given w/in 30 min of chemo start, used for post op and post radiation
AE: well tolerated, constipation, dizzyness and headache

Question 8

Dimenhydrinate

Answer 8

H1 Antagonist and antimuscarinic effects, not pumped out of CNS so cause sedation
AE: anticholinergic effects (drymouth, confusion) interacts with antibiotics, not used in pregnancy.

Question 9

Diphenhydramine

Answer 9

H1 Antagonist and antimuscarinic effects, not pumped out of CNS so cause sedation
AE: anticholinergic effects (drymouth, confusion) interacts with antibiotics, not used in pregnancy.

Question 10

Meclizine

Answer 10

H1 Antagonist and antimuscarinic effects, not pumped out of CNS so cause sedation
AE: anticholinergic effects (drymouth, confusion) interacts with antibiotics, not used in pregnancy.

Question 11

Scopolamine

Answer 11

Anticholinergic which is a muscarinic and cholinergic receptor antagonist. It is given in a transdermal patch for decreased side effects. Most effective for motion sickness

Question 12

Aprepitant

Answer 12

NK1 Antagonist, antagonist of substance P receptor. Cenral higher order center NK1 receptors involved. Used for chemo induced N&V in combo with 5HT3 receptor antagonist and detramethasone.
AE: well tolerated, fatigue dyspnea, diarrhea. CYP3A4 metabolism may increase [chemo drug] which affect bone marrow

Question 13

Fosaprepitant

Answer 13

NK1 Antagonist, antagonist of substance P receptor. Cenral higher order center NK1 receptors involved. Used for chemo induced N&V in combo with 5HT3 receptor antagonist and detramethasone.
AE: well tolerated, fatigue dyspnea, diarrhea. CYP3A4 metabolism may increase [chemo drug] which affect bone marrow

Question 14

Droperidol

Answer 14

D2 Antagonist, works in chemoreceptive trigger zone, muscarinic antagonist?? resets GI motility and causes sedation

Question 15

Metoclopramide

Answer 15

D2 Antagonist, works in chemoreceptive trigger zone, muscarinic antagonist?? resets GI motility and causes sedation

Question 16

Prochlorperzaine

Answer 16

D2 Antagonist, works in chemoreceptive trigger zone, muscarinic antagonist?? resets GI motility and causes sedation

Question 17

Thiethylperazine

Answer 17

D2 Antagonist, works in chemoreceptive trigger zone, muscarinic antagonist?? resets GI motility and causes sedation

Question 18

Dexamethasone

Answer 18

Corticosteroid Unknown mechanism at how it works for vomiting. Used with 5HT3 receptor antagonists and aprepitant

Question 19

Methylprednisolone

Answer 19

Corticosteroid Unknown mechanism at how it works for vomiting. Used with 5HT3 receptor antagonists and aprepitant

Question 20

Dronabinol

Answer 20

Cannabinoid, acts on central cannabinoid receptor likely causes sedation as MOA. Better agents are available, given with phenothiazines.
AE: hallucinations, euphoria, sedation, dry mouth and increased appetite.

Question 21

Nabilone

Answer 21

Cannabinoid, acts on central cannabinoid receptor likely causes sedation as MOA. Better agents are available, given with phenothiazines.
AE: hallucinations, euphoria, sedation, dry mouth and increased appetite.