Nausea and Vommiting Flashcards

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1
Q

Vomiting is coordinated by?

A

the vomiting centre + chemoreceptor trigger zone in the brain stem

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2
Q

The vomiting center contains?

A
  1. muscarinic M1 receptors 2. histamine H1 receptors 3. neurokinin 1 NK1 receptors 4. serotonin 5-HT3 receptors
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3
Q

Which part of the brain triggers vomiting after seeing something repulsive?

A

cortex

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4
Q

Which part of the brain triggers vomiting during motion sickness?

A

vestibular apparatus

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5
Q

Which part of the brain triggers vomiting after ingesting a toxin ?

A

stomach

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6
Q

The drugs which are recommeded for the induction of vomiting in cases of poisoning are?

A
  1. apomorphine 2. ipecacuanha syrup
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7
Q

Describe the syrup of ipecac emetic?

A

Prepared from the root of the ipecacuanha plant

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8
Q

What is its function?

A

induces emesis

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9
Q

What are the side effects?

A
  1. drowsiness, diarrhea and stomahc ache 2. myocardial conduction disturbances
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10
Q

Describe the action?

A

induces vomiting within 20-30 minutes - The emetic action is increased if 200-300ml water is taken immediately after ingesting the syrup

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11
Q

What is the recommeded dosage?

A
  1. adults - 20ml orally followed by 200-300ml water 2. children - 10ml orally followed by 100-150ml water
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12
Q

Describe the action of apomorphine hydrochloride?

A
  1. acts directly on the CTZ and induces vomiting within 10 minutes after IM or SC injection 2. More effective if 200 to 300ml water is given by mouth before injection
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13
Q

Emetics are contraindicated in?

A

unconscious patients

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14
Q

An overdose can cause?

A

euphoria, excitement, convulsion, violent vomiting, acute circulatory failure and respiratory depression

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15
Q

How can the depressant action be reversed?

A

administration of a narcotic antagonist like naloxone

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16
Q

Describe the dosage of apomorphine hydrochloride tablests?

A
  1. adults - 6mg 2. children - 0.06mg/kg
17
Q

What are antiemetics?

A

serotonin 5-HT3 antagonists

18
Q

Give examples?

A
  1. ondansetron 2. granietron 3. dolasetron 4. palonosetron
19
Q

Describe the action?

A

Block central 5-HT3 and peripheral (main effect) 5-HT3 receptors on intestinal vagal and spinal afferent nerves - prevent emesis due to vagal stimulation and chemotherapy

20
Q

What are the uses of antiemetics?

A
  1. Prevention of acute chemotherapy-induced nausea and emesis and postoperative nausea and vomiting 2. Prevention and treatment of nausea and vomiting in patients undergoing radiation therapy
21
Q

How is the efficacy enhanced?

A

combination therapy with dexamethasone and NK1-receptor antagonist

22
Q

Describe the adverse effects?

A

Headache, dizziness, and constipation