Vomiting and labyrinth disorder Flashcards
Antiemetic are harmful esp when cause can be treated esp in DKA true/false?
True
State when to prescribe antiemetic in children
When cause is known
Facts about Antihistamines use in N and V
Good for vertigo and motion sickness but different adr such as drowsiness and Antimuscarinic side effects
Facts about phenothiazine used in N/V
They are dopamine antagonist that blocks the chemo receptor trigger
zone
Severe dystonic rx occur esp in children
Indication of chlorperazine
Can be used for chemotherapy- induced and radiation induced Nausea and Vomiting
List examples of phenothiazines
Chloroperazine, prochloperazine , trifluoperazine
An antiemetic that is less sedating and buccal tablet that can be useful in severe nausea or persistent vomiting is..
Prochloperazine
What medication is used for N and V in terminal illness(palliative care)
HALOPERIDOL OR LEVOPROMAZINE
An antimetic that acts directly on GI tract used in vomiting associated with hepatic or gastroduodenal disease is called
Metoclopramide
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
Domperidone
Drug used to tx N and V following cytotoxic and post operative Nausea is called
5HT antagonist
Ondansetron or Granisetron
What drug is used to tx chemotherapy induced N and V alone or with 5HT3 antagonist
DEXAMETHASONE
An antiemetic used to tx N and V associated with chemotherapy given with Dexamethasone plus 5HT3 antagonist is called
Aprepitant
A synthetic cannabinoid , add on for chemo induced N and V as last option is called
Nabilone
Self care advice for N and V in pregnancy
Rest, oral rehydration and dietary changes
Non pharmacological tx for N and V in pregnancy
Ginger( mild to moderate)
Pharmacological tx options for N and V in pregnancy
Chlorpromazine
Cyclizine
Metoclopramide
Prochloperazine
Promethazine HCL
Ondansetron
State the tx for Hyperemesis Gravidarum
Requires regular antiemetic therapy
IV fluid and electrolytes replacement
Thiamine to reduce risk of wernicke’s encephalopathy
How to tx motion sickness
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
Eg of antihistamine used in motion sickness that is less sedating
Cyclizine, cinnarizine
List drugs to avoid in motion sickness
Domperidone, 5HT antagonist, phenothiazines,
Only use then if promethazine is ineffective
List drugs used in post operative N and V
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
Tx for meniere’s disease
Betahistine
Antihistamine
Prochloperazine
Indication for betahistidine in meniere’s disease
Licensed for vertigo, tinnitus and hearing loss associated with menieres disease ( inner ear disorder)
When is prochloperazine used in meniere’s disease
Reserved for acute symptoms where possible
Safety advice for Domperidone
Risk of cardiac side effects
Report if symptoms of Arrhythmia develop ( palpitations)
MHRA tx duration should not exceed 7days
Safety advice for Metoclopramide
Risk of neurological adverse effect, prescribe only for short term use ( up to 5days)
Safety advice for promethazine
Children < than 6yrs should not be given OTC cough and cold medicine containing promethazine
