Lecture 6 Flashcards
what is emesis/vomiting
-forceful expulsion of stomach
and intestines contents
through the esophagus and
mouth.
what is anti emetics
drugs that used to prevent
vomiting
what can be the causes of emesis
- adverse effects from medications
- systemic disorders/infections
- pregnancy, radiation/ chemotherapy
- vestibular dysfunction
- CNS infections/increase pressure
- peritonitis, GI infection/obstruction
- hepatobiliary disorder
what is the characteristics of motion sickness
cold sweats, hyperventilation, nausea and vomiting-when exposed to repetitive motions that unexpected and unfamiliar that cannot be controlled.
emetics can be divided to
central emetics and peripheral emetics
peripheral emetics can be divided to
rapidly acting and slowly acting
example of rapidly acting emetics are
a- Warm saturated solution of table salt (NaCl). BUT if NO vomiting → Hypernatremia. b- Copper sulfate (CuS0 4 ) in phosphorus poisoning. BUT if NO vomiting → Cu poisoning.
example of slowly acting emetics are
a- Examples: Tr. Ipecacuanha, Tr. Senega & Ammonium carbonate. b- Uses: ● Emetic dose →Evacuate stomach in cases of oral poisoning. ● Sub-emetic dose → Nauseant Expectorant.
what drug that can affect the brain by increasing dopamine 2 receptors in ctz
Apomorphine S.C
what are the centrally acting antiemetics
- Hyoscine(Scopolamine)
- Antihistamines
- Phenothiazines
- Butyrophenones
- Metoclopramide(Primperan)
- Domperidone(Motilium)
- Pyridoxine (Vit B-6)
- Glucocorticoids
- Serotonin (5-HT 3 ) Receptors Antagonists
- Cannabinoids
- Benzodiazepines
what are peripheral acting antiemetics
- Metoclopramide
- Domperidone
- Demulcents
explain the vomiting reflex
- Contraction of the abdominal muscle and also
the diaphragm. - That will squeeze the stomach and upper intestine.
- Causing an expel of its content.
- As part of this reflex, the lower esophageal sphincter
relaxes and the glottis closes.
what receptor is at ctz?
Serotonin (5HT3)
Dopamin 2
what receptor is at vomiting centre
RECEPTOR: Muscarinic
what receptor is at vestibular nuclei
Histamine 1
Muscarinic
what are the receptor that been blocked by antiemetics
- MUSCARINIC RECEPTOR (in vomiting center & vestibular nuclei )
- HISTAMINE 1 RECEPTOR (in vestibular nuclei)
- DOPAMINE 2 RECEPTOR (in CTZ)
- SEROTONIN RECEPTOR (in CTZ & GI tract)
state the uses of antiemetics
- pregnancy
- premedication for anaesthesia
- management of post-operative pain
- motion sickness and vestibular disturbances
- migraine
- STEMI
- ANTIPSYCHOTIC AGENTS
- parkinsonism side effects
what are the actions of antiemetics in premedication for anaethesia
-enhance gastric emptying
-decrease the incidence of
nausea and vomiting
-reduce gastric acidity and
volume in certain conditions
