n/v drugs

Question 1

5ht-3 RA moa

Answer 1

block serotonin receptors on sensory vagal fibers in gut wall

Question 2

5ht-3 ra use

Answer 2

more effective at preventing acute phase than late phase

Question 3

5ht-3 ra ae

Answer 3

qt prolongation, headache, asthenia, constipation

Question 4

pearl with palonosetron

Answer 4

longer t 1/2 (40 hr vs 3-6 hr) and less effect on QT

Question 5

granisetron dosage forms

Answer 5

transdermal patch, ER SQ injection

Question 6

ondansetron dosage forms

Answer 6

tablet, ODT, IV

Question 7

NK1 moa

Answer 7

substance P binds to NK1 and is thought to be primary mediator of delayed n/v

Question 8

NK1 use

Answer 8

combo therapy for prophylaxis of ponv and cinv

Question 9

NK1 ae

Answer 9

constipation, diarrhea, headache, hiccups, dyspepsia, fatigue

Question 10

aprepitant drug interactions

Answer 10

moderate inhibitor of CYP3A4, weak inducer of 2C9. reduce dexamethasone dose by 50%, dec efficacy of estrogen containing contraceptives, dec INR with warfarin, inc conc of chemo

Question 11

fosaprepitant is ___

Answer 11

injectable form of aprepitant, less drug interactions

Question 12

rolapitant clinical pearls

Answer 12

longer half life (7 days vs 9 hours), FDA warning for anaphylaxis and hypersensitivity

Question 13

netupitant clinical pearl

Answer 13

only available in a combination product with palonosetron

Question 14

corticosteroids moa

Answer 14

unknown

Question 15

corticosteroids use

Answer 15

single agent or combo for prevention of cinv and ponv

Question 16

corticosteroids ae

Answer 16

insomnia, agitation, appetite stimulation, HTN, hyperglycemia, fluid retention

Question 17

butyrophenones moa

Answer 17

block dopaminergic stimulation of CTZ

Question 18

butyrophenones use

Answer 18

rescue therapy in breakthrough n/v

Question 19

butyrophenones ae

Answer 19

sedation, constipation, hypotension, EPS, QT prolongation

Question 20

antihistamine/anticholinergic MOA

Answer 20

block muscarinic/histamine receptors in VC and vestibular system that stimulate n/v

Question 21

antihistamine/anticholinergic ae

Answer 21

drowsiness, confusion, blurred vision, dry mouth, urinary retention

Question 22

phenothiazines moa

Answer 22

block dopamine receptors in ctz

Question 23

phenothiazines use

Answer 23

simple n/v or breakthrough

Question 24

phenothiazines ae

Answer 24

qt prolongation, constipation, dizziness, tachycardia, tardive dyskinesia, drowsiness

Question 25

promethazine black box warning

Answer 25

severe tissue injury, including gangrene. severe chemical irritation and damage to tissues regardless of route of administration

Question 26

promethazine ae

Answer 26

burning, pain, thrombophlebitis, tissue necrosis, gangrene

Question 27

promethazine preferred parenteral route

Answer 27

deep im injection

Question 28

if promethazine must be given iv what are the rules

Answer 28

no more than 25 mg/mL, rate no faster than 25 mg/min

Question 29

metoclopramide moa

Answer 29

blocks dopamine receptors in ctz, 5ht-4 agonist, stimulates gi smooth muscle contraction promoting gastrokinesis

Question 30

____ activity of metoclopramide is useful in gastroparesis

Answer 30

prokinetic

Question 31

metoclopramide ae

Answer 31

asthenia, headache, somnolence, eps

Question 32

avoid use of metoclopramide with ___

Answer 32

other dopamine antagonists like olanzapine, haloperidol due to increased risk of eps

Question 33

olanzapine moa

Answer 33

antipsychotic; blocks dopamine, serotonin, adrenergic, and histaminic receptors

Question 34

olanzapine ae

Answer 34

sedation, qt prolongation, eps

Question 35

caution with olanzapine in ___

Answer 35

elderly

Question 36

benzodiazepines moa

Answer 36

anxiolytic activity on anticipatory n/v

Question 37

benzodiazepine ae

Answer 37

sedation, dizziness, memory impairment, additive sedation with opioids

Question 38

benzodiazepines are contraindicated with ___

Answer 38

olanzapine

Question 39

cannabinoids moa

Answer 39

synthetic analog of THC, complex effects on CNS and cannabinoid receptor 1

Question 40

cannabinoids use

Answer 40

breakthru n/v

Question 41

cannabinoids ae

Answer 41

euphoria, somnolence, xerostomia

Question 42

cannabinoids are useful for ___

Answer 42

cancer-related adverse effects: pain and appetite stimulation

Question 43

concern with chronic use of cannabinoids

Answer 43

cannabinoid hyperemesis syndrome