Wk4 Anti-emetics Flashcards
Binds toxin in upper GI
acute tx of poisoning
activated charcoal
Induces vomiting
no longer used
Ipecac
Lower GI
cathartic
decontaminating agent
polyethylene glycol solution
Best tx for chemo nausea
given before chemo
5HT3 inhibitors
-setrons
dolasetron
granisetron
ondansetron (zofran)
palonosetron
Three H1 antagonists
cause sedation
Dimenhydrinate
Diphenhydramine
Meclizine
Anticholinergic
some D2 antagonism also
best for motion sickness
acts on cerebellum
transdermal to decrease side fx
scopolamine
Two NK1 antagonists (substance P)
chemo N/V
given with 5HT3’s + dex
CYP3A4 can interact with some chemo drugs
APREPITANT
fosAPREPITANT
D2 antagonists (5)
cause sedation
droperidole
metaclopramide
prochlorperazine
promethazine
thiethylperazine
Two corticosteroids
MOA: unknown in nausea
given with 5HT3s and NK1s in chemo
dexamethazone
methylpredisolone
act on central cannabinoid receptors
dronabinol
nabilone
Dolasetron
Granisetron
Ondansetron
Palonosetron
5HT3 antagonists
act mostly in GI
some vomiting center and chemoreceptor activity
-“redundancy”
Best given BEFORE chemo
Acute phase – first 24 hrs
Dimenhydrinate
H1 antagonist
causes sedation
**maybe some anticholinergic
Diphenhydramine
H1 antagonist
causes sedation
**maybe some anticholinergic
Meclizine
H1 antagonist
causes sedation
**maybe some anticholinergic
Scopolamine
Anticholinergic
Motion sickness
cerebellum
some D2 action
transdermal patch decreases side fx
Aprepitan
Fosaprepitan
NK1 (substance P) antagonists
chemo N/V
given with 5HT3’s and dex
CYP3A4 –> chemo interactions
Droperidol
D2 antagonist
sedation
Metoclopramide
D2 antagonist
sedation
Prochlorperazine
D2 antagonist
sedation
Promethazine
D2 antagonist
sedation
Thiethylperazine
D2 antagonist
sedation
Dronabinol
canniboid receptors
Nabilone
canniboid receptors
Important antiemetic receptors in cerebellum:
muscarinics
H1’s
Important antiemetic receptors in Solitary tract nucleus
muscarinic
H1
also have 5HT3 and D2
Important receptors in higher centers:
NK1
cannabinoid
Important receptor in vomiting center
muscarinic
also have:
5HT3
D2
Important receptors in chemoreceptive trigger zone:
5HT3
D2
opiod
also have:
M1
H1