Nausea & Labyrinths disorders

Question 1

Special senses MORE DETAIL

Answer 1

Check them cards
ONLY NEED TO KNOW DRUGS AND SAFETY ADVICE NO EXTRA STUFF IE SYMPTOMS for exam.

Question 2

Safety advice

Answer 2

Domperidone - Risk of Cardiac AEs MAX duration no > 7 days

Metoclopramide: Risk of Neurological AEs. only short term use up to 5 days

Promethazine - AVOID Children<6yrs

Question 3

Pregnancy suitable Antiemetics

Answer 3

1st line is self care. (rest, oral rehydration, Diet change)
2. Ginger (mild/moderate)

Pharmacological
Chlorpromazine
Cyclizine
Metoclopramide
Prochlorperazine
Promethazine
Ondansetron

Hyper emesis:
Regular antiemetics
IV fluid & Electrolyte replacement
Thiamine to reduce risk of Wernicke’s encephalopathy

Question 4

Motion sickness (EXAM Q)

Answer 4

CHECK Special senses CARDS
Give Antiemetic to prevent:
- Hyoscine hydrobromide
- Promethazine (Sedating) ALT non Sedating Cyclizine/Cinnarizine

AVOID Domperidone, 5HT3 antagonist, Metoclopramide, Phenothiazines (except promethazine)

Question 5

Post OP NV

Answer 5

Normally combo of 2/+ of:

5HT3 antagonist - Ondansetron
Dexamethasone
Droperidol & Haloperidol
Prochlorperazine
Cyclizine

Question 6

Meniere disease

Answer 6

Betahistine

Antihistamine

Prochlorperazine

Question 7

Some drugs and there uses

Answer 7

Antiemetics only used when cause of vomiting is known.
- Can be dangerous to use them if the cause can be treated without them

Antihistamines (cyclizine, promethazine cinnarizine) are effective for N/V for many underlying conditions. Good for vertigo/Motion sickness

Phenothiazines [Antihistamines/psychotics] (Chlorpromazine, Prochlorperazine etc) - Dopamine antagonists - Block CTZ. severe dystonic reaction can happen in kids.
- Prochlorperazine - Chemo/Radiation induced N/V. This drug less sedating buccal used in severe cases.

• Levopromazine/Haloperidol - N/V in terminal illness
• Metoclopramide - works on GI tract
• Domperidone - CTZ. Low doses possible use in PD.
• 5HT3 antagonist (Granisetron/Ondansetron) N/V after cytotoxics (chemo) & Post OP
• Dexamethasone - Vomiting in chemo NV alone/with 5HT3 antagonist
• Aprepitant - NV with chemo used with dexa + 5HT3 -ve
• Nabilone - Cannabinoid add om for chemo NV