Nausea and Vomiting Flashcards
what is nausea and what is vomiting?
Nausea:
Defined as the sensation signaling the urge to vomit.
Felt in the throat or epigastric area.
Indicates that vomiting may occur imminently.
Vomiting (Emesis):
The act of expelling gastric contents through the mouth.
Often a forceful and involuntary bodily response.
Prevalence:
Nausea and vomiting are common in various care settings.
Can be symptomatic of many underlying causes.
what is the mechanism of vomiting?
Mechanism of Vomiting: Triggered by afferent impulses to the vomiting center in the medulla.
Receives signals from:
Chemoreceptor trigger zone (CTZ)
Cerebral cortex
Visceral afferents from the pharynx and GI tract
Integration of impulses results in efferent signals to:
Salivation center
Respiratory center
Pharyngeal, GI, and abdominal muscles
Leads to the act of vomiting
how does nausea and vomiting present?
Presentation and Classification of Nausea/Vomiting (N/V):
Patients may present from mild to severe distress.
Classified as Simple or Complex:
Simple N/V:
Queasiness or discomfort reported by the patient.
Self-limiting, resolves spontaneously. Requires only symptomatic therapy.
Complex N/V:
Accompanied by weight loss, fever, and abdominal pain.
Persists despite antiemetics.
May cause progressive deterioration due to fluid-electrolyte imbalance.
what’s the overall goal of treatment for nausea and vomiting?
Antiemetic Therapy Goals and Strategies:
Overall Goal:
Prevent or eliminate nausea and vomiting (n/v).
Achieve this with minimal or acceptable adverse effects.
Nonpharmacological Approaches:
Dietary moderation or avoidance.
Addressing the underlying condition.
Maintaining a stable physical position.
Antiemetic Medications:
Aim for symptom relief.
Prevent fluid and electrolyte disturbances.
Single-agent antiemetics are often sufficient.
Multi-agent regimens for:
Non-responsive patients.
Those undergoing highly emetogenic chemotherapy.
Treatment Considerations:
Simple n/v typically requires minimal therapy.
Over-the-counter (OTC) and prescription drugs effective in small, infrequent doses.
Complex n/v may necessitate combination therapy, especially with cytotoxic chemotherapy.
what kind of meds helps with motion sickness?
anticholinergic for motion sickness
which drug is good for pregnant women to prevent nausea and vomiting?
diphenhydramine good to prevent nausea and vomiting in pregnant…not first line
what meds is commonly preferred for nausea and vomiting?
ondansetron (zofran) commonly used for nausea an vomiting
what are some antacids?
Magnesium Hydroxide (MgOH):
Also known as “milk of magnesia.”
Brands include Phillips’ Milk of Magnesia, Dulcolax, and Philips’ Chewables.
Aluminum Hydroxide (AlOH):
Found in antacid tablets such as Alu-Tab and Amphojel.
Calcium Carbonate:
A common ingredient in antacids like Rolaids and Tums, which provide relief for heartburn and acid indigestion.
Sodium Citrate:
Used in Citra pH to neutralize stomach acid and increase urine alkalinity.
Aluminum Hydroxide and Magnesium
Hydroxide (AlOH/MgOH):
A combination found in antacids such as Alamag, Maalox, and RuLox, which work together to reduce stomach acid.
Aluminum Hydroxide, Magnesium
Hydroxide, Simethicone, and Sorbitol:
This combination, found in products like Maalox, Mylanta, and Gelusil, helps reduce gas and discomfort from acid indigestion and heartburn.
Aluminum Hydroxide and Magnesium Trisilicate:
Combined in Gaviscon, these ingredients work to treat symptoms of too much stomach acid such as stomach upset, heartburn, and acid indigestion.
what form does scopolamine come in?
scopolamine comes in patch form.
how does anticholinergic toxicity present?mnemonic
red as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare, full as a flask.
flushing, dry skin, and mucous membrane (anhidrosis, dry mouth, dry skin), mydriasis with loss of accommodation, altered mental status, fever, urinary
how do you prevent serotonin syndrome?
Interaction Warnings:
Avoid concomitant use with other serotonin-increasing medications (e.g., SSRIs) to prevent serotonin syndrome.
Symptoms range from mild (shivering, diarrhea) to severe (muscle rigidity, fever, seizures).
Use caution in patients with QT prolongation.
