Nausea and Labyrinth disorders

Question 1

Example of Phenothiazine that can be used in N&V

Answer 1

Prochlorperazine, trifluoperazine, perphenazine

Question 2

How do the phenothiazine drugs work as an antiemetic?

Answer 2

Block the Chemoreceptor trigger zone

Question 3

In terminal illness, what other antipsychotic drugs can be used?

Answer 3

Haloperidol and Levomopromazine

Question 4

Which antiemetic is a prokinetic

Answer 4

Metoclopramide

Question 5

Why is domperidone able to be used in parkinsons disease?

Answer 5

It does not cross the BBB so is less likely to cause sedation and dystonic reactions

Question 6

Below what weight is domperidone unlicesned?

Answer 6

35kg

Question 7

When is it appropriate to use Ondansetron/ Granisetron as antiemetics?

Answer 7

Post op (short term) or in chemotherpay N&V

Question 8

what drug class is Netupitant?

Answer 8

Neurokinin 1 receptor antagonist

Question 9

Examples of Neurokinin 1 receptor antagonists

Answer 9

Aprepitant, Netupitant, Fosaprepitant, Rolapitant

Question 10

What are NK1 receptor antagonist drugs given alongisde?

Answer 10

Dexamethasone or a 5HT3 antagonist

Question 11

Example of a synthetic cannabinoid

Answer 11

Nabilone

Question 12

Which antiemeitc is used in pregnancy induced N&V

Answer 12

Promethazine, prochloperazine or metoclopramide

Question 13

Risk factors of PONV

Answer 13

female, non smoker, history of PONV, motion sickness, intraoperative use of opioids

Question 14

Which antiemetics are used to help with PONV

Answer 14

Ondanestron, cyclizine and prochlorperazine

Question 15

Most effective drug for prevention of motion sickness

Answer 15

Hyoscine hydrobromide

Question 16

If a sedative effect is required in motion sickness, what drug can be used?

Answer 16

Promethazine or a slighly less sedating antihistamine e.g Cyclizine, cinnarizine

Question 17

Antiemetic licensed for vertigo. tinnitusd and hearing loss associated with Menierres disease?

Answer 17

Betahistadine

Question 18

What age are cyclizine tablets not licensed for use?

Answer 18

<6 years

Question 19

What age is domperidone contraindicated in

Answer 19

<12 years

Question 20

Maximum duration of Domperidone and why?

Answer 20

7 days - due to cardiac side effects

Question 21

What is the MHRA warning associated with Metoclopramide

Answer 21

neurological adverse effets e.g. Tardive Dyskinesia; max 10mg TDS 5 days `

Question 22

IV metoclopramide should be given over how long?

Answer 22

slow bolus, 3 minutes

Question 23

Can metoclopramide be given in Parkinsons or Epilepsy?

Answer 23

NO

Question 24

Which patient group is most likely to experience adverse effects of Metoclopramide?

Answer 24

Very young and eldery

Question 25

Caution wiht 5HT3 antagonists

Answer 25

QT prolongation

Question 26

what is the MHRA alert regarding Ondansetron therapy in pregnacy?

Answer 26

Small increased risk of Cleft palate following use in first 12 weeks of pregnancy

Question 27

What drug can cause anticholinergic syndrome (particularly in eldery)

Answer 27

Hyoscine hydrobromide

Question 28

What are some symptoms of anticholinergic syndrome

Answer 28

Excitement, ataxia, hallucinations, behavioural abnormalities, drowsiness

Question 29

Kwells and scopoderm are examples of what drug?

Answer 29

Hyoscine hydrobromide