nausea and vomiting pharm Flashcards
Serotonin (5-HT3) Receptor Antagonists
- strong antiemetic
- end with “setron”
- risk of serotonin syndrome when combined with other 5HT affecting drugs
- dose dependent QT prolongation
Dolasetron
- Serotonin (5-HT3) Receptor Antagonists
- high risk of dose dependent QT prolongation (Torsades)
Granisetron
-Serotonin (5-HT3) Receptor Antagonists
Ondansetron
-Serotonin (5-HT3) Receptor Antagonists
Palonosetron
-Serotonin (5-HT3) Receptor Antagonists
Neurokinin (NK1) Receptor antagonists
- end with “pitant”
- moderate antiemetic
- chemotherapy induced NV
- mild GI and CNS AE
Aprepitant
- Neurokinin (NK1) Receptor antagonists
- PROPHYLAXIS of post-op NV
Fosaprepitant
-Neurokinin (NK1) Receptor antagonists
Netupitant
- Neurokinin (NK1) Receptor antagonists
- moderate CYP450 inhibitor
Fosnetupitant
-Neurokinin (NK1) Receptor antagonists
Rolapitant
- Neurokinin (NK1) Receptor antagonists
- moderate CYP450 inhibitor
Histamine (H1) Receptor Antagonists
- weak antiemetic
- anticholinergic activities
- can cause dry mouth, drowsiness, constipation, urinary retention….
Diphenhydramine
-Histamine (H1) Receptor Antagonists
Dimenhydrinate
-Histamine (H1) Receptor Antagonists
Hydroxyzine
-Histamine (H1) Receptor Antagonists
Promethazine
-Histamine (H1) Receptor Antagonists
Meclizine
- Histamine (H1) Receptor Antagonists
- oral only!
- only indicated for motion sickness/vertigo
Cyclizine
- Histamine (H1) Receptor Antagonists
- oral only!
- only indicated for motion sickness/vertigo
Doxylamine
- Histamine (H1) Receptor Antagonists
- REQUIRES VIT B6
- Indicated for pregnant pt
Dopamine (D2) Receptor Antagonists
- weak-moderate antiemetic
- anticholinergic activity
Chlorpromazine
- Dopamine (D2) Receptor Antagonists
- phenothiazine
Perphenazine
- Dopamine (D2) Receptor Antagonists
- phenothiazine
- oral only!
Prochlorperazine
- Dopamine (D2) Receptor Antagonists
- phenothiazine
Metoclopramide
- Dopamine (D2) Receptor Antagonists
- stimulates ACh in GI, generates peristalsis (diabetic gastroparesis)
Haloperidol, olanzipine, trimethobenzamide
- Dopamine (D2) Receptor Antagonists
- mostly used in psych
Scopolamine
- M1 muscarinic receptor antagonist
- 72hr active transdermal patch
- weak antiemetic, used for motion sickness
- SIGNIFICANT anticholinergic activity
Cannabinoid (CB) Receptor AGONISTS
- synthetic derivatives of THC
- decreases excitability of neurons
- strong antiemetic
- indicated for treatment resistant CINV
Dronabinol
- Cannabinoid (CB) Receptor AGONISTS
- Schedule III
- large first pass effect
Nabilone
- Cannabinoid (CB) Receptor AGONISTS
- Schedule II
- Metabolized into multiple active compounds
