Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cpt > Antemetis Nd Antidiarrhoeals > Flashcards

Antemetis Nd Antidiarrhoeals Flashcards

(56 cards)

Start Studying
1
Q

What is vomiting

A

Involuntary, forceful expulsion of gastric contents through the mouth

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

What is the difference between vomiting and regurgitation

A

S

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

What are teh process that occur in vomiting

A

Vomiting Centre in Medulla signals to vomit
1. Nausea, salivation, sweating
Ss

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

What us the CTZ and what triggers it?

A

Chemoreceptor Trigger Zone (CTZ)

Sensory afferent s, vestibular nuclei, direct triggers, visceralal afferent s from gut

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

What are some anti emetic drugs

A

Ss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drugs act on the vestibular nuclei

A
  • Muscarinic receptor Antagonists - H1 receptor antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe muscaring receptor antagonists

A

• Competitive blockade of muscarinic acetylcholine receptors
• In the vestibular nuclei
• Also at the CTZ
• Remember these receptor are all over the
body – part of the parasympathetic nervous system!!
• Good for :-
• People who can’t take tablets
• Motion sickness
• Bowelobstruction

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

What are the side effects os muscariic antagonists

A 
Side effects
• Sedation
• Memoryproblems
• Glaucoma
• Dry mouth and
constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the effects h1 antagonists

A

• Centrally
• Acts on the vestibular nuclei
• Inhibits histaminergic signals from the vestibular system to
the CTZ in medulla

  • Good for :-
  • Motion sickness – long plane journeys
  • Promethazine – morning sickness in pregnancy
  • Not good for:-
  • Cyclizine – little old ladies and children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the side effects of h1 antagonists

A 
Side effects
• Sedation
• Excitation
• Antimuscarinic–dry
mouth, constipation,
urinary retention,
• Cardiactoxicity(longQT
interval)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are agents acting on visceral afferent s

A
  • 5HT3 receptor Antagonists - D2 receptor antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Descrive serotonin in the gut

A
  • 95% serotonin in the body is located in the gut
  • Produced by the enterochromaffin cells
  • In response to parasympathetic stimulation, serotonin excited enteric neurones
  • Smooth muscle contraction increases motility (except in the stomach)
  • Increases gut secretions
  • Regulates appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to 5ht3 receptor antagonists acts

A
  • Peripherally
  • ReducesGImotility
  • ReducesGIsecretions
  • Centrally
  • Acts to inhibit the CTZ
  • Goodfor:-
  • Almost everyone – it’s often the 1st line treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the side effects o 5ht3 receptor antagonists

A 
Side effects - uncommon
• Constipation
• Headache
• Elevated liver enzymes
• Long QT syndrome
• Extra-pyramidal
effects – dystonia, parkinsonism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe d2 receptor antagonists

A

Metaclopramide
• Increases acetylcholine at muscarinic receptors in the gut
• Promotesgastricemptying
• ↑ tone at lower oesophageal sphincter so it
closes
• ↑ tone and amplitude of gastric contractions
• ↓ tone of pylorus so it opens
• Increases peristalsis • Goodfor:-
• GORD • Ileus

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

What are the side effects ofetaclopramide

A

Side effects
• Galactorrhoeavia prolactin release
• Extra-pyramidal effects – dystonia, parkinsonism

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

What is domperidone

A

Domperidone
• Similar mechanism as metoclopramide
• Used to be used very frequently BUT new
evidence and a few high profile cases showed an increased risk of significant cardiac side effects.
• Goodfor:-
• Improvinglactationinbreastfeeding
mothers

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

What are the side effects of domperidone

A

Side effects
• Sudden cardiac death (long QT and VT)
• Galactorrhoea

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

What agents act on the ctz

A
  • 5HT3 receptor antagonists
  • H1 receptor antagonists
  • Muscarinic receptor antagonists
  • D2 receptor antagonists
  • Corticosteroids
  • Cannabinoids
  • NK1 receptor antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Descrube “the zines” action and usage

A 
D2 antagonists 
• The ‘zine’s =
• Act on the CTZ
• May also block H1 and Muscarinic receptors
• Good for - Motion sickness, vertigo.
Prochlorperazine in pregnancy
Prochlorperazine
Chlorpromazine
Levomepromazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is haloperidol and when is it used?

A

D2 antagonist
• Haloperidol
• Act on the CTZ
• Good for :- chemotherapy and palliation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the side effects of “the zines” and haloperidol?

A

Side effects
• Extra-pyramidal effects – dystonia, parkinsonism - USE WITH CAUTION
• Sedation
• hypotension
haloperidol also - sick, anxious, agitated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the action and usage of corticosteroids

Study These Flashcards
A 
Dexamethasone
Methylprednisolone
• Assumed to act on the CTZ
• May also have properties of D2 receptor
antagonists
  • Good for:-
  • Perioperative nausea and vomiting
  • Chemotherapy
  • Palliation
24
Q

What are the side effects of corticosteroids

Study These Flashcards
A

Side effects
• Insomnia
• ↑ appetite - ive if people dont eat bc nausea
• ↑ blood sugar

