Nausea and Vomiting

Question 1

antacids

Answer 1

contain magnesium (causes diarrhea) or calcium (causes constipation)

ask: if pt is experiencing any of these side effects before Rx

Question 2

antihistamines-anticholinergics

Answer 2

for motion sickness or vertigo

block muscarinic and histaminic receptors in the vomiting center

dimenhydrinate, diphenhydramine, hydroxyzine (IM), meclizine, scopolamine patch
caution for elderly, NPH, narrow-angle glucoma, asthma

Question 3

benzodiazepines

Answer 3

alprazolam and lorazepam

for anticipatory N/V
s/e: sedation, appetite changes, memory impairment

Question 4

butyphenones

Answer 4

haloperidol

for tx of N/V, particularly palliative-care setting

not 1st line tx
a/e: sedation, extrapyramidal, prolong QT interval

Question 5

histamine (h2) antagonists

Answer 5

for N/V r/t GERD or heartburn

avoid cimetidine bc of possible interaction

Question 6

metoclopramide

Answer 6

N/V tx effective from diabetic gastroparesis by causing a quicker emptying of gastric contents

s/e: asthenia, headache, somnolence

Question 7

diabetic gastroparesis

Answer 7

nerve damage from high blood sugar can cause those muscles to slow down or not work at all. Your stomach doesn’t empty properly, and your food may take a long time to leave your stomach

Question 8

phenothiazines

Answer 8

chlorpromazine, prochlorperazine, and promethazine for tx of simple N/V

s/e: drowsiness, headache, blurry vision
a/e: tardive dyskinesia

Question 9

tardive diskinesia

Answer 9

a movement disorder characterized by uncontrollable, abnormal, and repetitive movements of the face, torso, and/or other body parts

Question 10

promethazine

Answer 10

blocks DA2 receptors in the CTZ (chemoreceptor trigger zone) & have antihistamine & anticholinergic effects

ADRs: EPS (extrapyramidal symptoms), sedation, hypotension

general purpose antiemetics (not effective in severe cases)