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Pharmacology 2 > Exam 4 - GI Nausea and Vomiting > Flashcards

Exam 4 - GI Nausea and Vomiting Flashcards

1
Q

Causes of N/V?

A

CNS-related, infection, GI disorders, meds, radiation

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2
Q

What and where is the Chemoreceptor Trigger Zone?

A

Area in the brain which receives signals from brain and GI tract. Stimulates brain’s vomiting center via NTs.

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3
Q

Who gets Chemo-Induced NV (CINV) most often?

A

Young people and women.

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4
Q

What causes CINV? What is the intensity based on?

A

Chemo agents, based on potency of chemo agent.

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5
Q

3 risk factors for CINV?

A

Hx of prior CINV
Hx of motion sickness
Hx of morning sickness

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6
Q

Acute CINV in what time frame?

A

0-24h after chemo

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7
Q

Delayed CINV in what time frame? Mostly due do?

A

More than 24h after chemo.

Mostly due to high emetogenic chemo agents

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8
Q

What is Anticipated CINV?

A

Conditioned response to prior N/V from chemo.

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9
Q

Tx for High Emetic Risk?

A
  1. NK-1 Antagonist
  2. 5-HT3 Antagonist
  3. Corticosteroid
    combo of all three
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10
Q

What percent is high emetic risk? Which two chemo agents cause it most?

A

Over 90%. Cisplatin and Cyclophodoid.

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11
Q

What percent range in Moderate Emetic Risk? Which agent causes it most?

A

30-90%. Doxarubicin.

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12
Q

Tx for Moderate Emetic Risk?

A
  1. Dopamine-antagonist
  2. Corticosteroid
    combo of the two
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13
Q

What is range for Low Emetic Risk? Which chemo agent often causes?

A

10-30%. Roxtinamib

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14
Q

Tx for Low Emetic Risk?

A

Corticosterois

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15
Q

Percent range for Minimal Emetic Risk?

A

0-10%

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16
Q

Tx for Minimal Emetic Risk?

A

May or may not need treatment

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17
Q

MOA and indications for Serotonin 5-HT3 Antagonist?

A

Blocks 5-HT3 receptors centrally and peripherally.

CINV (acute better than delayed), PONV, RINV. Give before chemo!

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18
Q

5HT3 route, SE, and name?

A

PO or IV.

Constipation, mild HA, possible QT prolongation.
“-setron”

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19
Q

NK-1 Antagonist MOA and indications?

A

Antagonized NK-1 receptors.

Strongest available! Prevent acute and delayed CINV. Give with 5HTP or steroid.

20
Q

When to give 5HT3 Antagonist?

A

Before chemo

21
Q

Give NK-1 Antagonist with what other meds?

A

Give with 5HTP or steroid.

22
Q

NK-1 routes, SE, and name?

A

PO or IV.

Diarrhea, dizzy, fatigue, CYP3A4, CYP2C9.
“-itant”

23
Q

NK-1 regimen? Routes during regimen?

A

3 day regimen.
Day 1=IV
Day 2-3=PO

24
Q

Dopamine Antagonist MOA and indications?

A

Dopamine-antagonist.

Delayed CINV w/moderate to low emetogenic chemo.

25
Q

Dopamine-antagonist SE, name, and potency?

A

“-azine”

Low potency. An older drug.

26
Q

Corticosteroid MOA and indications?

A

MOA unknown.

Acute and delayed CINV. Given with 5HT3 to increase efficacy.

27
Q

Corticosteroid route, SE, and name?

A

PO and IV.

Insomnia, jittery, fluid retention, check BGL in DM.
“-one”

28
Q

Corticosteroids given with what? Why?

A

Given with 5HT3 Antagonists to improve effectiveness.

29
Q

Benzo MOA and use?

A

Anoxiolytic activity.

Anticipatory CINV to allow to sleep through.

30
Q

Benzo name? Does it have antiemetic properties?

A

“-zepam”

No antiemetic properties

31
Q

Cannabinoid MOA and use?

A

Interacts with cannabinoid receptors. Poorly understood MOA.

Refractory and delayed CINV.

32
Q

Cannabinoid names?

A

Dronabinol (Marinol)

Nabilone (Cesamet)

33
Q

Dronabinol and Nabilone in what class? Use?

A

Cannabinoid receptors. Refractory and delayed CINV.

34
Q

Two classes for Motion Sickness?

A
  1. Antihistamines

2. Anticholinergics

35
Q

Antihistamine for Motion Sickness MOA and use?

A

Blocks H1-receptors. Crosses BBB and sedates.

Prevent or treat motion sickness for short trips!

36
Q

Which class to use for short trips?

A

Antihistamines

37
Q

Antihistamine for Motion Sickness SE?

A

Weak cholinergic activity. Dry mouth, sedation, constipation, urinary retention, blurry vision

38
Q

Names of Antihistamines or Motion Sickness?

A

Dimenhydrate (Dramamine), Meclizine (Antivert)

39
Q

Anticholinergic use for motion sickness?

A

Travel sickness. Apply patch behind ear 3h before starting trip. Reapply q3d. Long trips.

40
Q

Length of trip Anticholinergic patch used for?

A

Long trips! Apply patch behind ear 3h before trip, reapply q3d.

41
Q

Anticholinergic SE? Name?

A

Dry mouth, sedation, constipation, urinary retention, blurry vision

Scopolamine patch.

42
Q

Which med for Acute CINV, PONV, and RINV?

A

5HT3 Antagonist. “-setron”

43
Q

Which med to prevent acute and delayed CINV?

A

NK-1

“-itant”

44
Q

Which med for delayed CINV from moderate to low emetogenic chemo?

A

Dopamine Antagonist

“-azine”

45
Q

Which med for Anticipatory CINV?

A

Benzo

“-zepam”

46
Q

Med class for Scopolamine patch?

A

Anticholinergic

Pharmacology 2 (17 decks)

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