Nausea & Vomiting Flashcards

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1
Q

What are different causes of N/V?

A

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

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2
Q

Dramamine (class)

A

Antihistamine

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3
Q

Dramamine (generic)

A

Dimenhydrinate

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4
Q

Dimenhydrinate (brand)

A

Dramamine

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5
Q

Benadryl (class)

A

antihistamine

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6
Q

Benadryl (generic)

A

diphenhydramine

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7
Q

diphenhydramine (brand)

A

benadryl

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8
Q

Bonine (class)

A

antihistamine

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9
Q

Bonine (generic)

A

meclizine

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10
Q

meclizine (brand)

A

Bonine

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11
Q

Unisom (class)

A

antihistamine

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12
Q

Unisom (generic)

A

Doxalymine

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13
Q

doxalymine (brand)

A

unisom

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14
Q

Scolamine (class)

A

antihistamine

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15
Q

hydroxyzine (class)

A

antihistamine

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16
Q

antihistamine side effects

A

drowsiness, dry mouth, constipation, fall risk

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17
Q

antihistamine MOA

A

H1 blockers

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18
Q

phenothiazines MOA

A

inhibit dopamine, H1, muscarinic receptors

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19
Q

Promethazine (class)

A

phenothiazine

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20
Q

Prochlorperazine (class)

A

phenothiazine

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21
Q

Promethazine (BBW)

A

cannot be administered IV due to potential for tissue damage

22
Q

phenothiazines side effects

A

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

23
Q

Ondansetron (class)

A

5-HT3 antagonist

24
Q

Dolansetron (class)

A

5-HT3 antagonist

25
Q

Granisetron (class)

A

5-HT3 antagonist

26
Q

Palusetron (class)

A

5-HT3 antagonist

27
Q

Zolfran (generic)

A

Ondansetron

28
Q

Ondansetron (brand)

A

Zolfran

29
Q

5-HT3 antagonist side effects

A

headache, QT prolongation, constipation

30
Q

Metocloparamide (class)

A

Prokinetic

31
Q

Erythromycin (class)

A

Prokinetic

32
Q

Metocloparamide side effects

A

EPS, QT prolongation, diarrhea

33
Q

Erythromycin side effects

A

N/V, diarrhea, QT prolongation

34
Q

dexamethasone (class)

A

corticosteroids

35
Q

dexamethasone side effects

A

agitation, insomnia, increased BP BG appetite (chronic)

36
Q

when to avoid QTc prolonging agents

A

QTc >450 ms

37
Q

discontinue or lower dose on QTc prolonging agents if…

A

QTc increases >60 ms during treatment

38
Q

discontinue QTc prolonging agent if…

A

QTc > 500 ms

39
Q

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

A

K > 4
Mg > 2

40
Q

Treatments of General N/V

A

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

41
Q

Treatments for Disorders of Balance

A

antihistamines

42
Q

Treatments for Gastroporesis

A

metocloparamide (first line)
erythromycin (second line)

43
Q

Treatments for NVP

A

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

44
Q

options for vitamin B6 in NVP

A

diclegis
bonjesta

45
Q

Apfels score criteria

A

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

46
Q

apfels score interpretation

A

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

47
Q

high risk (scored) treatments for Post-Op NV

A

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

48
Q

moderate risk (scored) treatments for Post-Op NV

A

5-HT3 antagonist after anesthesia

49
Q

low risk (scored) treatments for Post-Op NV

A

no planned therapy (use if needed)

50
Q

rescue therapy for Post-Op NV

A

5-HT3 antagonist or drug from another class