Nausea/Vomiting

Question 1

Bilious vomiting suggests

Answer 1

prolonged vomiting or obstruction distal to ampulla of vater

Question 2

relief of ab pain with vomiting or vomiting during eating suggests

Answer 2

peptic ulcer

Question 3

mallory weiss

Answer 3

linear mucosal tears in cardio-esophageal junction with hematemesis

Question 4

3 Dopamine antagonists for N/V

Answer 4

promethazine, prochlorperazine, metoclopramide

Question 5

dexamethasone dose for N/V

Answer 5

8mg IV one time dose.

inc doses are NOT known to inc efficacy

Question 6

avoid dexamethasone in what pt population

Answer 6

DM (inc risk of high sugars)

Question 7

anti-emetic for pts with migraine, motion sickness, or vertigo

Answer 7

meclizine

dimenhydrinate

Question 8

anti-emetic for post-chemo nausea

Answer 8

5-HT antagonists (zofran, etc.), dexamethasone, promethazine

benzos as adjunct

Question 9

if N/V persist after 1st dose of odansetron/zofran is a 2nd dose beneficial?

Answer 9

No, you should switch classes. Higher doses of zofran don’t inc efficacy either (unless chemo-induced N/V)

Question 10

anti-emetic for gastroparesis

Answer 10

metoclopramide (inc doses may inc efficacy)