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Neuro > Sweatman: Vertigo, Hearing, N/V > Flashcards

Sweatman: Vertigo, Hearing, N/V Flashcards

1
Q

Name the 5HT3 antagonists

A

Dolasteron
Granisetron
Ondansetron
Palonosteron

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2
Q

NK1 antagonists

A

Aprepitant

Fosaprepitant

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3
Q

Cannabinoid Receptor Agonists

A

Dronabinol

THC

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4
Q

Ototoxics

A

Cisplatin-not reversible and is dose dep
Gentamicin-dose dep=not reversible
Lasix-Lood Diuretix=dose dep=reversible

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5
Q

D2 antagonists

A

chlorpramazine

prochlorperazine

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6
Q

Corticostroids

A

Dexamethasone

MethylprednisOLONE

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7
Q

Benzos

A

Diazepam (Valium)

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8
Q

Antihistamine/Anticholinergics

A

Scopalamine
Meclizine
Diphenhydramine
Promethazine

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9
Q

describe AG toxicity and Cisplatin ototoxicity

A

AG (gentamicin)=enters cell and kill in Caspace dependent or caspace independent mechs-apoptosis

CIsplatin-enters cell and kills via caspace dependent mechs only-APOPTOSIS

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10
Q

NaK2Cl channels in the inner ear responsible for______and are oft inhibited by_____ when taken for CHF etc

A

production/regulation of endolymph

furosemide (LOOPS LOSE K) diuretics

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11
Q

endolymph made in the ____ of the iner ear

A

stria vascularis

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12
Q

loop diuretics in the inner ear

A

by inhibitiing Na/K/2CL channels they throw off the balance of the endolymph production
resulting in edema and loss of function

dose-rate dependent -important for degree of penetraiton in this area of the body

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13
Q

tx for vertigo

A 
meclizine
promethizine
diphenhydramine
scopalamine
diazepam
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14
Q

useful for psychosomatic vertigo (anxiety induced)

A

diazepam

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15
Q

useful for nausea arising from higher brain centers mediatering fear, emotion, anticipation

A

diazepam

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16
Q

Mex, Diphen, Scopal,prometh, primarily work on?

A

M1 and H1 receptors on the cerebeullum

block transmission of signal to emetic center in the brain stem/brain??

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17
Q

longest duration of the primary vertigo tx’s

A

scopalamine-72 hours

18
Q

anti-vertigants are all metabolised via____ and you should caution with____

A

hepatic-other antimuscarinics and sedatives

19
Q

bbw for use by injection

A

promethazine

20
Q

xerostomia, and ocular effects if patch substance touches eye

A

scopalamine

21
Q

all the anti-vertigants can cause what ADE

A

drowsiness, dizziness, confusion, asthenia, weakness,

meclizine worse in women

22
Q

emesis is coordinated in the

A

central emesis center in the lateral reticular formation of the mid-brainstem adjacent to both the chemoreceptor trigger zone and the lateral area postrema at the bottom of the fourth ventricle and the solitary tract nucleus

23
Q

CTZ has high concentrations of what type of receptor

A

5HT3, dopamine D2, Opioids

24
Q

STN rich in receptors for

A

enkephalin
histamine
ACH
5HT3 receptors

25
Q

5HT3 antagonist exert their blocking effects where

A

CTZ and NTS

26
Q

dose adjust for liver dysfuction

A

ondansetron only

27
Q

side effects of 5HT3 receptors antagonist

A

QT prolonging
Hypersensitivity
HA, constipation, Diarrhea,

28
Q

not used for CI NV

A

D2 receptor antagonsits

29
Q

D2 antagonist work at

A

CTZ

work peripherally as antihistaminergic and anticholinergics

30
Q

useful in other forms of nausea such as motion sickness

A

D2Rantagonists

31
Q

phenothiazines associated with established risk of

A

Qt prolongation and torsade de points

32
Q

Substance P/neurokinin 1 inhibitors

A

aprepitant

fosaprepitant

33
Q

Aprepitant and fosaprepitant work mainly at the

A

solitary tract

peripherally vagal terminals in G1 tracts

34
Q

MOA for cannabinoid receptor agonists

A

G protein coupled decrease in neuronal activity in medullary vomitting center and NTS

35
Q

Cannabinoid agonists work in what 2 places

A

NTS and Medullary vomiting center

36
Q

oppose 5HT3 stimulation from vagal afferents

A

Cannabinoid agonists

dronabinol
THC

37
Q

stimulate appetite via CB in lateral Hypothalamus

A

Cannabinoid agonists

dronabinol
THC

38
Q

which chemo drugs most likley to induce CI NV

A 
cisplatin
mechlorethamine
streptozotocin
cyclophosphamide
carmustine
dacarbazine
39
Q

treatment of choice for CI NV

A

Serotinin antagonist

corticosteroid and NK1 antagonist

40
Q

when giving Corticosteroids for emesis prophylaxxis whats the rule

A

never alone, always in combo

41
Q

MOA for corticosteroid anti-emetic effects

A

POSTULATED THAT THEY WORK IN THE NTS

REDUCE SEROTONIN RELEASE

Neuro (19 decks)

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