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GI 2 > Nausea/Vomiting drugs > Flashcards

Nausea/Vomiting drugs Flashcards

1
Q

What are the receptors targeted by anti emetic drugs

A
  • 5-HT3 . . serotonin type-3
  • H1
  • M1
  • D2
  • NK1
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2
Q

Which of the classes of drugs for vomiting is the only AGONIST

A

Cannabinoid Receptor Agonist

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3
Q

What do Serotonin receptor antagonists end with

A

Setron

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4
Q

Tell me about serotonin receptor antagonists

A
  • Very strong and effective
  • Indicated for chemo induced N/V (CINV)
  • also Radiation induced, Post-operative, and Pregnancy
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5
Q

Most worrisome adverse effect of Serotonin antagonists

A
  • Dose-dependent QT prolongation and Torsade’s

- Use extreme caution when other QT-prolonging agents (anti-arrhythmics)

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6
Q

Most 5-HT3 receptors have short half-lives . . which is the one that has long half life that lasts 24-40 hours

A

Palonsetron

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7
Q

What do NK1 antagonists end with

A

Pitant

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8
Q

Indications for NK1 antagonists

A

-moderate antiemetic agents so only used for Chemo and with another agent

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9
Q

What are the NK1 antagonists that are used for prophylaxis of post-operative N/V

A
  • only aprepitant and fosaprepitant

- up to 3 hours prior to anesthesia induction

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10
Q

Which of the NK1 antagonists have moderate-major active metabolites and longer half lives

A

Netupitant/Rolapitant

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11
Q

What are the H1 receptor antagonists

A
  • Diphenhydramine
  • Dimenhydrinate
  • Hydroxyzine
  • Promethazine
  • Meclizine
  • Cyclizine
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12
Q

Describe the H1 receptor antagonists

A
  • weak antiemetics
  • Never used by themselves for chemo
  • usually just used for normal run of the mill N/V
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13
Q

What are the adverse effects of H1 antagonists

A

Classic anticholinergic effects

  • Dry mouth
  • Urinary retention
  • Blurred vision
  • Sedation
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14
Q

H1 antagonists for motion sickness

A
  • Meclizine

- Cyclizine

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15
Q

What are the antiemetic D2 antagonists?

A
  • Chlorpromazine
  • Perphenazine
  • Prochlorperazine
  • Metoclopramide
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16
Q

what is the D2 antagonist used to stimulate ACh actions in GI, enhanding GI motility and increasing LES tone

A

Metoclopramide

17
Q

Adverse effects of dopamine receptor antagonists

A

Classic anticholinergic effects

18
Q

M1 receptor antagonist

A

Scopolamine

19
Q

Weak antiemetic transdermal patch for motion sickness

A

Scopolamine

20
Q

Cannabinoid receptor Agonists

A
  • Dronabinol

- Nabilone

21
Q

Strength of Cannabinoid receptor agonists

A

Strong Antiemetic agents

22
Q

Use for cannabinoids

A

commonly reserved for TREATMENT RESISTANT clinical scenarios

23
Q

Cannabinoids can be used for appetite stimulation in what patients

A

-Anorexic patients due to severe disease (Cancer or AIDS)

24
Q

Drug interactions for Cannabinoids

A
  • CNS depressants

- Cardiovascular and sympathomimetics

25
Q

Drug regimen with High Emetogenic chemo

A
  • 5 HT3 antagonist
  • NK1 antagonist
  • Corticosteroid (dexamethasone)
26
Q

In high emetogenic chemo, what do you add on in treatment resistant patients

A

cannabinoid

27
Q

Drug regimen with moderate emetogenic chemo

A
  • 5 HT3 antagonist

- Corticosteroid (dexamethasone)

28
Q

What do you add in moderate emetogenic chemo in treatment resistance

A
  • Add NK1 antagonist

- if still resistant . . add canabinoid

29
Q

Drug regimen with low emetogenic chemo

A

-Corticosteroid (dexamethasone)

30
Q

Non chemo application: motion sickness

A

Scopolamine (Patch) or Dimenhydrinate (oral)

31
Q

Non chemo application: vertigo

A

-Meclizine or Cyclizine

32
Q

Non chemo application: Diabetic Gastroparesis

A

Metoblopramide

33
Q

Non chemo application: pregnancy induced emesis

A

STEPPED THERAPY (not adding on but try one . . then try another)

  • 5-HT antagonist or Histamine antagonist
  • Dopamine antagonist
  • Steroid or different dopamine antagonist

GI 2 (13 decks)

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