Nausea, Vomiting, Diarrhea

Question 1

What area of the brain is said to cause the vomiting reflex

Answer 1

vomiting center

Question 2

what three mechanisms stimulate the vomiting centre

Answer 2

Higher cortical centres (vestibular)

Chemoreceptor trigger zone

Visceral Stimulation fro GI

Question 3

Tell me about Higher cortical stimulation

Answer 3

CAUSED BY:
Vestibular disorders/opiods
Increased ICP
Irritation
Psychogenic

Related to Histamine, Serotonin and Acetylcholine Release.

PHARMA- Odansetron (Serotonin), dimenhydrinate (H), Scoplamine- (Ach)

Question 4

Tell me about Visceral stimulation of Vomiting centre

Answer 4

a

Question 5

Tell me about CTZ

Answer 5

a

Question 6

Describe 6 key Meds of GI

Answer 6

Diphenoxylate with atropine: Antidiarrheal. Used with an anticholinergic to minimize abuse because it is an opioid. Opioids minimize gi motility.

Odansetron: antiemetic. Seretonin receptor blocker. CNS And GI tract. Used for PONV and cytotoxic nausea prevention. The golden med.

Dimenhydrinate: Antihistamine: used for motion sickness and morning sickness. Withhold from giving to infants.

Scopolamine: anticholinergic. Blocks acetylcholine. Anti-motion sickness. CAT C

Prochlorperazine: Antiemetic. Dopamine blocker of receptors in the medulla. Used for radiation/opioid/general anesthetic sickness. CAT C

Metoclopramide: antiemetic. Dopamine and serotonin receptor blocker. Gi stimulant. Used for GI indused NV but NOT when there is an obstruction.

Question 7

What is an adsorbent?

Answer 7

Antidiarrheal
• Bind to toxins or Ions and allow elimination through stool
• EXAMPLES- Bismuth Subsalicylate (like liquid aspirin) for intestines OR Charcoal for stomach

Question 8

What do anticholinergics do for diarrhea

Answer 8

• Slow peristalsis by slowing contractions (often used in conjunction with other tx)
• Intestinal Flora Modifiers
Same as bodies “normal” flora, provided exogenous replenishment of “good” bacteria, which limits growth of diarrhea causing bacteria
• Lactobacillus is common family

Question 9

type of laxatives

Answer 9

o	Bulk forming (psyllium/fibre- attracts water)
o	Emollient (docusate salts- fecal softeners)
o	Hyperosmotic (glycerine- pulls in water)
o	Stimulant (castor oil- induce peristalsis)

Question 10

What is Normal ingestion to defecation time?

Answer 10

Normal ingestion to defecation time is 24to 36hrs