Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI/Hepatic > Nausea/Vomiting > Flashcards

Nausea/Vomiting Flashcards

1
Q

What are the high emetic risk chemotherapy regimens?

A
  1. doxorubicin or epirubicin + cyclophosphamide
  2. carmustine
  3. cisplatin (>50 mg/m2)
  4. cyclophosphamide (≥ 1,500 mg/m2)
  5. dacarbazine
  6. ifosfamide (>10 g/m2)
  7. mechlorethamine
  8. streptozotocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does acute vomiting require treatment?

A

Not always

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Match the symptom with the diagnosis: hematemesis

A

Upper GI tract bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Match the symptom with the diagnosis: fever

A

Gastroenteritis, appendicitis, PID, UTI, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Match the symptom with the diagnosis: constipation

A

Appendicitis, intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Match the symptom with the diagnosis: diarrhea

A

Gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Match the symptom with the diagnosis: dysuria/vaginal discharge

A

UTI, PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Match the symptom with the diagnosis: amenorrhea

A

Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Match the symptom with the diagnosis: headache

A

Migraine, meningitis, stroke, head trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Match the symptom with the diagnosis: abdominal pain

A

Cholecystitis, PID, gastroenteritis, appendicitis, pancreatitis, intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Match the symptom with the diagnosis: chest pain

A

myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What meal habits are beneficial in N/V patients?

A
  1. frequent small meals
  2. avoid spicy or fatty foods
  3. high protein snacks
  4. BRAT diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dose of peppermint oil in dyspepsia and motion sickness

A

weak evidence of one tablet (0.2 mL) 2-3 times per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Use of ginger in motion sickness and pregnancy induced N/V

A

weak evidence of 250 mg po TID with food or 1-4 g/day in divided doses of powder/tablet/capsules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe physical treatment option for N/V

A

acupuncture/acupressure on the p6 (Neiguan) point on the inside of the wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hyperemesis gravidarum?

A

Severe N/V in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What psychological treatment may be effective for hyperemesis gravidarum?

A

psychotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the factors to consider when choosing a pharmacologic agent for N/V

A
  1. Suspected etiology
  2. Frequency, duration, severity of symptoms
  3. Route of medication tolerated
  4. What has worked in past
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the major drug classes for N/V

A
  1. Phenothiazines
  2. Serotonin antagonists
  3. Antihistamines
  4. Butyrophenones
  5. NK1 antagonists
  6. Antimuscarinic agent
  7. Cannabinoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the three phenothiazines?

A
  1. promethazine (phenergan)
  2. prochlorperazine (compazine)
  3. chlorpromazine (thorazine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MOA of phenothiazines?

A

block D2 dopaminergic receptors in the brain and chemotrigger zone (CTZ blockade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can phenothiazines be used for?

A

acute vomiting of central origin (motion sickness, migraine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the major side effects of phenothiazines?

A

sedation and extrapyramidal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

By what route of administration can you NOT give phenothiazines?

A

subQ because of injection site reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What phenothiazine causes the most drowsiness?

A

promethazine (phenergan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why are prochlorperazine and chlorpromazine less drowsy?

A

They are predominantly antidopaminergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the four serotonin antagonists?

A
  1. ondansetron (Zofran)
  2. granisetron (Kytril)
  3. palonosetron (Aloxi)
  4. dolasetron (Anzemet)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the MOA of serotonin antagonists?

A

block 5-HT3 serotonin receptors in the gut wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What drug is contraindicated with the serotonin antagonists?

A

apomorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which serotonin antagonists can cause QTC prolongation?

A

ondansetron, granisetron, and dolasetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

With which two serotonin antagonists do you have to correct hypomagnesemia and hypokalemia?

A

ondansetron and dolasetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which serotonin antagonists typically only require one dose?

A

palonosetron and dolasetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What types of N/V are serotonin antagonists used for?

A

PONV, CINV, RINV, and refractory N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the Antihistamines used for N/V?

A
  1. dimenhydrinate (dramamine)
  2. meclizine (bonine)
  3. doxylamine (unisom)
  4. diphenhydramine (benadryl)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the MOA of antihistamines in N/V?

A

blocks H-1 and M-1 receptors in the vomiting center and vestibular system

36
Q

What are the antihistamine used for?

A

Vertigo and motion sickness

37
Q

What are the major side effects of antihistamines?

A

sedation and anticholinergic effects

38
Q

When should antihistamines be taken?

A

30-60 minutes before travel or motion activity

39
Q

What are the two butyrophenones?

A

haloperidol (haldol) and droperidol (inapsine)

40
Q

What are butyrophenones used for?

