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Year2 GI Exam I > NVDC Tx I > Flashcards

NVDC Tx I Flashcards

1
Q

What are the 2 groups of D2 R antagonists antimetics

A

substituted benzamides and phenothiazines

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2
Q

what is the substituted benzamide antimetics

A

metoclopramide

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3
Q

what are the phenothiazines antimetics

A

prochlorperazine

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4
Q

what are the antihistamines antimetics

A

diphenhydramine

promethazine

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5
Q

what are the antimuscarinic anitmetics

A

scoppolamine

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6
Q

what are the cannabinoid antimetics

A

dronabinol

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7
Q

what are the opiod antidiarrheal

A

loperamide

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8
Q

what are the mucosal protective agents for antidiarrhea

A

bismuth subsalicylate

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9
Q

what are the types of laxatives

A

bulk forming
osmotic
stimulant
stoof softners

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10
Q

what are the osmotic laxatives

A

saline and polyethylene glycol-electrolytes

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11
Q

what are the prokinetic (pro motility agents)

A

metoclopramide

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12
Q

what R are found in the vomiting center

A

Ach Muscarinic, histmaine, neurokinin1 and serotonin

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13
Q

MOA ondansetron

A

blocks central serotonin R in vomiting center and chemR trigger zone and on peripheral extrinsic vagal and spinal afferent nn

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14
Q

how is ondansetron taken and where is majoirty metabolized

A

PO or IV

hepatic metabolism

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15
Q

therapeutic use ondansetron

A

acute chemotherapy induced nausea and vomiting

post operative and post radiation

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16
Q

how cna you increase efficacy of ondansetron

A

when used in combination with corticosteroid and NK R antagonist

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17
Q

adverse effects ondansetron

A

HA, dizziness, constipation

QT prolongation

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18
Q

drug interactions with ondansetron

A

no significant ones

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19
Q

MOA metoclopramide and prochlorperazine

A

block D2-like R in CTZ and solitary tract nucleus

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20
Q

therapeutic use metoclopromide

A

chemo induced emesis

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21
Q

therapeutic use phenothiazine

A

general purpose antiemetic

antihistaminic and antichoinergic activities

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22
Q

adverse effects metoclopromide

A

cross bbb so restlessness, dystonias, parkinsonian Sx

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23
Q

adverse effects chronic use phenothiazine

A

hypotension, sedation, hyperprolactinemia, extrapyramidal movement disorders

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24
Q

MOA antihistamines

A

H1 antagonism with anticholinergic and antidopaminergic properties

25
Q

therapeutic use of antihistamines

A

mostion sickness
post operative nausea and vomiting
suppress vertigo

26
Q

adverse effects antihistamines

A

dizziness, sedation, confusion, drymouth and urinary retention

27
Q

MOA scopolamine

A

prototypical cholinergic antagonis

28
Q

therapeutic use scopalamine

A

motion sickness

29
Q

adverse effects scopolamine

A

anticholinergic effects

better tolerated as transdermal patch

30
Q

MOA cannabinoids

A

unknown, maybe stimulation of central CB1 R

31
Q

therapeutic use cannabinoids

A

appetite stimulant and antiemetic

32
Q

adverse effects cannabinoids

A

euphoria, dysphoria, sedation, hallucinations, dry mouth, increased appetite
tachycardia, conjunctival injection and orthostatic hypotension

33
Q

What is prototype neurokinin R antagonist

A

aprepitant

34
Q

MOA aprepitant

A

substance P is a peptide NT that is highly selective. crosses bbb

35
Q

therapeutic use NK R antagonist aprepitant

A

used in combo with serotonin antagonists and corticosteroids for acute delayed nausea and vomiting

36
Q

adverse effects NK R antagonists

A

fatigue, dizziness, diarrhea

37
Q

drug interatctions NK R antagonists

A

CYP3A4

Will decrease INR in warfarin patients

38
Q

prototype corticosteroids

A

dexamethasone

39
Q

MOA dexamethasone

A

exact antiemetic mech unknown, may involve suppression of inflammation and PG production

40
Q

therapeutic use dexamethasone

A

increase efficacy of serotonin antagonist for prevention acute and delayed nausea and vomiting in those having chemo.
post operative nausea and vomiting prevention

41
Q

what are the benzodiazepines

A

lorazepam, alprazolam, diazepam

42
Q

Acute nausea and vomiting definition from chemo

A

within 24 hours chemo

43
Q

delayed definition chemo

A

nausea and vomtiing after 24 hours

44
Q

anticipatory deficinition for chemo vomitiing

A

prior to chemo

learned, conditioned, usually by 4th cycle

45
Q

risk factors for anticipatory vomiting and nause with chemo

A

<50y.o, nausea, vomiting after previous chemo, sweating, susceptibility to motion sickness

46
Q

breakthrough emesis with chemo

A

emesis despite prophylactic antiemetic administration (need rescue agents)

47
Q

refractory emesis with chemo

A

poor response to multiple antiemetic regimens

48
Q

drug regimen for acute CINV highly emetogenic

A

day1: serotoni R antagonist + NK R antagonist+glucocorticoid
day 2: NKR antagonist+ glucocorticoid
day3: NKR antagonist
day4: glucocorticoid

49
Q

moderate emetogenic chemo for acute CINV

A

day 1: 2 drug regimen of serotonin R antagonist+glucocorticoid
day 3: glucocorticoid

50
Q

drug for acute CINV low emetogenic chemo

A

dexamethasone +
prochlorperazine or metoclopramide
or diphenhydramine
or lorazepam

51
Q

anticipatory NV prophylaxis

A

alprazolam or lorazepam night before and morning of

52
Q

rescue mediations for breakthrough/refractory CINV

A

prochlorperazine, promethazine, lorazepam, metoclopramide, serotonin antagonist, desxamethasone, cannabinoids

53
Q

Post operative Tx for Nausea and vomitiing

A

serotonin antagonists, prochlorperazine, metoclopramide, haloperidol

54
Q

when to administer dexamehtasone for post operative NV prevention

A

at time of anesthesia

55
Q

what is used for mild to moderate motion sickness

A

promethazine

56
Q

initial management for vomiting from pregnancy

A

dietary changes and lifestyle modificaion

57
Q

persistant vomiting during pregnancy Tx

A

1st line: pyridoxine
dehydration Sx: IV and thiamine
ondansetron IV prn

58
Q

when to use corticosteroids for pregnancy assoc nausea and vomiting

A

reserved for refractory Sx or hyperemesis gravidarum

Year2 GI Exam I (18 decks)

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