Vomiting and Nausea

Question 1

what are 2 chemotherapy drugs which are highly emetogenic?

Answer 1

cisplatin

doxorubicin

Question 2

what are the different types of CINV?

Answer 2

acute (within 24 hrs chemo)
delayed (24hrs after chemo)
anticipatory (in anticipation of chemo)

Question 3

what is the drug regimen for CINV?

Answer 3

5HT receptor antagonist + dexamethasone + aprepitant

Question 4

in addition to the triple regimen, what is the treatment for acute CINV?

Answer 4

pre-treatment with dexamethasone/ lorazepam

Question 5

in addition to the triple regimen, what is the treatment for delayed CINV?

Answer 5

metoclopramide

Question 6

what is the treatment for anticipatory CINV?

Answer 6

lorazepam

Question 7

which drugs can be used to treat PONV?

Answer 7

5HT3 receptor antagonists
droperidol
prochloroperazine
cyclizine
dexamethasone (combine 2 or more antiemetics of different classes for high risk patients)

Question 8

what causes morning sickness in pregnancy?

Answer 8

human chorionic gonadotropin (HCG) produces by the placenta

begins around 4-8 weeks, peaks wk7-12, subsides around wk16

Question 9

what is the first line treatment for morning sickness?

Answer 9

diet changes (use ginger/ pyridoxine)
wrist acupressure

Question 10

what is hyperemesis gravidarum?

Answer 10

complication of pregnancy characterised by severe nausea and vomiting - leads to weight loss and dehydration. May get fluid and electrolyte disturbances from intractable vomiting in pregnancy

Question 11

What is the first line treatment for hyperemesis gravidarum?

Answer 11

antihistamine e.g. promethazine or cyclizine

Question 12

what is the second line treatment for hyperemesis gravidarum?

Answer 12

prochloroperazine (dopamine antagonist) or metoclopramide (dopamine antagonist)