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Anesthesia Drug Test Quick Facts > anti-emetics > Flashcards

anti-emetics Flashcards

(75 cards)

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1
Q

aprepitat category

A

NK1 receptor antagonist

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2
Q

dose of aprepitat

A

40 mg 3 hours prior to induction

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3
Q

peak of aprepitat

A

3 hours

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4
Q

brand name aprepitat

A

emend

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5
Q

MOA aprepitat

A

as an anti-emetic
G protein coupled receptors found in BOTH
central and peripheral NS
also in GI tract
HIGH concentrations of these receipts in regions responsible for N/V

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6
Q

regions of the brain responsible for the vomiting reflex

A

brainstem nuclei
nucleus tractus solataries
area postrema

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7
Q

metabolism aprepitat

A

hepatic

crosses BBB

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8
Q

major A/E of aprepitat

A 
fatigue
nausea
constipation
weakness
hiccups
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9
Q

contraindications of other medications with aprepitat

A

Do not combine w/ pimozide,
terfenadine,
astemizole,
or cisapride.

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10
Q

how does aprepitat affect warfarin?

A

Concurrent Warfin use decreases INR

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11
Q

what drugs improve aprepitat’s efficacy?

A

Greater efficacy for preventing vomiting than any other single intervention
*Combine w/ other anti-emetics

(5HT3 antagonist - ondansetron

or dexamethasone - steriod

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12
Q

category of diphenhydromine

A

H1 receptor antagonist

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13
Q

activity of diphenhydromine

A

anticholinergic
antimuscarinic
weak antidopaminergic

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14
Q

dose of diphenhydromine PONV

A

12.5 mg

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15
Q

dose of diphenhydromine allergic RXN

A

10-50 mg

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16
Q

max dose of diphenhydromine

A

400 mg/day

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17
Q

onset diphenhydromine IV

A

IV 2-3 minutes

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18
Q

onset diphenhydromine PO

A

15-30 minutes

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19
Q

peak diphenhydromine IV

A

30-60 minutes

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20
Q

peak diphenhydromine PO

A

2.5 hours

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21
Q

DOA diphenhydromine

A

3-6 hours

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22
Q

uses of diphenhydromine

A

PONV

allergic rxn

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23
Q

metabolism diphenhydromine

A

hepatic

SIGNIFICANT first pass

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24
Q

elimination diphenhydromine

A

urine

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25
major A/E diphenhydromine
``` Drowsiness, dry mouth, blurred vision, urinary retention extrapyramidal symptoms, sedation, increased IOP ```
26
contraindications of diphenhydromine
Acute asthma, neonates or premature infants, breast-feeding, use as local anesthetic
27
category of dolasetron
Serotonin (5ht3) receptor antagonist
28
brand name dolasetron
anzemet
29
dose of dolasetron
IV 12.5 mg PONV
30
peak dolasetron
40 minutes
31
MOA dolasetron
Inhibit central and peripheral stimulation of 5ht3 receptors
32
metabolism dolasetron
Hepatic(plasma t ½ twice as long as ondanestron)
33
elimination dolasetron
urine
34
major adverse effects dolasetron
QTc prolongation, headache, diarrhea, serotonin syndrome (agitation, tachycardia, muscle twitching/
35
what is dolasetron not effective for?
chemo related N/V
36
category of droperidol
Dopamine receptor antagonist | other receptors antagonized include GABA, NE, and 5HT3
37
name all the receptors antagonized by droperidol
Dopamine- main | GABA, NE, 5Ht3
38
dose of droperidol
0.625- 1.25 mg IV
39
onset droperidol
3-10 minutes
40
peak droperidol
30 minutes
41
DOA droperidol
2-4 hours
42
uses of droperidol
Anti-emetic and antipsychotic. Low doses- alpha adrenergic receptor blocker  increased sedation. Antiemetic tx for PONV at higher doses
43
metabolism droperidol
hepatic | crosses BBB
44
major A/E droperidol
``` QT prolonged, hypotension, torsade de pointes, depression, hallucinations, neuroleptic malignant syndrome, extrapyramidal symptoms ```
45
contraindications droperidol
Pt’s with known/suspected QT prolongation, Parkinson’s disease, bradycardia (
46
trade name droperidol
Inapsine,
47
warning with droperidol
2001 FDA BB warning arrhythmia and death
48
ondansetron category
Serotonin (5ht3) receptor antagonist | not other receptors found for droperidol
49
ondansetron dose
4 mg IV
50
onset ondansetron
30 minutes
51
peak ondansetron
1 hour
52
uses of ondansetron
Cancer induced N/V (CINV), postoperative N/V, radiotherapy induced N/V
53
metabolism of ondansetron
Hepatic (crosses BBB, limited accumulation of these drugs in CNS)
54
elimination of ondansetron
urine/feces
55
side effects of ondansetron
``` H/A, constipation, QTc prolongation, cardiac arrhythmia, drowsiness, serotonin syndrome (agitation, tachycardia, muscle twitching/stiffness) ```
56
ondansetron MOA
*5ht3 receptors are ligand gated Na/K channels in the CNS/PNS, notably CTZ and afferent fibers of vagus nerve in gut and CNS; 5ht3 activation of CTZ and vagal afferents canvomiting reflex
57
Palonosetron category
Newest | Serotonin (5ht3) receptor antagonist
58
dose palonsetron
0.25 (CINV)-0.075 (PONV) mg
59
A/E of palonsetron
QTc prolongation, bradycardia, HA,
60
promethazine MOA
Phenothiazine derivative | and a potent antihistamine w/ moderate anti-muscarinic (anticholinergic) activity
61
dose of promethazine
12.5-25 mg Q4hrs
62
promethazine onset
~ 5 mins
63
promethazine DOA
4-6 hrs (up to 12 hrs)
64
uses promethazine
Effective rescue tx PONV, use for allergic reactions, sedative
65
metabolism promethazine
hepatic
66
promethazine adverse side effects
Altered cardiac conduction, anticholinergic effects, extrapyramidal symptoms, neuroleptic syndrome
67
conditions that promethazine is contraindicated with
``` Glaucoma, myasthenia gravis, Parkinson’s disease, respiratory disease, seizure disorder ```
68
promethazine severe warning
FDA BB warning 2004: do not use in children
69
Metoclopramide MOA
Procainamide derivative and a benzamide prokinetic agent
70
metoclopramide dose
25-50 mg IV/IM
71
uses of metoclopramide
Most commonly used D2 receptor antagonist for antiemetic prophylaxis, primarily for PONV and chemo associated w/ low emetogenic risk
72
metoclopramide metabolism
1st pass hepatic metabolism decreases bioavailability to 75%; readily passes BBB and placenta
73
side effects of metoclopramide
``` GI obstruction, tardive dyskinesia when used beyond 12 wks., Sedation, hypotension, brady/tachycardia ```
74
contraindications of metoclopramide
Avoid after GI surgery
75
MOA
Central and peripheral D2 receptor antagonist activity Also acts on peripheral D2, muscarinic, and 5HT4 receptors prokinetic activity Enhances GI motility decreases stomach reflux/urge to vomit

Anesthesia Drug Test Quick Facts (19 decks)

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