Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pre Reg Pharmacy > Chapter 4 - Nausea And Labrynth Disorders > Flashcards

Chapter 4 - Nausea And Labrynth Disorders Flashcards

1
Q

What is the lifestyle advice associated with nausea and vomiting?

A 
Eat smaller, more frequent meals
Remain hydrated (with water, not juice)
Eat as tolerated
Eat light, bland foods 
Ginger may help
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of antihistamines in nausea and vomiting?

A

Block muscarinic receptors

And inhibit cholinergic transmission to the vomiting centre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give some examples of sedating antihistamines

A 
Chlorphenamine
Promethazine
Diphenhydramine 
Cinnarizine
Cyclizine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give some examples of non-sedating antihistamines

A

Fexofenadine
Cetirizine
Loratadine
Acarvistine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List some antimuscarinic side effects associated with antihistamines

A 
Sedation
Dry mouth 
Constipation 
Blurred vision
Urinary retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which antipsychotics can be used in nausea and vomiting?

A

Chlorpromazine
Prochlorperazine

In palliative care, haloperidol and levopromethazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is buccal gem licensed OTC?

A

Nausea and vomiting associated with previously diagnosed migraine in over 18 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the mechanism of phenothiazines in nausea and vomiting?

A

Block the CTZ

They act centrally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give examples of prokinetic agents used in nausea and vomiting

A

Metoclopramide

Domperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the mechanism of prokinetic agents in nausea and vomiting?

A

Inhibit the CTZ

Also acts on the GIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which antiemetic affects the CTZ and the GI system, metoclopramide or prochlorperazine?

A

Metoclopramide, therefore it can be used in nausea and vomiting associated with gastric, hepatic and biliary disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the maximum duration of use of metoclopramide?

A

5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is the maximum use of metoclopramide 5 days?

A

Risk of EPSEs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the minimum age of metoclopramide?

A

18 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why doesn’t domperidone act centrally?

A

It doesn’t cross the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what weight is domperidone unlicensed?

A

Less than 35kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which class of antiemetics shouldn’t be co-prescribed with a prokinetic agent?

A

Antimuscarinics

This increases antimuscarinic side effects
Concurrent use can lead to confusion in the elderly
The GI effects of prokinetics are antagonised by antimuscarinics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give examples of 5HT3 receptor antagonists

A

Onsansetron

Granisetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When are 5HT3 receptor antagonists used in nausea and vomiting?

A

Cytotoxic induced nausea and vomiting

Postoperative nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is dexamethasone used in nausea and vomiting?

A

Chemotherapy induced nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the different classes of antiemetics?

A 
Antihistamines 
Prokinetics
5HT3 receptor antagonists 
Neurokinin 1-receptor antagonists 
Dexamethasone
Nabilone
22
Q

Give examples of neurokinin 1-receptor antagonists

A

Aprepirant

Fosaprepitant

23
Q

When are neurokinin 1-receptor antagonists used?

A

Moderately emetogenic chemotherapy

24
Q

What is nabilone and when is it used?

A

A synthetic cannabinoid

It is used as add on treatment for chemotherapy induced nausea and vomiting

25
Q

When does nausea and vomiting in pregnancy usually resolve?

A

16-20 weeks

26
Q

Which antiemetics can be used in pregnancy?

A

Antihistamines e.g. promerhazine, certirizine, chlorphenamine

27
Q

What is the most effective drug for motion sickness?

A

Hyoscine

28
Q

What options are available for motion sickness?

A 
Hyoscine
Promethazine
Cinnarizine
Cyclizine
Ginger
Acupressure
29
Q

Which antiemetics should be used in gastric stasis/drug induced nausea and vomiting?

A

Metoclopramide

Domperidone if EPSEs are a problem

30
Q

What antiemetic would you give for nausea and vomiting associated with diseases of the inner ear?

A

Cyclizine

31
Q

What antiemetic is used for the nausea and vomiting associated with tinnitus, vertigo and hearing loss associated with Ménière’s disease?

A

Betahistine

32
Q

Should betahistine be taken with or without food?

A

With food

33
Q

What age is cyclizine licensed in?

A

> 6 years old
It can be given to >1 month old

Don’t give to neonates due to significant antimuscarinic activity

34
Q

Why is cyclizine cautioned in severe heart failure?

A

It reduces cardiac output, and therefore increases heart rate

35
Q

How does alcohol and cyclizine interact?

A

The effects of alcohol are enhanced

36
Q

Can patients drive if they have taken nabilone?

A

Yes, as long it has been taken as prescribed, is within certain limits, and has not impacted the patients driving

It is an offence to drive if nibolone has impaired driving

37
Q

What are the indications of domperidone?

A

Nausea and vomiting in adults and children in >12 years
GI pain in palliative care
Neonates with GORD - specialist use only

38
Q

What is the maximum duration of domperidone and why?

A

7 days

Due to the risk of CVD effects (arrhythmia)

39
Q

When are the cardiovascular side effects of domperidone increased?

A

Over 60 year olds
Daily domperidone doses above 30mg
Patients taking other drugs that increase QT interval prolongation

40
Q

What is the dose of metoclopramide?

A

<60kg - 500mcg/kg daily in 3 divided doses

> 60kg - 10mg TDS

41
Q

When metoclopramide is given by IV injection, how long should it be administered for?

A

At least 3 minutes

42
Q

How can the risk of EPSEs be reduced in patients taking metoclopramide?

A

Short term use (5 days max)
Max 30mg daily
Give the injection over at least 3 mins

43
Q

When taking metoclopramide, which patient groups are at the highest risk of EPSEs?

A

Women

The very round or very old

44
Q

When do EPSEs usually start after taking metoclopramide?

A

Within 24h

45
Q

What is the maximum duration of use of ondansetron and why?

A

5 days

Due to risk of arrhythmias

46
Q

What is the risk associated with taking ondansetron in pregnancy in the first trimester?

A

Small risk of cleft lip and/or palate

47
Q

Which antiemetics are available as a patch?

A

Hyoscine - change every 72 hours

Granisetron - change every 10 days

48
Q

What are the indications of hyoscine?

A

Motion sickness
Excess secretions in palliative care
Bowel colic pain in palliative care
Hypersalivation due to clozapine

49
Q

How is the hyoscine patch used?

A

Apply behind the ear 5-6 hours before the journey
Change patch after 72 hours if needed

The patch can be cut if required

50
Q

What are the brand names of hyoscine?

A

Patch - scopoderm

Tablets - keels, joyrides

Pre Reg Pharmacy (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions