GI 1 Antiemetics 🤮 Flashcards
What is the general mechanism of action of antiemetics?
Prevent or tx nausea and vomiting
by blocking one of the vomiting pathways (block the neurological stimulus that induces vomiting)
Why might marihuana (cannabinoids - nabilone) be used for tx of nausea and vomiting?
For which pt and what other beneficial effects could it bring to pts in these conditions?
Alters the mood and body perception of its surrounding which has been shown to decrease nausea and vomiting in some pts being treated for cancer or AIDS.
Used mostly in pts being treated for cancer or AIDS which chemo.
Can also stimulate appetite, which is beneficial bc of the occurrence of anorexia in both these diseases.
What is the main goal of antiemetic treatment in focus to chemotherapy induced and postop nausea and vomiting ?
- Minimize or prevent fluid and electrolyte disturbances (avoid dehydration)
and
- minimize deterioration of the pt’s nutritional status (avoid malnutrition)
What are the main assessments needing to be done before giving an antiemetic?
- assess nausea and vomiting
- assess intake and output
-assess for glaucoma if scopolamine is prescribed - assess for hx of epilepsy or seizures as it is a contraindication with metoclopramide
- skin, mucous membranes, turgor, colour, cap refill (for dehydration)
- If tests ordered: asses for fluid imbalances (sodium, potassium, chloride, hgb, hct, RBC, WBC, urinalysis)
- contraindications
- possible interactions (include OTC drugs and natural health products)
What are some interventions that can be taught to pta to minimize nausea and vomiting apart from medications?
- avoid foods that provoke n&v (spicy, salty, and fatty foods)
- avoid foods with a strong odour
- eat small frequent meals
- bland meals every 1 to 2 hrs
- avoid mixing liquids and solide foods (drink in between meals not during)
- cool, carbonated drinks
- avoid laying down flat after eating
When is the best time to administer Metoclopramide (Reglan) (prokinetics antiemetic) PO ?
Should be given PO 30min before meals and at bedtime
What disorder has been associated with long term metoclopramide tx?
And what does it consist of?
Tardive dyskinesia
Involuntary neurological movement disorder (involuntary contraction of oral and facial muscles)
And wavelike movements of extremities
When is the best time to administer odansetron (Zofran) a serotonin blocker antiemetic if used for chemotherapy induced n&v ?
Best if taken 30minutes before chemo treatment
What are the main AE of most antiemetics ?
And what element (med or other) should be avoided to avoid worsening that symptom?
Drowsiness and hypotension
Alcohol or other CNS depressant meds bc of possible toxicity or exacerbation of CNS depression
Avoid driving and using heavy machinery
A 33 year old pt is in an outpatient cancer centre for his first round of chemo. The nurse knows that which schedule is the most appropriate timing for the IV antiemetic drug?
a) 4hrs before the chemo begins
b) 30min before the chemo begins
c) at the same time as the chemo drugs
d) at the first sign of nausea
B)
When reviewing the various types of antiemetic meds, the nurse recognizes that prokinetic drugs (metoclopramide) are also used for which disorder?
a) motion sickness
b) vertigo
c) delayed gastric emptying
d) GI obstruction
C
A pt is asking about THC. Which statements about dried marihuana therapy are true? Select all that apply.
A) it is useful for n&v related to cancer chemo
B) it is approved for the tx of hyperemesis gravidarum
C) it is useful to help stimulate the appetite in pts with nutritional wasting.
D) it may cause drowsiness or euphoria
A, C, D
What is the best time to take scopolamine (anticholinergic antiemetic drug) if used for post op nausea and vomiting?
Best taken 30min before end of surgical procedure
When is the best time to administer ondansetron (zofran) the serotonin blocker antiemetic for chemo induced n&v?
Should be taken 30 minutes before chemo and
Should be continued for 24-48hrs post chemo
Can be up to 2 weeks after
What is the main possible AE of IV ondansetron administration?
Serotonin blocker antiemetic
Dysrythmias may occur if administered IV fast and In large doses
