GI: Nausea/Vomiting

Question 1

Which 5HT3 antagonist is only used for IBD

Answer 1

Alosetron

Question 2

5HT3 receptor agonists are ____ antiemetic agents

Answer 2

strong

Question 3

What is the side effect with 5HT3 receptor antagonists associated with Confusion, Agitation or restlessness, Dilated pupils, Headache, Changes in blood pressure and/or temperature?

Answer 3

Serotonin syndrome

Question 4

Dolasetron has the highest risk of what adverse side effect of all 5HT3 receptor antagonists?

Answer 4

Dose-Dependent QT prolongation and torsades

Question 5

what two 5HT3 receptor antagonists are longer acting and can be given as a single dose for 24+ hours?

Answer 5

Palonsetron and Granisetron

Question 6

What NK1 receptor antagonists is only given in combo with palonosetron?

Answer 6

Netupitant and Fosnetupitant

Question 7

Which drug is given prophylatically for N/V from surgery?

Answer 7

Alprepitant

Question 8

What is the recommended drugs for pregnancy induced nausea/vomiting?

Answer 8

1. B6 or Doxylamine + B6 or 5HT3 blocker
2. D2 blocker
3. Steroid

Question 9

Which two H1 antagonists can treat N/V from motion sickness

Answer 9

Meclizine and Cyclizine

Question 10

What is the adverse effect common of all H1 receptor antagonists?

Answer 10

Anticholinergic effects:

-drowsiness, constipation, dry guy ya eyes, urinary retention, blurred vision, decreased BP

Question 11

What drug is given for a patient with Diabetic gastroparesis?

Answer 11

Metoclopramide!

-diabetic gastroparesis is due to dysmotility, so metoclopramide increases motility and increases LES tone

Question 12

What side effect is caused by all D2 blockers?

Answer 12

Anticholinergic effects:

-drowsiness, constipation, dry eyes, urinary retention, blurred vision, decreased BP

Question 13

What is the common suffix for serotonin receptor antagonists?

Answer 13

-setron

Question 14

what is common suffix for all NK1 antagonists

Answer 14

-pitant

Question 15

What is the M1 receptor antagonist that is used for motion sickness?

Answer 15

Scopolamine

Question 16

What are the examples of D2 receptor antagonists?

Answer 16

Chlorpromazine, perphenazine, prochlorperazine, and metoclopramide

Question 17

What are the two cannabinoid receptor agonists?

Answer 17

Dronabinol and Nabilone

Nab rhymes with Dab.. what you hit.

Question 18

What patch can be worn for 72 hours for motion sickness?

Answer 18

Scopolamine

Question 19

What can be used to treat excessive secretions in end-of-life care?

Answer 19

Scopolamine patch

Question 20

M1 blockers have this side effect..

Answer 20

Anticholinergic effects:

-drowsiness, constipation, dry eyes, urinary retention, blurred vision, decreased BP

Question 21

Cannabinoids are only saved for what condition?

Answer 21

treatment resistant CINV

Question 22

How do cannabinoids work, whats their MOA?

Answer 22

They activate CB1 and CB2 GPCRs, which decreases excitability of neurons
-this minimizes 5HT3 released from the vagus nerve

Question 23

Which is longer acting.. nabilone or dronabinol

Answer 23

Nabilone is longer acting, so fewer doses per day

Question 24

What drug-drug interactions do the cannabinoids have to watch out for?

Answer 24

they interact with CNS depressants, CV agents, and sympathomimmetics

Question 25

What is the High Emetogenic Regimen?

Answer 25

1. NK1 (pitant)
2. 5HT3 blocker (setron)
3. Dexamethasone

Question 26

What can be added to the any emetogenic regimens?

Answer 26

1. Can add olanzapine (D2 blocker)

2. Can add a cannabinoid

Question 27

What is the moderate emetogenic regimen?

Answer 27

1. 5HT3 receptor antagonist (-setron)
2. Dexamethasone

-can add NK1 blocker, olanzapine, or cannabinoid

Question 28

what can be used to treat low emetogenic regimen?

Answer 28

Any of the follow:

1. 5HT3 blocker or
2. Dexamethasone or
3. Metoclopromide or
4. Prochlorperazine (D2 blocker)