Nausea/Vomiting/Constipation Pharm

Question 1

Odansetron

Mechanism

Use

Pharmacokinetics

Metabolized by

Answer 1

serotonin 5HT3 antagonist (CTZ)

anti-emetic for chemo

effects persist as it leaves circulation

cyp450

Question 2

H1 receptor

tissues

mechanism

effect

Answer 2

Nonvascular smooth muscle, vasc smooth muscle, brain

inc DAG/IP3

Inc vasc permeability, VD, constrict vascular sm

Question 3

Diphenhydramine

Mechanism

Metabolized by

Effect

Works best

SE

Answer 3

inverse ag of H1 receptor

cyp450

inhibit capillary permeability, little effect on HTN, bronchocontstriction

prior to histamine release (not an inhibitor)

cross BBB (sedation), antimuscarinic

Question 4

Prmomethazine

Mechanism

Significant effects on

Relieves N/V from

Answer 4

inverse H1 agonist

Inhibits musc Ach receptor, leading to sedation, antiemesis

motion sickness

Question 5

Opioid receptor locations

all

u and K

Delta

Answer 5

PNS, GI, cerebral cortex, hippocampus, dorsal horn of spinal cord

midbrain PAG

amygdala

Question 6

Morphine GI effect

pain w

dec

Answer 6

inc SM tone, dec propulsion (act on gut receptors)

spasms in LI/biliary tract

secretions of GI

Question 7

SE of Palonosetron

EKG SE of odansetron worse with

Possible mechanism for GC antiemetic effect

Other SE of prochlorperazine

Ex of cannabinoid

Answer 7

Diarrha, HA, light headed

pts with EKG probs, over 75, electrolyte imbalances

suppress peritumoral inflamm and PG production

Drowsiness, jaundice (dont take with depressants)

Dronabinol (may inc appetite)

Question 8

Bisacodyl is excreted in

Lubriprostone comes from

Linaclotide inhibits

Loperamide metabolized by

Diphenoxylate used alongside

Concern w eluxadoline w/out a gallbladder

Answer 8

stool

PG E1

colonic sensory neurons (less pain/contractions)

liver

atropine

Pancreatitis