Pharmacology of Anti-Emetics

Question 1

What receptors are located in the vestibular system?

Answer 1

M1 & H1

Question 2

This emetic mechanism responds to information about motion and equilibrium.

Answer 2

Vestibular System

Question 3

This emetic mechanism responds to mechanoreceptors and chemoreceptors.

Answer 3

GI tract

Question 4

This D2 antagonist is most often used to treat anesthetic-induced emesis.

Answer 4

Droperidol

Question 5

What benzodiazepines are used to prevent stress-induced emesis?

Answer 5

Diazepam & lorazepam

Question 6

This D2 antagonist is also a weak antagonist of 5-HT3 receptors and treats emesis due to chemotherapy.

Answer 6

Metoclopramide

Question 7

This class of anti-emetics may reduce the effectiveness of hormonal contraceptives.

Answer 7

NK1 antagonists

Question 8

What receptors are located in the chemoreceptor trigger zone?

Answer 8

D2, 5-HT3, NK1

Question 9

What corticosteroid is used as an anti-emetic?

Answer 9

Dexamethasone (often combined with a 5-HT3 antagonist)

Question 10

True/False. In high doses, cannabinoids may cause emesis.

Answer 10

True - this is called cannabis hyperemesis syndrome

Question 11

This class of drugs is used primarily to treat drug-induced emesis.

Answer 11

D2 antagonists

Question 12

This emetic mechanism responds directly to chemical stimuli in the blood and CSF.

Answer 12

Chemoreceptor trigger zone

Question 13

What is the MOA of aprepitant, fosaprepitant, and rolapitant?

Answer 13

NK1 antagonists (receptor for substance P)

Question 14

These anti-emetics are used primarily to treat motion sickness and labyrinth disorders.

Answer 14

Anticholinergics (scopalamine), Anti-Histamines (meclizine), diphenhydramine (both MOA)

Question 15

What anti-emetic is associated with anxiety, restlessness, and depression?

Answer 15

Metoclopramide (D2 antagonist)

Question 16

What is the MOA of diphenhydramine?

Answer 16

Both anticholinergic and anti-histamine properties

Question 17

What are the 5-HT3 antagonist anti-emetics?

Answer 17

Dolasteron, palonosteron

Question 18

This class of anti-emetics is becoming more commonly used for chemotherapy-induced and post-operative emesis.

Answer 18

5-HT3 antagonists

Question 19

What anti-emetic is a cannabinoid?

Answer 19

Dronanibol

Question 20

This emetic mechanism responds to visual, emotional, and other high-level stimuli.

Answer 20

Higher cortical centers

Question 21

What ADRs are unique to Droperidol?

Answer 21

Dose-dependent QT prolongation

Question 22

These classes of anti-emetics inhibit the CYP3A4 enzyme.

Answer 22

NK1 antagonists, cannabinoids

Question 23

What receptors are located in the GI tract related to emesis?

Answer 23

5-HT3

Question 24

NK1 antagonists should never be combined with what anti-psychotic?

Answer 24

Thioridazine

Question 25

These D2 antagonists are most effective for nausea in GI disorders and block alpha, cholinergic, and histamine receptors.

Answer 25

Perchlorperazine