Vomiting and labyrinth disorder

Question 1

Antiemetic are harmful esp when cause can be treated esp in DKA true/false?

Answer 1

True

Question 2

State when to prescribe antiemetic in children

Answer 2

When cause is known

Question 3

Facts about Antihistamines use in N and V

Answer 3

Good for vertigo and motion sickness but different adr such as drowsiness and Antimuscarinic side effects

Question 4

Facts about phenothiazine used in N/V

Answer 4

They are dopamine antagonist that blocks the chemo receptor trigger
zone
Severe dystonic rx occur esp in children

Question 5

Indication of chlorperazine

Answer 5

Can be used for chemotherapy- induced and radiation induced Nausea and Vomiting

Question 6

List examples of phenothiazines

Answer 6

Chloroperazine, prochloperazine , trifluoperazine

Question 7

An antiemetic that is less sedating and buccal tablet that can be useful in severe nausea or persistent vomiting is..

Answer 7

Prochloperazine

Question 8

What medication is used for N and V in terminal illness(palliative care)

Answer 8

HALOPERIDOL OR LEVOPROMAZINE

Question 9

An antimetic that acts directly on GI tract used in vomiting associated with hepatic or gastroduodenal disease is called

Answer 9

Metoclopramide

Question 10

An anti emetic that low dose can be used in PD since it is less sedating and less Dystonic side effect compared to Metoclopramide that triggers the chemoreceptor zone is called

Answer 10

Domperidone

Question 11

Drug used to tx N and V following cytotoxic and post operative Nausea is called

Answer 11

5HT antagonist
Ondansetron or Granisetron

Question 12

What drug is used to tx chemotherapy induced N and V alone or with 5HT3 antagonist

Answer 12

DEXAMETHASONE

Question 13

An antiemetic used to tx N and V associated with chemotherapy given with Dexamethasone plus 5HT3 antagonist is called

Answer 13

Aprepitant

Question 14

A synthetic cannabinoid , add on for chemo induced N and V as last option is called

Answer 14

Nabilone

Question 15

Self care advice for N and V in pregnancy

Answer 15

Rest, oral rehydration and dietary changes

Question 16

Non pharmacological tx for N and V in pregnancy

Answer 16

Ginger( mild to moderate)

Question 17

Pharmacological tx options for N and V in pregnancy

Answer 17

Chlorpromazine
Cyclizine
Metoclopramide
Prochloperazine
Promethazine HCL
Ondansetron

Question 18

State the tx for Hyperemesis Gravidarum

Answer 18

Requires regular antiemetic therapy
IV fluid and electrolytes replacement
Thiamine to reduce risk of wernicke’s encephalopathy

Question 19

How to tx motion sickness

Answer 19

Give antiemetic to prevent motion sickness rather after N and V develop

Eg Hyoscine hydrobromide
Promethazine ( if sedative effect required) but less sedating antihistamines such as cyclizine /cinnarizine are preferred

Question 20

Eg of antihistamine used in motion sickness that is less sedating

Answer 20

Cyclizine, cinnarizine

Question 21

List drugs to avoid in motion sickness

Answer 21

Domperidone, 5HT antagonist, phenothiazines,
Only use then if promethazine is ineffective

Question 22

List drugs used in post operative N and V

Answer 22

Normally a combination of two or more antiemetic
5HT3 eg Ondansetron
Dexamethasone
Droperidol and haloperidol
Prochloperazine (licenced for tx and prevention of N and V)
Cyclizine ( Prevention and tx of post operative N and V caused by opiods and general anaesthetics

Question 23

Tx for meniere’s disease

Answer 23

Betahistine
Antihistamine
Prochloperazine

Question 24

Indication for betahistidine in meniere’s disease

Answer 24

Licensed for vertigo, tinnitus and hearing loss associated with menieres disease ( inner ear disorder)

Question 25

When is prochloperazine used in meniere’s disease

Answer 25

Reserved for acute symptoms where possible

Question 26

Safety advice for Domperidone

Answer 26

Risk of cardiac side effects
Report if symptoms of Arrhythmia develop ( palpitations)
MHRA tx duration should not exceed 7days

Question 27

Safety advice for Metoclopramide

Answer 27

Risk of neurological adverse effect, prescribe only for short term use ( up to 5days)

Question 28

Safety advice for promethazine

Answer 28

Children < than 6yrs should not be given OTC cough and cold medicine containing promethazine