Anti-Emetics Flashcards

(39 cards)

1
Q

4 main classes of anti-emetics?

A

5-HT receptor antagonists
Histamine receptor antagonists
Muscarinic receptor antagonists
Dopamine receptor antagonists

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2
Q

How does cisplatin result in 5-HT release

A

Toxic to enterochromaffin cells, causes them to apoptose, releases free radicals as well as 5-HT

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3
Q

Enterochromaffin cells apoptosis results in release of what

A

free radicals as well as 5-HT

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4
Q

Where do the emetic nerve fibres from the stomach go to in the brain

A

nucleus tractus solitarius, vomiting centre, and CTZ

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5
Q

Where is the vomiting centre in the brain

A

Medulla oblongata

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6
Q

What part of the brain has emetic fibres to the stomach

A

The vomiting centre in the medulla oblongata

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7
Q

Vomiting centre AKA

A

Area postrema

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8
Q

Area postrema AKA

A

Vomiting centre

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9
Q

How is the positioning of the chemoreceptor trigger zone useful to its function?

A

Outside BBB so can detect shit in blood

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10
Q

How does the stomach induce vomiting

A

Serotonin stimulates 5-HT receptors, which have nerves projecting up to the NTS, VC and CTZ, when then have fibres to the VC, which then triggers emesis

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11
Q

Treatment for stomach induced emesis?

A

Ondansteron - 5HT antagonist

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12
Q

Example of 5HT antagonist/

A

Ondansteron

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13
Q

Ondansteron iss an example of?

A

5HT antagonist

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14
Q

Main use of a 5HT receptor antagonist?

A

Chemotherapy induced nausea and vomiting

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15
Q

Main use of a histamine H1 receptor antagonist?

A

Motion sickness

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16
Q

Main use of a muscarinic receptor antagonist?

A

Motion sickness

17
Q

Main use of a dopamine receptor antagonist?

A

Gastroperesis induced N&V

18
Q

Treatment for Chemotherapy induced nausea and vomiting

A

5HT receptor antagonist

19
Q

Treatment for motion sickness?

A

muscarinic receptor antagonist

20
Q

Treatment for Gastroperesis induced N&V

A

dopamine receptor antagonist

21
Q

Role of the nucleus tractus solitarius?

A

Innervates the vomiting centre

22
Q

Role of the CTZ?

A

communicates with the VC

23
Q

Mechanistic triggers of emesis?

A

Cytotoxic drugs, motion sickness, GI problems

24
Q

Why do we get motion sickness?

A

Visual/neural mismatch

25
What receptors connect the labyrinth and vestibular systems
Muscaronic M1-5
26
What receptors connect the vestibular systems and VC
Muscarinic M1-5
27
What receptors connect the hypothalamus and CTZ
Histamine H1-receptor
28
Where does promethazine act
H1 receptor antagonist, blocks signals from hypothalamus to CTZ
29
Where does hyoscine act
Muscarinic receptor for neurons from labyrinth to vestibular system, and vestibular system to VC
30
What is promethazine
H1 receptor antagonist
31
What is hyoscine
Muscarinic receptor antagonist
32
How does gastroparesis trigger emesis (2)
Reduced stomach contraction activates 5HT receptors in stomach which sends signals directly to VC and releases dopamine to stimulate its D2 receptors There are also fibres to the CTZ
33
What is the treatment for gastroparesis induced N&V
Metoclopramide - D2 receptor antagonist And 5HT receptor antagonist to inhibit activation of CTZ
34
Effects of metoclopramide (2)
Prokinetic - stimulates gastric emptying Inhibits D2 receptors in VC Slight 5HT receptor antagonist to inhibit activation of CTZ
35
Example of a D2 receptor antagonist
Metaclopramide
36
Side effects of 5HT receptor antagonism (2)
- Headaches | - Constipation
37
Side effects of histamine H1 receptor antagonism
- Drowsiness
38
Side effects of dopamine D2 receptor antagonism
- Extrapyramidal side-effects
39
Side effects associated with MUSCARINIC RECEPTOR ANTAGONISM:
- Drowsiness - Dry mouth - Constipation