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Pharmacology > Unit 2- Antiemetics > Flashcards

Unit 2- Antiemetics Flashcards

1
Q

Emesis Trigger Centers

A

Vomiting center, chemoreceptor trigger zone, cerebral cortex, and vestibular apparatus

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2
Q

Vomiting Center

A

Located in medulla oblongata and receives input from CTZ, vestibular disturbance, higher cortical centers, and peripheral sensory

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3
Q

CTZ Receptors

A

5-HT3, D2, opioid R, NK1, CB1

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4
Q

Pharynx and GI Receptors

A

5-HT3, 5-HT4, D2

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5
Q

Vestibular Receptors

A

H1, Ach M3/5

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6
Q

Histamine receptor

A

H1

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7
Q

Serotonin Receptor

A

5-HT3

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8
Q

Substance P Receptor

A

NK1

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9
Q

GABA Receptor

A

GABA A and GABA B

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10
Q

Acetylcholine Receptor

A

M1

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11
Q

Dopamine Receptor

A

D2

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12
Q

Endorphin Receptors

A

opioid receptors and CB1

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13
Q

Therapeutic Emetics

A

Apomorphine, hydrogen peroxide, xylazine, medetomidine, midazolam/hydromorphone

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14
Q

Dog CTZ Receptors

A

Increase D2 receptors make emesis stimulation more successful, increased H1 receptors

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15
Q

Cat CTZ Receptors

A

Decreased D2 receptors, increased sensitivity to α2 receptors

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16
Q

Apomorphine

A

Dopamine agonist, antagonist to serotonin and adrenergic receptors, more successful in dogs, may have opioid like effects

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17
Q

Apomorphine Administration

A

IV reaches CTZ before crossing BBB to reach emesis center that prevents emesis

18
Q

Apomorphine Sedative Reversal

A

Opioid antagonists like naloxone

19
Q

Apomorphine Emesis Reversal

A

Dopaminergic antagonist like Acepromazine

20
Q

Cat Emetics

A

α2-agonists: xylazine and medetomidine/dexmedetomidine that are highly lipophilic and directly reach receptors in the brain and GI

21
Q

Xylazine

A

α2 antagonist, common in cats, not reliable in dogs, use lower doses than for sedation

22
Q

Serotonin 5-HT3 Antagonists

A

Ondansetron and granisetron, block 5-HT3 in VC and CTZ for chemotherapy nausea

23
Q

Serotonin 5-HT3 Antagonist Adverse Effects

A

Headache, dizziness, itching, constipation, ECG abnormalities

24
Q

Prokinetic D2 Antagonists

A

Metoclopramide, domperidone

25
Q

Neuroleptic D2 Antagonists

A

Chlorpromazine and Droperidol

26
Q

D2 Antagonists

A

Block D2 and serotonin receptors in CTZ, used for vomiting of non-specific cause

27
Q

D2 Antagonist Adverse Effects

A

Dyskinesia, sedation, postural hypotension, extrapyramidal symptoms

28
Q

Substance P Antagonists

A

Aprepitant, Cerenia, binds neurokinin 1 receptor in VC to treat motion sickness, chemotherapy vomiting, post-op vomiting

29
Q

Substance P Antagonist Adverse Effects

A

Dyskinesia, sedation, dizziness, hiccup, hypotension

30
Q

Antihistamines

A

Diphenhydramine and dimenhydrinate, block histamine at H1 receptor and Ach at M1 receptor for motion sickness and morning sickness

31
Q

Antihistamine Adverse Effects

A

Sedation, hypotension, confusion, dry mouth, dilated pupils, urinary retention, constipation

32
Q

Anticholinergics

A

Hyoscine Butylbromide, Dicyclomine block Ach at M1 receptor in motion sickness and morning sickness

33
Q

Anticholinergic Adverse Effects

A

Tachycardia, blurred vision, dry mouth, constipation, urinary retention

34
Q

Benzidiazepines

A

Lorazepam, diazepam, Midazolam enhance GABA effects, used as psychotropic, calms the brain, and prevents anticipatory vomiting

35
Q

Benzodiazepine Adverse Effects

A

Sedation, dry mouth, dizziness, paradoxical agitation

36
Q

Corticosteroids

A

Dexamethasone, methylprednisolone used in chemotherapy-induced comitign

37
Q

Corticosteroid Adverse Effects

A

Hyperglycemia, hypertension, osteoporosis, insomnia, intraocular pressure, infection susceptibility, increased appetite, obesity

38
Q

Cannabinoids

A

Nabilone and Dronabinol used in anticancer-induced vomiting

39
Q

Cannabinoid Adverse Effects

A

Euphoria, dysphoria, sedation, agitation, hallucination, restlessness, insomnia, irritability, tachycardia, and palpitation

40
Q

Post Operative Vomiting Drugs

A

Dopamine antagonists, 5HT3 antagonists, and NK1 antagonists acting on CTZ

41
Q

Cytotoxic Drug Induced Vomiting Drugs

A

5-HT3 antagonists, NK1 antagonists, D2 antagonists, Cannabinoids, and Glucocorticoids acting on CTZ

42
Q

Motion Sickness Drugs

A

Muscarinic antagonists and antihistamines acting on H1 and M1-M3 receptors in vestibular system

Pharmacology (32 decks)

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