TC5-C--Nausea, Vomiting, and Hematemesis--AND muscarinic antagonists

Question 1

Diphenoxylate

Answer 1

Anti-diarrheal (weak mu agonist)

SE: sedation, dizziness, nausea, vomiting, respiratory depression, constipation

Question 2

Promethazine

Answer 2

D2, Histamine I receptor antagonist
Tx of nausea/vomiting, motion sickness; sedative
SE: drowsy, dry mouth, neuroleptic malignant syndrome

Question 3

Octreotide

Answer 3

SST analog
Tx of hematemesis (esophageal varices, ulcers), VIPoma, carcinoid tumors, diarrhea
SE: steatorrhea, gallstones (decreased CCK, bile flow)

Question 4

Atropine

Answer 4

Muscarinic antagonist

SE: overheating, dry skin, thirst, visual disturbances, mydriasis, flushed, mental disturbances

Question 5

Loperamide

Answer 5

Anti-diarrheal (weak mu agonist)

SE: sedation, dizziness, nausea, vomiting, respiratory depression, constipation

Question 6

Kaolin

Answer 6

Anti-diarrheal (binder)

SE: can bind to medications –> decreased efficacy

Question 7

Ipecac

Answer 7

Mucosal chemoreceptor irritant

Used to induce vomiting (not any more)

Question 8

Meclizine

Answer 8

Nonselective histamine I receptor antagonist
Tx of motion sickness
SE: anticholinergic symptoms, drowsiness

Question 9

APrePitant

Answer 9

Substance P antagonist, NK1 receptor blocker
Tx of nausea (preventive)
SE: ?

Question 10

Prochlorperazine

Answer 10

D2 receptor antagonist
Tx of nausea/vomiting, motion sickness; sedative
SE: drowsy, dry mouth, neuroleptic malignant syndrome

Question 11

Pectin

Answer 11

Anti-diarrheal (binder)

SE: can bind to medications –> decreased efficacy

Question 12

Dicyclomine

Answer 12

Muscarinic antagonist
Tx of spasms, cramps from IBS
SE: overheating, dry skin, thirst, visual disturbances, mydriasis, flushed, mental disturbances

Question 13

Ondansetron

Answer 13

5-HT3 antagonist
Tx of acute nausea (abortive, preventive)
SE: prolonged QT (v. uncommon)