Nausea & Vomiting

Question 1

What are different causes of N/V?

Answer 1

Gastroenteritis
Pancreatitis
Disorders of Balance (motion sickness, vertigo, dizziness)
NVP
Post-Op NV
Gastroporesis
Chemo/Cancer NV

Question 2

Dramamine (class)

Answer 2

Antihistamine

Question 3

Dramamine (generic)

Answer 3

Dimenhydrinate

Question 4

Dimenhydrinate (brand)

Answer 4

Dramamine

Question 5

Benadryl (class)

Answer 5

antihistamine

Question 6

Benadryl (generic)

Answer 6

diphenhydramine

Question 7

diphenhydramine (brand)

Answer 7

benadryl

Question 8

Bonine (class)

Answer 8

antihistamine

Question 9

Bonine (generic)

Answer 9

meclizine

Question 10

meclizine (brand)

Answer 10

Bonine

Question 11

Unisom (class)

Answer 11

antihistamine

Question 12

Unisom (generic)

Answer 12

Doxalymine

Question 13

doxalymine (brand)

Answer 13

unisom

Question 14

Scolamine (class)

Answer 14

antihistamine

Question 15

hydroxyzine (class)

Answer 15

antihistamine

Question 16

antihistamine side effects

Answer 16

drowsiness, dry mouth, constipation, fall risk

Question 17

antihistamine MOA

Answer 17

H1 blockers

Question 18

phenothiazines MOA

Answer 18

inhibit dopamine, H1, muscarinic receptors

Question 19

Promethazine (class)

Answer 19

phenothiazine

Question 20

Prochlorperazine (class)

Answer 20

phenothiazine

Question 21

Promethazine (BBW)

Answer 21

cannot be administered IV due to potential for tissue damage

Question 22

phenothiazines side effects

Answer 22

hypotension (needs slow IV infusion), QT prolongation, twitching in face

Question 23

Ondansetron (class)

Answer 23

5-HT3 antagonist

Question 24

Dolansetron (class)

Answer 24

5-HT3 antagonist

Question 25

Granisetron (class)

Answer 25

5-HT3 antagonist

Question 26

Palusetron (class)

Answer 26

5-HT3 antagonist

Question 27

Zolfran (generic)

Answer 27

Ondansetron

Question 28

Ondansetron (brand)

Answer 28

Zolfran

Question 29

5-HT3 antagonist side effects

Answer 29

headache, QT prolongation, constipation

Question 30

Metocloparamide (class)

Answer 30

Prokinetic

Question 31

Erythromycin (class)

Answer 31

Prokinetic

Question 32

Metocloparamide side effects

Answer 32

EPS, QT prolongation, diarrhea

Question 33

Erythromycin side effects

Answer 33

N/V, diarrhea, QT prolongation

Question 34

dexamethasone (class)

Answer 34

corticosteroids

Question 35

dexamethasone side effects

Answer 35

agitation, insomnia, increased BP BG appetite (chronic)

Question 36

when to avoid QTc prolonging agents

Answer 36

QTc >450 ms

Question 37

discontinue or lower dose on QTc prolonging agents if...

Answer 37

QTc increases >60 ms during treatment

Question 38

discontinue QTc prolonging agent if...

Answer 38

QTc > 500 ms

Question 39

lab values to monitor when on QTc prolonging agents (and ranges to maintain)

Answer 39

K > 4 Mg > 2

Question 40

Treatments of General N/V

Answer 40

5-HT3 antagonists (first line) metocloparamide (first line) phenothiazine (second line)

Question 41

Treatments for Disorders of Balance

Answer 41

antihistamines

Question 42

Treatments for Gastroporesis

Answer 42

metocloparamide (first line) erythromycin (second line)

Question 43

Treatments for NVP

Answer 43

antihistamines (first line) vitamin b-6 (pyridaxine) (first line) 5-HT3 antagonists (second line) metocloparamide (second line)

Question 44

options for vitamin B6 in NVP

Answer 44

diclegis bonjesta

Question 45

Apfels score criteria

Answer 45

female non-smoker history of motion sickness or post-op NV planned use of opioids post-op

Question 46

apfels score interpretation

Answer 46

4 - high risk 2-3 - moderate risk 1 - low risk

Question 47

high risk (scored) treatments for Post-Op NV

Answer 47

scopolamine patch 2 hrs before anesthesia dexamethasone at start of anesthesia 5-HT3 antagonist after anesthesia

Question 48

moderate risk (scored) treatments for Post-Op NV

Answer 48

5-HT3 antagonist after anesthesia

Question 49

low risk (scored) treatments for Post-Op NV

Answer 49

no planned therapy (use if needed)

Question 50

rescue therapy for Post-Op NV

Answer 50

5-HT3 antagonist or drug from another class