Sweatman: Vertigo, Hearing, N/V

Question 1

Name the 5HT3 antagonists

Answer 1

Dolasteron
Granisetron
Ondansetron
Palonosteron

Question 2

NK1 antagonists

Answer 2

Aprepitant

Fosaprepitant

Question 3

Cannabinoid Receptor Agonists

Answer 3

Dronabinol

THC

Question 4

Ototoxics

Answer 4

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

Question 5

D2 antagonists

Answer 5

chlorpramazine

prochlorperazine

Question 6

Corticostroids

Answer 6

Dexamethasone

MethylprednisOLONE

Question 7

Benzos

Answer 7

Diazepam (Valium)

Question 8

Antihistamine/Anticholinergics

Answer 8

Scopalamine
Meclizine
Diphenhydramine
Promethazine

Question 9

describe AG toxicity and Cisplatin ototoxicity

Answer 9

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

Question 10

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

Answer 10

production/regulation of endolymph

furosemide (LOOPS LOSE K) diuretics

Question 11

endolymph made in the ____ of the iner ear

Answer 11

stria vascularis

Question 12

loop diuretics in the inner ear

Answer 12

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

Question 13

tx for vertigo

Answer 13

meclizine
promethizine
diphenhydramine
scopalamine
diazepam

Question 14

useful for psychosomatic vertigo (anxiety induced)

Answer 14

diazepam

Question 15

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

Answer 15

diazepam

Question 16

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

Answer 16

M1 and H1 receptors on the cerebeullum

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

Question 17

longest duration of the primary vertigo tx’s

Answer 17

scopalamine-72 hours

Question 18

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

Answer 18

hepatic-other antimuscarinics and sedatives

Question 19

bbw for use by injection

Answer 19

promethazine

Question 20

xerostomia, and ocular effects if patch substance touches eye

Answer 20

scopalamine

Question 21

all the anti-vertigants can cause what ADE

Answer 21

drowsiness, dizziness, confusion, asthenia, weakness,

meclizine worse in women

Question 22

emesis is coordinated in the

Answer 22

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

Question 23

CTZ has high concentrations of what type of receptor

Answer 23

5HT3, dopamine D2, Opioids

Question 24

STN rich in receptors for

Answer 24

enkephalin
histamine
ACH
5HT3 receptors

Question 25

5HT3 antagonist exert their blocking effects where

Answer 25

CTZ and NTS

Question 26

dose adjust for liver dysfuction

Answer 26

ondansetron only

Question 27

side effects of 5HT3 receptors antagonist

Answer 27

QT prolonging Hypersensitivity HA, constipation, Diarrhea,

Question 28

not used for CI NV

Answer 28

D2 receptor antagonsits

Question 29

D2 antagonist work at

Answer 29

CTZ work peripherally as antihistaminergic and anticholinergics

Question 30

useful in other forms of nausea such as motion sickness

Answer 30

D2Rantagonists

Question 31

phenothiazines associated with established risk of

Answer 31

Qt prolongation and torsade de points

Question 32

Substance P/neurokinin 1 inhibitors

Answer 32

aprepitant fosaprepitant

Question 33

Aprepitant and fosaprepitant work mainly at the

Answer 33

solitary tract peripherally vagal terminals in G1 tracts

Question 34

MOA for cannabinoid receptor agonists

Answer 34

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

Question 35

Cannabinoid agonists work in what 2 places

Answer 35

NTS and Medullary vomiting center

Question 36

oppose 5HT3 stimulation from vagal afferents

Answer 36

Cannabinoid agonists dronabinol THC

Question 37

stimulate appetite via CB in lateral Hypothalamus

Answer 37

Cannabinoid agonists dronabinol THC

Question 38

which chemo drugs most likley to induce CI NV

Answer 38

``` cisplatin mechlorethamine streptozotocin cyclophosphamide carmustine dacarbazine ```

Question 39

treatment of choice for CI NV

Answer 39

Serotinin antagonist corticosteroid and NK1 antagonist

Question 40

when giving Corticosteroids for emesis prophylaxxis whats the rule

Answer 40

never alone, always in combo

Question 41

MOA for corticosteroid anti-emetic effects

Answer 41

POSTULATED THAT THEY WORK IN THE NTS REDUCE SEROTONIN RELEASE