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Kol- Pharm 323 Spring > Anti Emetic Anti Diarrheal IBD > Flashcards

Anti Emetic Anti Diarrheal IBD Flashcards

(58 cards)

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1
Q

7 classes of antiemetic

A
  1. Serotonin Receptor Antagonists
  2. Substance P Neurokinin1 Antagonists
  3. Glucocorticoids
  4. Benzodiazepines
  5. Dopamine Antagonists
  6. Cannabinoids
  7. Anticholinergics/Antihistamines
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2
Q

side effect profile for antiemetics is usually

A

CNS

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3
Q

prototype for Serotonin Receptor Antagonists

A

ondansetron (Zofran)

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4
Q

how does ondansetron (Zofran) fxn

A

Block 5-HT3 Receptors (serotonin receptors) on the vagal neurons and in the CTZ

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5
Q

most effective antiemetic

A

ondansetron (Zofran

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6
Q

side effects of ondansetron (Zofran)

A

headache, diarrhea, dizziness, prolong QT interval (electrolyte abnormalities, bradycardia use caution)

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7
Q

use caution in which patient population with ondansetron (Zofran)

A

electrolyte abnormalities, bradycardia use caution b/c of risk of QT prolongation

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8
Q

indication for using ondansetron (Zofran)

A

chemo, postop, gastroenteritis

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9
Q

route for ondansetron (Zofran)

A

Oral, sublingual, IV

◦ Max dosing in a day

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10
Q

prototype for Substance P Neurokinin1Antagonists

A

aprepitant (Emend)

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11
Q

how does aprepitant (Emend) fxn

A

Blocks neurokin1type receptors (for substance P) in the chemoreceptor trigger zone

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12
Q

indication for using aprepitant (Emend)

A

Preventing postop N/V and Chemo induced n/v

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13
Q

admin of aprepitant (Emend)

A

Single agent or Used in conjunction with other antiemetics

◦ dexamethasone + ondansetron (Zofran)+ aprepitant (Emend)

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14
Q

drug-drug interactions: for aprepitant (Emend)

A

warfarin, oral contraceptive pills (need alternate form)

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15
Q

side effects of aprepitant (Emend)

A

fatigue and asthenia (loss of strength/energy)

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16
Q

aprepitant (Emend) route

A

oral formulation

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17
Q

prototype for Glucocorticoids

A

dexamethasone (Decadron)

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18
Q

how does dexamethasone (Decadron) fxn to help nausea?

A

MAO unknown

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19
Q

indication for using dexamethasone (Decadron) for n/v

A

chemo induced n/v

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20
Q

side effects of dexamethasone (Decadron)

A

No serious SE when used intermittently and short term

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21
Q

prototype for Benzodiazepines for nausea

A

lorazepam (Ativan)

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22
Q

indication for using lorazepam (Ativan) for nausea?

A

Used in chemo induced n/v–> suppression of anticipatory emesis

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23
Q

side effects of lorazepam (Ativan)

A

Sedation, retrograde amnesia

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24
Q

how do dopamine antagonists fxn?

Study These Flashcards
A

Block dopamine2receptors in the chemo receptor trigger zone

25
3 types of dopamine antagonists
1. Phenothiazines 2. Butyrophenones 3. Metoclopramide (Reglan)
26
indication for using dopamine agonists
postop, chemo, toxins
27
side effects of dopamine antagonist (in general)
extrapyramidal symptoms, anticholinergic effects, hypotension, sedation, movement disorders (involuntary movement of face/arms, dystonia)
28
prototype for phenothiazines
Promethazine (Phenergan)
29
consideration for Promethazine (Phenergan)
risk of tissue injury due to IV extravasation | -can form precipitate w/ other drugs in tubing
30
side effects of Promethazine (Phenergan)
respiratory depression (not under age of 2)
31
indication for using metoclopramide (Reglan)
postoperative, CINV, radiation, toxins, opioids, GERD, gastroparesis
32
how does metoclopramide (Reglan) fxn
Blocks dopamine and serotonin in the chemo trigger zone | -->Antiemetic + Motility agent (prokinetic)
33
long term vs high dose side effects of metoclopramide (Reglan)
* High dose: sedation, diarrhea | * Long term: tardive dyskinesia --> irreversible eventually
34
prototype for cannabinoids
dronabinol (Marinol)
35
indication for using dronabinol (Marinol)
Used for Chemo induced n/v, stimulate appetite in AIDS
36
side effects of dronabinol (Marinol)
temporal disintegration, dissociation, dysphoria
37
which of our antiemetics is a schedule III
dronabinol (Marinol)
38
consideration for dronabinol (Marinol) - use caution with....
other CNS drugs
39
prototype for Anticholinergics/ Antihistamines
hydroxyzine (Vistaril)
40
indication for using hydroxyzine (Vistaril)
Used for motion sickness and Chemo induces n/v
41
how does hydroxyzine (Vistaril) fxn?
block histamine and muscarinic receptors from the inner ear
42
side effects of hydroxyzine (Vistaril)
sedation and anticholinergic SE
43
Anti-diarrheal agents (2)
OPIOIDS: - diphenoxylate plus atropine (Lomotil) (V) - loperamide (Imodium)
44
most effective anti-diarrhea agents
diphenoxylate plus atropine (Lomotil) (V) and loperamide (Imodium)
45
side effects of diphenoxylate plus atropine (Lomotil) (high doses)
high doses: morphine like euphoria with Lomotil
46
weird side effects of bismuth subsalicylate (Pepto-Bismol)
turn tongue and stool black
47
5 classes of drugs for IBD (crohn's, uc)
1. 5-aminosalicylates 2. glucocorticoids 3. immunosuppressants 4. targeted therapy 5. antibiotics
48
prototype for 5-Aminosalicylates
Sulfasalazine
49
how does Sulfasalazine fxn?
Inhibit prostaglandins --> decrease inflammation for IBD
50
admin considerations for Sulfasalazine- when give in relation to food?
Give after meals to dec. GI distress | **check for sulfa allergy
51
side effects of Sulfasalazine
nausea, fever, rash and arthralgia.
52
admin for glucocorticoids for IBD- routes? dosing for acute?
IV or oral • Acute=high dose ◦ Tapered over 2-3 months •Rectal enemas with steroids
53
how do we give immunosuppressive drugs for IBD? (give them w/ something else)
Given in combination with steroids
54
side effects of | Immunosuppressive Drugs for IBD
suppressed immune system, anemia, thrombocytopenia, RF, hepatotocity
55
prototype for targeted therapy for IBD
Monoclonal antibodies : infliximab (Remicade)
56
how does infliximab (Remicade) fxn?
inhibit TNF
57
side effects of infliximab (Remicade)
infections and infusion reactions
58
Antibiotics for Crohn's
• Metronidazole (Flagyl) AND Ciprofloxacin (Cipro) **nopt for UC

Kol- Pharm 323 Spring (41 decks)

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