A

PONV and palliative care

41
Q

What is the black box warning on butyrophenones?

A

QTC prolongation and torsades

42
Q

What is the major risk with butyrophenones?

A

EPS

43
Q

When should ECGs be obtained with butyrophenones?

A

baseline and 2-3 hours post dose

44
Q

What are the four NK1 antagonists?

A
  1. aprepitant
  2. fosaprepitant
  3. netupitant/palonsetron
  4. rolapitant
45
Q

What is the MOA of NK1 antagonists?

A

inhibits substance P/NK-1 receptor

46
Q

What are the NK1 antagonists used for?

A

CINV

47
Q

What are the common side effects of aprepitant?

A

fatigue and hiccups

48
Q

When should netupitant/palonsetron be avoided?

A

In pt with severe renal or hepatic disease

49
Q

What are the drug interactions associated with aprepitant and fosaprepitant?

A

dose-dependent inhibitor of CYP3A4. Reduces efficacy of warfarin and oral contraceptives

50
Q

How long is the half life of rolapitant?

A

7 days

51
Q

What is the one antimuscarinic agent?

A

scopolamine (patch)

52
Q

What are the indications for antimuscarinic agents?

A

motion sickness and PONV

53
Q

What is the MOA of muscarinic agents?

A

blocks M-1 receptors in the VC and the vestibular system

54
Q

What are the directions for scopolamine for PONV?

A

place patch the evening prior to surgery or 1 hour prior to C-section

55
Q

What are the directions for scopolamine for motion sickness?

A

place patch 4 hours prior to activity

56
Q

What happens if a scopolamine patch dislodges during treatment time?

A

remove patch and place another at a different postauricular site

57
Q

What are the two cannabinoids?

A

dronabinol (marinol) and nabilone (cesamet)

58
Q

What is the MOA of the cannabinoids?

A

CB1 and CB2 receptor antagonists

59
Q

Which receptor causes the antiemetic effect of cannabinoids?

A

CB1

60
Q

What are cannabinoids used for?

A

CINV and refractory vomiting

61
Q

What are the major ADRs of cannabinoids?

A

appetite stimulation, euphoria, cognitive impairment, somnolence, and psychotropic reactions

62
Q

What is the MOA of metoclopramide (reglan)?

A

D2 dopaminergic receptor blocker

63
Q

What is metoclopramide most used for?

A

gastroparesis

64
Q

What is the black box warning on metoclopramide?

A

tardive dyskinesia

65
Q

What are the main ADRs associated with metoclopramide?

A

restlessness, anxiety, somnolence, EPS, and QTC prolongation

66
Q

What is the MOA of emetrol?

A

unknown, helps reduce muscle contractions

67
Q

What is emetrol used for?

A

upset stomach secondary to GI virus or food indiscretions

68
Q

What patient population should NOT use emetrol?

A

diabetics due to fructose and dextrose

69
Q

What are the instructions on emetrol?

A

15-30 mL q15 minutes no more than 5 doses

70
Q

What is the MOA of erythromycin?

A

motilin receptor agonist

71
Q

What is erythromycin used for?

A

gastroparesis

72
Q

What are the ADRs associated with erythromycin?

A

GI upset, diarrhea, and N/V

73
Q

What is methylprednisolone and dexamethasone used for?

A

CINV (prophylaxis) + another antiemetic

74
Q

What are the ADRs of methylprednisolone and dexamethasone?

A

GI upset, anxiety, and insomnia

75
Q

What is the MOA of lorazepam?

A

GABA agonist

76
Q

What is lorazepam used for?

A

anxiety induced N/V

77
Q

What are the major ADRs of lorazepam?

A

sedation and amnesia

78
Q

What is the MOA of antacids/H2RAs?

A

reduce gastric acid to neutralize stomach

79
Q

What are antacids/H2RAs used for

A

N/V associated with GERD

80
Q

What is the MOA of doxylamine/pyridoxine (diclegis)?

A

H-1 receptor blocker

81
Q

What is doxylamine/pyridoxine used for?

A

PINV

82
Q

What is the treatment for hyperemesis gravidarum?

A

non-pharm first then pyridoxine w/wo doxylamine. IV hydration and nutrition

83
Q

What is the gold standard for CINV?

A

ondansetron

84
Q

What are the risk factors for CINV?

A
  1. age < 50
  2. female
  3. nonsmoker
  4. hx of PONV or motion sickness
  5. anesthesia
  6. nitrous oxide
  7. opioids
85
Q

How many prophylactic antiemetics should a high risk person receive?

A

2 or more

GI/Hepatic (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions