GI: ANTIEMETICS - PHENOTHIAZINES Flashcards

1
Q

ANTIEMETICS PHENOTHIAZINE: INDICATIONS

A
  • Prophylaxis and Tx of Nausea and Vomiting - particularly when due to vertigo
  • Psychotic disorders (eg Schizophrenia) - 1st gen Antipsychotics
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2
Q

ANTIEMETICS PHENOTHIAZINE: MOA

A
  • Blockade of various receptors (D2 in the CTZ and gut), lesser extent H1 and Ach (Muscarinic) receptors in the vomiting and vestibular system
  • Effective for nausea and vomiting in a variety of settings (eg chemo, radio therapy, vertigo)
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3
Q

ANTIEMETICS PHENOTHIAZINE: ADVERSE EFFECTS

A
  • Drowsiness and postural hypertension
  • Movement abnormalities (eg EXTRAPYRAMIDAL SYNDROMES - arising from D1 receptor blockade)
  • Acute dystonic rxn (such as an oculogyric crisis) - ST
  • Extrapyramidal syndromes (TARDIVE DYSKINESIA)
  • QT-interval prolongation
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4
Q

ANTIEMETICS PHENOTHIAZINE: WARNINGS

A
  • Sedative effect
  • Potential for hepatotoxicity -> avoided in severe liver dx patients
  • Avoided in patients susceptible to anticholinergic SEs - PROSTATIC HYPERTROPHY ( who may develop urinary rtn)
  • Reduced doses in the elderley
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5
Q

ANTIEMETICS PHENOTHIAZINE: INTERACTIONS

A
  • Extensive list of interactions, consult the BNF

- Drugs that prolong QT interval (eg antipsychotics, amiodarone, ciprofloxacin, maroclides, quinine, SSRIs)

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6
Q

ANTIEMETICS PHENOTHIAZINE: EXAMPLES

A
  • Prochlorperazine

- Chloropromazine

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