Nausea and Labyrinth disorders Flashcards
Example of Phenothiazine that can be used in N&V
Prochlorperazine, trifluoperazine, perphenazine
How do the phenothiazine drugs work as an antiemetic?
Block the Chemoreceptor trigger zone
In terminal illness, what other antipsychotic drugs can be used?
Haloperidol and Levomopromazine
Which antiemetic is a prokinetic
Metoclopramide
Why is domperidone able to be used in parkinsons disease?
It does not cross the BBB so is less likely to cause sedation and dystonic reactions
Below what weight is domperidone unlicesned?
35kg
When is it appropriate to use Ondansetron/ Granisetron as antiemetics?
Post op (short term) or in chemotherpay N&V
what drug class is Netupitant?
Neurokinin 1 receptor antagonist
Examples of Neurokinin 1 receptor antagonists
Aprepitant, Netupitant, Fosaprepitant, Rolapitant
What are NK1 receptor antagonist drugs given alongisde?
Dexamethasone or a 5HT3 antagonist
Example of a synthetic cannabinoid
Nabilone
Which antiemeitc is used in pregnancy induced N&V
Promethazine, prochloperazine or metoclopramide
Risk factors of PONV
female, non smoker, history of PONV, motion sickness, intraoperative use of opioids
Which antiemetics are used to help with PONV
Ondanestron, cyclizine and prochlorperazine
Most effective drug for prevention of motion sickness
Hyoscine hydrobromide
If a sedative effect is required in motion sickness, what drug can be used?
Promethazine or a slighly less sedating antihistamine e.g Cyclizine, cinnarizine
Antiemetic licensed for vertigo. tinnitusd and hearing loss associated with Menierres disease?
Betahistadine
What age are cyclizine tablets not licensed for use?
<6 years
What age is domperidone contraindicated in
<12 years
Maximum duration of Domperidone and why?
7 days - due to cardiac side effects
What is the MHRA warning associated with Metoclopramide
neurological adverse effets e.g. Tardive Dyskinesia; max 10mg TDS 5 days `
IV metoclopramide should be given over how long?
slow bolus, 3 minutes
Can metoclopramide be given in Parkinsons or Epilepsy?
NO
Which patient group is most likely to experience adverse effects of Metoclopramide?
Very young and eldery
Caution wiht 5HT3 antagonists
QT prolongation
what is the MHRA alert regarding Ondansetron therapy in pregnacy?
Small increased risk of Cleft palate following use in first 12 weeks of pregnancy
What drug can cause anticholinergic syndrome (particularly in eldery)
Hyoscine hydrobromide
What are some symptoms of anticholinergic syndrome
Excitement, ataxia, hallucinations, behavioural abnormalities, drowsiness
Kwells and scopoderm are examples of what drug?
Hyoscine hydrobromide
