GIT Flashcards
meclizine
1st gen antihistamine (H1)
minimal anticholinergic an sedating
Vomiting centre
in lateral medullary reticular formation
receptors: H1, M1, NK1, 5HT3
5HT3 antagonists
ondansetron, dolasetron (long QT), palonesetron (long half life)
post op nausea and post chemo (no effect on delayed nausea)
Aprepitant
NK1 antagonist, central blockade CRTZ
chemo related vmiting in combo 5HT and steroid
Steroids in post chemo
with 5HT3 antag to help with delayed nausea
CRTZ
outside BBB 4th vent
blood and CSF
D2 receptors and opioid receptors
Domperidone
D2 antagonist
Doesn’t cross BBB so EPSEs rare
Contraindications D2 antagnists
e.g. metoclopromide, domperidone
phaeochromocytoma, previous EPSE, parkinsons, porphyria
Loratadine
2nd gen antihistamine H1
high vD, does not cross BBB
inc QTc
1st gen antihistamines
all sedating and anticholinergic ecept meclizine
diphenhydramine, promethazine
Loperamide
opioid agonist doesn’t cross BBB
Diphenoxylate
opioid agonist for diarrhoea
analgesic at high dose, contains atropine to stop OD
Bulk forming laxative
psyllium, methylcellulose
SE bloating and flatus
Softener laxative
docusate, glycerin suppository, mineral oil
mineral oil - aspiration pneumonitis and de absorption ADEK
Stimulant laxatives
aloe, senna, cascara, bisacodyl
SE colonic dilation and atony
except bisacodyl cause brown pigmentation colon (melanosis coli)