Nausea & Labyrinth disorders Flashcards
When can antiemetics be prescribed?
When cause of vomiting is known, esp in children.
Because it might be unnecessary if the cause can be treated.
Examples of antihistamines and what can they be used for?
- Cyclizine
- Promethazine
- Cinnarizine
Effective against nausea & vomiting. Good for vertigo and motion sickness.
Give examples of Phenothiazines? What are they?
What are they used for? And what side effects can they cause?
- Prochloperazine
- Chlorpromazine
- Perphenazine
- Trifluoperazine
They are dopamine antagonist and block chemoreceptor trigger zone. Used for n&v.
Prochlorperazine used for chemotherapy-induced and radiation induced n&v.
Which Phenothiazines is less sedating?
Prochlorperazine
What kind of Prochlorperazine tablet should be given for severe nausea & persistent vomiting?
Buccal tablets
Name which drugs can be used for nausea and vomiting and in which conditions/diseases?
Levopromazine & Haloperidol - Used for n&v in terminal illness (palliative care)
Metoclopramide - acts directly on GI tract and for vomiting assoc with hepatic, gastroduodenal disease.
Domperidone - acts on chemoreceptor trigger zone and doesn’t cross BBB. Used in Parkinsons disease.
5HT 3 Antagonist (Granisetron & Ondansetron) - n&v with cytotoxics (chemo) & postoperative nausea
Dexamethasone - Vomiting in chemo. Usually used with 5HT3 antagonist but can be used alone.
Aprepitant - N&V associated with chemo. Usually given with dexamethasone & 5ht3 antagonist
Nabilone - synthetic cannabinoid, add on for chemo induced n&v
What self care advice and non-pharmacological treatment can be given for Pregnant women who have nausea & are vomiting?
Self-care advice:
- Rest
- Oral rehydration
- Dietary changes
Non-Pharmacological:
- Ginger (mild-moderate nausea)
What drugs an be given for Pregnant women who have nausea & are vomiting?
- Chlorpromazine
- Cyclizine
- Metoclopramide
- Prochlorperazine
- Promethazine hydrochloride
- Promethazine teoclate
- Ondansetron
What is Hyperemesis Gravidarum?
Excessive nausea and vomiting in pregnancy
What is the treatment for hyperemesis gravidarum?
Requires regular antiemetic therapy
Intravenous fluid & electrolyte replacement.
Thiamine to reduce risk of Wernicke’s encephalopathy.
What should be given for Motion sickness?
- Give antiemetics to PREVENT it, rather than after n&v has developed.
- Hyoscine hydrobromide
- Promethazine (if sedative effect required), but less sedating antihistamines such as cyclizine/cinnarizine are preferred.
Which drugs should NOT be given for motion sickness and why?
- Domperidone
- 5HT3 antagonist
- Metoclopramide
- Phenothiazines (EXCEPT PROMETHAZINE)
Because they are ineffective in motion sickness.
What can be used to treat Post-operative nausea & vomiting?
Normally a combination of two or more antiemetics:
- 5HT3 (e.g. Ondansetron)
- Dexamethasone
- Droperidol & Haloperidol
- Prochlorperazine
- Cyclizine (post-op n&v caused by opioids & general anaesthetics)
What is Meniere’s Disease?
A rare inner ear condition that can affect your balance and hearing.
What is used to treat Meniere’s Disease?
- Betahistine: licensed for vertigo, tinnitus & hearing loss associated with Meniere’s Disease
- Antihistamines (e.g. cinnarizine) & Phenothiazines (e.g. prochloperazine) are also used.
Prochloperazine should only be reserved for acute symptoms where possible
