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OTC Exam 3 > N/V > Flashcards

N/V Flashcards

1
Q

Etiology

A
  • Motion sickness
  • Pregnancy
  • Drug-induced
  • Infectious disease
  • Overindulging
  • Food poisoning
  • Psychogenic-induced
  • Pathology-induce
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2
Q

Vomiting Process

A

• Involves CNS and GI tract
• Vomiting center receives impulses
o CTZ, GI and/or labyrinth apparatus in ear
• Many types involve stimulation of the chemoreceptor trigger zone (CTZ), which elicits nausea and vomiting
• Overstimulation of labyrinth apparatus
• Morning sickness: unknown MOA

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3
Q

Treatment Goals

A
  • Identify and correct underlying cause

* Symptomatic relief may not be possible unless this is done

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4
Q

Non-pharm: pregnancy

A
  • Fresh air
  • Crackers
  • No sudden movements
  • 4/5 small meals a day
  • No fluids or soups at meal time
  • Small sips of carbonated drinks or fruit juice
  • Avoid greasy foods
  • Eat chilled foods
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5
Q

Pharm treatments: pregnancy

A
  • Pyridoxine (B6) – 25mg q8h
  • Antacids
  • Acupressure
  • Acustimulation
  • Ginger – Cat. B
  • Preggie Pop Drops (Citric Acid)
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6
Q

Avoid: preganacy

A
  • Antihistamines (30-60min before travel)
  • H2RA
  • PPI
  • Bismuth
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7
Q

Motion Sickness Treatments

A
  • Antihistamines
  • Acupressure – applies continuous pressure on the P6 point on each wrist using a plastic stud
  • Acustimulation – mild electrical stimulation of acupuncture points
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8
Q

Meclizine

A

> 12 y.o.
25-50mg 1h before travel
• Drowsiness
• Possible hyper-activity in children

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9
Q

Cyclizine

A

> 6 y.o. 25mg q6-8h
12 y.o. 50mg 30min before travel, then 1T 4-6h prn
• Drowsiness
• Possible hyper-activity in children

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10
Q

Diphenhydramine

A

> 6 y.o. 12.5-25mg q4h

> 12 y.o. 25-50mg q4h
• Drowsiness
• Possible hyper-activity in children

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11
Q

Diphenhydrinate

A

> 6 y.o. 25-50mg q6-8h

> 12 y.o. 50-100mg q4-6h
• Drowsiness
• Possible hyper-activity in children

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12
Q

Overindulgence

A
  1. Antacids start here
  2. H2RAs or here
  3. Omeprazole
  4. Bismuth
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13
Q

Nauzene

A

for overindugence
Dextrose-Glucose 968mg-Anti-nausea
Levulose-Fructose 175mg-Anti-nausea
Sodium Citrate Dihydrate-230mg-Antacid

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14
Q

Food Poisoning

A 
•	F&E replacement therapy
o	Sodium
o	Potassium
o	Chloride
o	Dextrose
o	Fructose
•	Diet
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15
Q

Viral Gastroenteritis

A

• Phosphorated carbohydrate solution (Emetrol)
o Cherry
o Levulose/Dextrose/Phosphoric acid
o 1-2 TBSP q 15min until vomiting ceases
o Max 5 doses/hr
o Not for use in diabetics
o Use sparingly if already have diarrhea  levulose can cause diarrhea

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16
Q

Misc. Therapies

A
  • Preggie Pop Drops (citric acid)
  • Preggie Pops (cirtic acid)
  • Queasy Pops
  • Motion Eaze (100% natural blend of herbal oils)
  • Cola Syrup (sugar)
  • Hyland’s Motion Sickness
17
Q

Chamomile

A
  • Spasmolytic properties

* Gastric complaints

18
Q

Ginger

A
  • N&V (chemo-C, surgery-C)
  • N&V (pregnancy-B)
  • Motion Sickness – C
19
Q

Lemon Balm

A
  • Spasmolytic and carminative effects

* GI complaints including vomiting

20
Q

Peppermint - C

A
  • Spasmolytic properties

* Dyspepsia

21
Q

When to refer adults?

A
  • Diabetic with high blood glucose or urine ketones plus dehydration
  • Suspected food poisoning continuing >12 hours
  • Blood in vomitus
  • Severe right upper, middle, or lower quadrant abdominal pain – appendicitis
  • Suspected to be caused by undiagnosed pregnancy (missed period)
  • Pregnant female whose n/v is unresponsive to non-drug measures
22
Q

When to refer adults cont

A
  • Lactating females
  • Yellow skin/eye discoloration, wt. loss, and dark urine
  • Stiff neck, headache, light sensitivity
  • Head injuries accompanied by n/v, blurred vision or numbness
  • N/V >48 hours – possibility of dehydration
  • Dehydration/wt. loss >5% of BW
23
Q

When to refer children

A
  • Wt. loss/sings of dehydration present
  • <1 year of age
  • Child refuses to drink
  • Child has not urinated in past 8-12 hours
  • Child appears lethargic, sleepy, or is crying
  • Stiff neck
  • Vomiting occurs with each feeding
24
Q

When to refer children cont.

A
  • Projectile or continuous vomiting >8 hours
  • Vomitus contains red, black, or green fluid
  • Associated with diarrhea, distended abdomen, fever, or severe headache
  • Vomiting occurs following head injury
  • Suspected poisoning
  • Recurrent, severe abdominal pain
  • N/V continues >24-48 hours
25
Q

Treatment Opt: lactating

A

o All except antihistamine are OK

26
Q

Treatment Opt: Advanced Age

A 
o	Phosphorated carbohydrate solution
	Caution diabetes
o	Acupressure OK
o	Acustimulation 
	No if pacemaker
o	Antihistamine 
	Caution with SE
o	Antacids, H2RAs, PPIs, Bismuth
	Caution about drug interactions
27
Q

Treatment Opt: Children

A 
o	Antihistamines
	Side effects
o	Phosphorated carbohydrate solution
	2-12 same dose as adults
	<2 – smaller dose
o	Oral rehydration solutions
	Sips every few minutes for 15 min
	If they are able to keep that down, increase the volume
28
Q

Avoid: Children

A

o Antacids, H2RAs, PPIs –NO

o Bismuth – NO (Reye’s Syndrome)

OTC Exam 3 (6 decks)

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