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PHAR154 > Nausea and Vomiting > Flashcards

Nausea and Vomiting Flashcards

1
Q

What can stimulate the vomiting center?

A

smells, sights, memories
stimulus from inner ear
chemicals in blood
GI tract

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2
Q

Roughly how many conditions present with nausea?

A

75

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3
Q

What are some common causes of nausea?

A

stomach flu (VGE)
motion sickness
drug-related
pregnancy
post-op
food poisoning
migraine
head injury
otitis media
IBS
peptic ulcer
chronic kidney
appendicitis

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4
Q

What are the odds of experiencing nausea and vomiting from amoxicilin?

A

2%

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5
Q

What are the common agents that cause drug-induced nausea? What can we do in each case?

A

antibiotics: power through
NSAIDs: take with food
CCB: change or dc agent
opiates: reduce dose
PlanB: pre-use of Gravol

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6
Q

What are the indications of Gravol?

A

motion sickness
post-op vomiting
drug-induced causes (we usually prefer to switch dose or drug)
radiation therapy
Menieres disease

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7
Q

True or false: we almost exclusively go for Pepto over Gravol for nausea

A

false

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8
Q

What are some non-drug strategies that can help with motion sickness?

A

focus on a distant area on horizon
fresh air can help/breathe deeply
sit in the middle of the ship or plane
dont attempt to read
front seat (higher) better than rear seat in car
driver better off than passengers

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9
Q

What is dimenhydrinate a salt of?

A

diphenhydramine

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10
Q

Explain how Gravol works for motion sickness.

A

motion sickness will cause stimulus from inner ear
-leads to cholinergic and histaminic signals being sent to CTZ
Gravol is anti-cholinergic and anti-histaminic, blocking the stimulation

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11
Q

What are the side effects of dimenhydrinate?

A

similar to 1st gen antihistamines
-slight sedation
-dry mouth

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12
Q

How is dimenhydrinate best used for motion sickness?

A

initial dose should be taken at least 1/2 hour (preferably 1-2hrs) before departure

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13
Q

Which age group is dimenhydrinate most common in?

A

more common in 2-15yrs than adults
less common in kids <2yrs

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14
Q

True or false: dimenhydrinate is contraindicated in pediatrics

A

false
its safe

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15
Q

Describe the use of scopolamine (Transderm V) for motion sickness.

A

apply 12hr before travel
works for 3 days
2nd patch in 3 days–>use other side of head
mainly anticholinergic

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16
Q

Which drug has more sedation and dry mouth, dimenhydrinate or scopolamine?

A

scopolamine

17
Q

True or false: scopolamine is easily accessed in a pharmacy

A

false
dc in 2022

18
Q

Describe meclizine.

A

dc in 2011
antihistamine/anticholinergic (less se than scopolamine)
OD dosing 1hr before travel
kids >12

19
Q

Describe the use of P6 pressure point for motion sickness.

A

unknown how it works, but its FDA approved
has to be 3 fingers width past wrist
one or both wrists
no need for prior application

20
Q

True or false: ginger has more proof for motion sickness than morning sickness

A

false
ginger has more proof for morning sickness
not helpful for motion sickness

21
Q

What do people think is causing nausea and vomiting in pregnancy?

A

human chorionic gonadotropin

22
Q

What do pregnancy tests pick up in the urine?

A

human chorionic gonadotropin

23
Q

When do most cases of N/V in pregnancy start to cease?

A

week 12
-hCG levels are dropping

24
Q

What percentage of women need a medicine during pregnancy for nausea and vomiting?

A

10%
-it is thought that throwing-up is more detrimental to her
baby’s health than med use

25
Q

What will 1% of women experience during pregnancy?

A

hyperemesis gravidarum

26
Q

What is Diclectin?

A

used for N/V in pregnant women
spin-off on Bendectin
contains 10mg of doxylamine and 10mg of pyridoxine

27
Q

What is the dosing of Diclectin?

A

up to four tablets a day
-two at bedtime
-one in the morning
-one in the afternoon

28
Q

Is the use of Diclectin in pregnant women our choice?

A

nope
MD choice

29
Q

What can be add on therapy to Diclectin?

A

dimenhydrinate 50-100mg q4-6h po or suppository
-up to 200mg/d when taking four Diclectin tabs
pyridoxine 25mg q8h
ginger 250mg q6h
-not from Gingerale
P6

30
Q

True or false: ginger is as effective for morning sickness as dimenhydrinate

A

true
and less sedation

31
Q

What is the dosing of Gravol Ginger?

A

adults and children >6yrs:
take 2 lozenges q4hrs OD-TID
max 6 lozenges a day
prevention: 2 lozenges 30min before departure

32
Q

How many mg of ginger extract is equivalent to 340mg of dried root?

A

20mg

33
Q

Gravol Ginger Multi-Symptom contains willow bark, what is the purpose of adding willow bark?

A

willow bark is a salicylate, thus likely for headaches66666666

34
Q

What can be tried for morning sickness if both pyridoxine/doxylamine and dimenhydrinate did not work?

A

ondansetron

PHAR154 (18 decks)

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