which antiemetic for what

Question 1

what to give for n/v caused by gastritis, gastric stasis, functional obstruction

Answer 1

metoclopramode

dopamine antagonist,prokinetic

avoid in PD and do not give with cyclizine
5 days max due to EXPD SE

Question 2

what to give for n/v caused by chemical causes , RI, hypercalcaemia, opioids

Answer 2

haloperidol
acts on CRTZ
dopamine antagonist
avoid in PD

Question 3

what antiemetic to give for vestibular symptoms

Answer 3

cycilizine
acts on vestibular centre
avoid in PD
has antihitsamine and antimuscarininc effect

Question 4

what antiemetic to give in raised intracranial pressure (combo)

Answer 4

dexa + cyclizine

Question 5

state 3 chemical causes of n+v in palliative care

Answer 5

hyperCa2+

renal failure

morphine use

Question 6

name 2 common post op antiemetics

Answer 6

dexa + 5ht3 receptor antagonist e.g. ondansetron

Question 7

name a preoperative anticipiatory antiemetic

Answer 7

lorazepam

Question 8

palliative care - pt should be advised that nausea may occur when starting (and titrating) strong opioids, but it is likely to be transient and improve after … days

Answer 8

5-7

Question 9

For patients who have little benefit from antiemetic therapy despite upward titration of the dose, review the likely cause(s), antiemetic choice and route of administration. Changing to a broad-spectrum antiemetic (such as …….) may sometimes be necessary, and dual therapy with antiemetics with different mechanisms (e.g. …… and …..) may occasionally be required.

Answer 9

levomepromazine

levomepromazine & ondansetron