Pharmacology: Anti-nausea and anti-emetic drugs

Question 1

What receptors are used in nausea/vomiting

Answer 1

• Serotonin receptor blockers
• NK1 blockers
• H1 receptors
• D2 receptors
• M1 receptors
• Cannabinoid receptors

Question 2

ending of Serotonin (5-HT3) receptor antagonists?

Answer 2

“setron”

• we use them a lot
• very strong

Question 3

one worriesome side effect of 5HT

Answer 3

Dose-dependent QT prolongation and Torsades

Question 4

Which one has the long half life?

Answer 4

Palonosetron

-single dose is good

Question 5

Neurokinin 1 receptor NK1 (substance P) antagonists ending?

Answer 5

“pitant”

Question 6

Therapeutic use of NK1?

Answer 6

chemotherapy induced N/V

Question 7

Which ones have long half lives?

Answer 7

Netupitant and Rolapitant

Question 8

Histamine (H1) receptor antagonists?

Answer 8

DDHPMC

-no pattern… :(

Question 9

Use of H1

Answer 9

run of the mill general nausea and vomiting

• used with something else usually… usually a setron
• a little sedation which is nice
• they are anticholinergic so remember that

Question 10

Vertigo?

Answer 10

meclizine and cyclazine

Question 11

Dopamine (D2) receptor antagonists?

Answer 11

CPP

-they are phenothiazines

Question 12

metoclopramide

Answer 12

can stimulate Ach actions in GI, enhancing it’s motility… increases lower esophageal sphincter tone
-so it’s great for dysmotility problems

Question 13

Therapeutic uses of D2?

Answer 13

Idopathic

-Dysmotility (metoclopramide)

Question 14

The ONE muscarinic receptor antagonist?

Answer 14

Scopolamine

• pretty great for sea sickness
• patch that you put behind the ear

Question 15

Cannabinoid receptor agonist

Answer 15

Dronabinol and Nabilon

• basically, synthetic THC
• Strong antiemetic agents

Question 16

Therapeutic uses of Cannabinoids?

Answer 16

-reserved for treatment-resistant clinical scenarios

Question 17

High-emetogenic Regimen?

Answer 17

• 5HT receptor blocker
• NK1 blocker
• corticosteroid (dexamethisone)
• if still doesn’t work, add the Mary J

Question 18

Moderate-emetogenic regimen

Answer 18

• 5HT blocker
• corticosteroid (dexamethasone)
• just drop NK1 *

Question 19

Low emetogenic regimen?

Answer 19

• just a corticosteroid (dexamethasone)

- if already on a steroid… 5HT blocker

Question 20

Pregnant patient that has N/V… what do you do?

Answer 20

give a “setron” I guess