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Year2 GI Exam I > NVDC Tx I > Flashcards

NVDC Tx I Flashcards

(58 cards)

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1
Q

What are the 2 groups of D2 R antagonists antimetics

A

substituted benzamides and phenothiazines

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2
Q

what is the substituted benzamide antimetics

A

metoclopramide

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3
Q

what are the phenothiazines antimetics

A

prochlorperazine

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4
Q

what are the antihistamines antimetics

A

diphenhydramine

promethazine

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5
Q

what are the antimuscarinic anitmetics

A

scoppolamine

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6
Q

what are the cannabinoid antimetics

A

dronabinol

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7
Q

what are the opiod antidiarrheal

A

loperamide

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8
Q

what are the mucosal protective agents for antidiarrhea

A

bismuth subsalicylate

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9
Q

what are the types of laxatives

A

bulk forming
osmotic
stimulant
stoof softners

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10
Q

what are the osmotic laxatives

A

saline and polyethylene glycol-electrolytes

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11
Q

what are the prokinetic (pro motility agents)

A

metoclopramide

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12
Q

what R are found in the vomiting center

A

Ach Muscarinic, histmaine, neurokinin1 and serotonin

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13
Q

MOA ondansetron

A

blocks central serotonin R in vomiting center and chemR trigger zone and on peripheral extrinsic vagal and spinal afferent nn

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14
Q

how is ondansetron taken and where is majoirty metabolized

A

PO or IV

hepatic metabolism

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15
Q

therapeutic use ondansetron

A

acute chemotherapy induced nausea and vomiting

post operative and post radiation

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16
Q

how cna you increase efficacy of ondansetron

A

when used in combination with corticosteroid and NK R antagonist

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17
Q

adverse effects ondansetron

A

HA, dizziness, constipation

QT prolongation

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18
Q

drug interactions with ondansetron

A

no significant ones

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19
Q

MOA metoclopramide and prochlorperazine

A

block D2-like R in CTZ and solitary tract nucleus

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20
Q

therapeutic use metoclopromide

A

chemo induced emesis

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21
Q

therapeutic use phenothiazine

A

general purpose antiemetic

antihistaminic and antichoinergic activities

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22
Q

adverse effects metoclopromide

A

cross bbb so restlessness, dystonias, parkinsonian Sx

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23
Q

adverse effects chronic use phenothiazine

A

hypotension, sedation, hyperprolactinemia, extrapyramidal movement disorders

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24
Q

MOA antihistamines

Study These Flashcards
A

H1 antagonism with anticholinergic and antidopaminergic properties

25
therapeutic use of antihistamines
mostion sickness post operative nausea and vomiting suppress vertigo
26
adverse effects antihistamines
dizziness, sedation, confusion, drymouth and urinary retention
27
MOA scopolamine
prototypical cholinergic antagonis
28
therapeutic use scopalamine
motion sickness
29
adverse effects scopolamine
anticholinergic effects | better tolerated as transdermal patch
30
MOA cannabinoids
unknown, maybe stimulation of central CB1 R
31
therapeutic use cannabinoids
appetite stimulant and antiemetic
32
adverse effects cannabinoids
euphoria, dysphoria, sedation, hallucinations, dry mouth, increased appetite tachycardia, conjunctival injection and orthostatic hypotension
33
What is prototype neurokinin R antagonist
aprepitant
34
MOA aprepitant
substance P is a peptide NT that is highly selective. crosses bbb
35
therapeutic use NK R antagonist aprepitant
used in combo with serotonin antagonists and corticosteroids for acute delayed nausea and vomiting
36
adverse effects NK R antagonists
fatigue, dizziness, diarrhea
37
drug interatctions NK R antagonists
CYP3A4 | Will decrease INR in warfarin patients
38
prototype corticosteroids
dexamethasone
39
MOA dexamethasone
exact antiemetic mech unknown, may involve suppression of inflammation and PG production
40
therapeutic use dexamethasone
increase efficacy of serotonin antagonist for prevention acute and delayed nausea and vomiting in those having chemo. post operative nausea and vomiting prevention
41
what are the benzodiazepines
lorazepam, alprazolam, diazepam
42
Acute nausea and vomiting definition from chemo
within 24 hours chemo
43
delayed definition chemo
nausea and vomtiing after 24 hours
44
anticipatory deficinition for chemo vomitiing
prior to chemo | learned, conditioned, usually by 4th cycle
45
risk factors for anticipatory vomiting and nause with chemo
<50y.o, nausea, vomiting after previous chemo, sweating, susceptibility to motion sickness
46
breakthrough emesis with chemo
emesis despite prophylactic antiemetic administration (need rescue agents)
47
refractory emesis with chemo
poor response to multiple antiemetic regimens
48
drug regimen for acute CINV highly emetogenic
day1: serotoni R antagonist + NK R antagonist+glucocorticoid day 2: NKR antagonist+ glucocorticoid day3: NKR antagonist day4: glucocorticoid
49
moderate emetogenic chemo for acute CINV
day 1: 2 drug regimen of serotonin R antagonist+glucocorticoid day 3: glucocorticoid
50
drug for acute CINV low emetogenic chemo
dexamethasone + prochlorperazine or metoclopramide or diphenhydramine or lorazepam
51
anticipatory NV prophylaxis
alprazolam or lorazepam night before and morning of
52
rescue mediations for breakthrough/refractory CINV
prochlorperazine, promethazine, lorazepam, metoclopramide, serotonin antagonist, desxamethasone, cannabinoids
53
Post operative Tx for Nausea and vomitiing
serotonin antagonists, prochlorperazine, metoclopramide, haloperidol
54
when to administer dexamehtasone for post operative NV prevention
at time of anesthesia
55
what is used for mild to moderate motion sickness
promethazine
56
initial management for vomiting from pregnancy
dietary changes and lifestyle modificaion
57
persistant vomiting during pregnancy Tx
1st line: pyridoxine dehydration Sx: IV and thiamine ondansetron IV prn
58
when to use corticosteroids for pregnancy assoc nausea and vomiting
reserved for refractory Sx or hyperemesis gravidarum

Year2 GI Exam I (18 decks)

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