25
What are cannabinoids
``` syntehitc analouge of cannabis NAbilone • Assumed to act on the CTZ • Good for chemotherapy - used as last line ```
26
What are the side effects of cannabinoids
Side effects • Dizziness • Drowsiness
27
What are neurokinin 1 antagonists
Aprepitant Fosaprepitant Netupitant • Prevent the action of substance P (excitatory neurotransmitter) at CTZ and in peripheral nerves • Boosts effects of 5HT3 receptor antagonists - synergistic, useful in chemo) • Anxiolytic and antidepressant properties • Good for chemotherapy – particularly for delayed emesis (good fot anxiety and depression)
28
What are some other random drugs used as anti emetics
ss
29
Whats is typically used to treat motion sickness
Hyoscine hydrobromide is 1st line (but potentially sedating) Cinnirazine typically has fewer side effects Pick the drug based on side effet profile
30
When is a nasogastric tube used?
Drain stomach and decrompress without them needing to vomit
31
What are prokinetics?
Prokinetic agents, or prokinetics, are medications that help control acid reflux. Prokinetics help strengthen the lower esophageal sphincter (LES) and cause the contents of the stomach to empty faster. Domperidone Metaclopramide Chewing gum can mimic eating and stimulate gut
32
When are prokinetics used?
Useful for • GORD • Ileus Don’t use • Obstruction • Risk of perforation due to inrceased peristalsis
33
What are drugs used to trreat nausea and vomiting due to GI pathology
Ondansetron and/or Cyclizine then add Dexamethasone
34
What are direct triggers of the ctz
``` Hormones – hyperemesis gravidarum • Drugs • Chemotherapy • Anaesthetics • Opiates • Many others! ```
35
What is hyperemesis gravidarum
* Rapid rise in ẞhcg stimulates the CTZ * Typically weeks 4-16 but may continue beyond * Higher risk with multiple pregnancies • More than just ‘morning sickness’ – dehydration, 5% weight loss, electrolyte imbalance, urinary ketones Causes nausea and comiting, common in first trimester True hyperemesis gravidarum can come with dehydration and weight loss - using drugs can be helpful. Normal morning sickness - oral rehydreation
36
What drugs are typicallly used in hyperemesis gravidarum
Promethazine - H1 receptor antagonist or Prochlorperazine - D2 receptor antagonist then add Metaclopramide - D2 receptor antagonist then add Ondansetron - 5HT3 receptor antagonist
37
what are some chemo drugs that can cause emesis
ss
38
what drugs are used for different risks of emesisi with chemotherapy
ss
39
What are some patient factor which increase wisk of post opertaive nausea and vomiting
Female, history of ponv or motion sickness, younger age, non smoker
40
What are some anaesthetic risk factors in post operatove nausea and vomititng
general > regiona, use of volatile anaesthetic gases or nitrous oxide, post operative opioids
41
What are some risk factors for post operative NV to do with the nauture of the surgert
duration of operation, laparoscopic surgery
42
What drusg are used for PONV
Low Risk Wait and see! Moderate Risk Pick 1 or 2 antiemetic agents High Risk pick more than 2 antiemetic agents If prophylaxis fails – use an antiemetic from another class
43
What is diarrhoea
Diarrhoea is defined as the passage of three or more loose or liquid stools per day Consider consistency, frequencyy, comparison to normal
44
What is infective gastroenteritis
Viral, bacterial or protozoal May be toxin mediated Osmotic or Secretory
45
What are the mechanisms by which diarrhoea can be treated
Treat the cause! Increase transit time - stool has more ocntact with gut - better hydration, better comfort Comfort Prevent incontinence (looser stool - more prone to incontinence)
46
name a class of drugs used as antidiarrhoeals, and give 3 examples
opiod receptor antagonist - loperamide, codeine, morphine
47
Describe the action of loperamide
Opioid receptor agonist Loperamide – specific to μ receptors in the myenteric plexus • Decreases tone of longitudinal and circular smooth muscle • Reduces peristalsis but increases segmental contractions • Decreases colonic mass movement by supressing gastrocolic reflex. Different people need different doses
48
Describe teh actions of codeine and morphine as anti diarrhorals
Codeine and morphine - μ and δ receptors Similar effects to loperamide More often used when patients have pain also
49
What are teh side effects of opioid receptor agonists
``` Side effects • Paralytic ileus • Nausea and vomiting • Sedation and Addiction (codeine and morphine) ```
50
What is the constipatign diet
For those with long term loose stools - IBS, IBD, short bowel, hypermotility, drug side effect Bananas - High in potassium and fibre (fibre bulks the stool) White Rice - Binds stool White bread/pasta - Low in fibre Limit fruit to 3 portions per day Avoid caffeine, sorbitol, fatty or spicy foods and fizzy drinks Consider Probiotics Re-instate a balanced intestinal flora
51
What are some diet and lifestyle changes to help constipation
14% Prevalence of Chronic Idiopathic Constipation Drink more water! Increase fibre intake - wholegrain foods, fruit & veg, nuts, pulses. Regular exercise Toilet routine and positioning
52
What are some medications ofr constipation
``` LAxatives: Osmotic (mush) stimulants (push) bulk forming stool softeners ``` Enemas Osmotic (Draw water in) Stimulants (move contents though)
53
What are osmotic laxatives
Lactulose, movicol, cosmocol Increase the amount of water in the large bowel Osmotically raw fluid in Lactulose OR Retain the fluid they came with Macrogols - needs to be enough fluid around
54
Describe stimualnt laxatives
``` Bisacodyl Sodium Picosulphate Senna Co-Danthromer Docusate Sodium (Glycerin) ``` Increase intestinal motility May be given orally or per rectum Docusate sodium acts as stimulant and stool softener Glycerin suppositories cause rectal irritation and lubrication
55
What are bulk forming laxatives
Ispaghula husk Methylcellulose They are medicinal fibres
56
What are stool softeners
Decrease surface tension of stool Increase penetration of fluid into stool Docusate sodium Glycerin suppository Arachis oil Liquid paraffin

Cpt (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions