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Ama - Nausea & labyrinth disorders > General info > Flashcards

General info Flashcards

1
Q

Causes

A

Drugs and toxic substances
Labyrinthitis (inner ear infection)
Vestibular disorders
Motion sickness
gut irritation
Higher stimuli (sights, smells, emotions)

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2
Q

Why does N + V occur?

A

Occurs when the vomiting centre inside the brain is activated by input from the chemoreceptor trigger zone (CTZ).

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3
Q

CTZ

A

Located in medulla oblongata of the brainstem.
Contains dopamine, serotonin, histamine and muscarinic receptors.

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4
Q

General MoA - antiemetics

A

Antagonise the receptors in the CTZ
Chosen according to the aetiology of vomiting.

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5
Q

Dopamine antagonists

A
  • Metoclopramide
  • Domperidone (used in PD)
    Also antipsychotics:
  • Prochlorperazine
  • Perphenazine
  • Trifluoperazine
  • Chlorpromazine
  • Haloperidol
  • Levomepromazine
  • Droperidol
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6
Q

Antihistamines

A
  • Cinnarizine
  • Cyclizine
  • Promethazine teoclate
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7
Q

Antimuscarinics

A
  • Hyoscine hydrobromide (most effective in motion sickness)
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8
Q

5-HT3 antagonsists

A
  • Granisetron
  • Ondansetron
  • Palonosetron
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9
Q

Others

A
  • Dexamethasone
  • Nabilone
  • Aprepitant
  • Fosaprepitant
  • Rolapitant
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10
Q

Post-op

A
  • Chlorpromazine
  • Droperidol
  • Dexamethasone
  • Granisetron
  • Ondansetron
  • Palonosetron
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11
Q

Vertigo

A
  • Cinnarizine
  • Cyclizine
  • Promethazine teoclate
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12
Q

Motion sickness

A
  • Hyoscine hydrobromide (most effective)
  • Cinnarizine
  • Cyclizine
  • Promethazine teoclate
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13
Q

Chemotherapy

A
  • Dexamethasone
  • Ondansetron
  • Granisetron
  • Palonosetron
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14
Q

Palliative care

A

Haloperidol
Levomepromazine

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15
Q

Prochlorperazine

A

Used as a buccal tablet in migraine
Also used post-op

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16
Q

Nabilone

A

Synthetic cannabinoid
Used in chemo unresponsive to other antiemetics

17
Q

Aprepitant, fosaprepitant, rolapitant

A

Used in chemo
Given with dexamethasone and 5-HT3

18
Q

Pregnancy

A

1st trimester
Mild = no drug treatment
Severe
- Chlorpromazine
- Cyclizine
- Doxylamine with pyridoxine
- Metoclopramide
- Prochlorperazine
- Promethazine hydrochloride + promethazine teoclate
- Ondansetron.

19
Q

“Zines”

A

When used in 3rd trimester can cause irritability/jitteriness in newborns

20
Q

What anti-emetics are limited to 5 days use?

A

Metoclopramide
Ondansetron

21
Q

What anti-emetic is limited to 7 days use?

A

Domperidone

22
Q

What are the risk factors for PONV?

A
  • Anaesthetic used
  • Type + duration of surgery
  • Females
  • Non smokers
  • Previous history
  • Motion sickness
  • Opioid use
23
Q

Antiemetic prevention (PONV)

A
  • 5-HT3 receptor antagonists
  • Droperidol
  • Dexamethasone
  • Phenothiazine antipyschotics (e.g. prochlorperazine)
  • Antihistamine e.g. cyclizine
24
Q

High risk of PONV

A

Combination of 2 or more antiemetics from differing drug classes

Ama - Nausea & labyrinth disorders (4 decks)

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