Antiemetic Agents Flashcards Preview

Pharmacology II > Antiemetic Agents > Flashcards

Flashcards in Antiemetic Agents Deck (14):
1

Where is the vomiting center in the brain?

lower medulla

2

Which receptors are involved in the chemoreceptor associated N/V?

-D2 (dopamine)
-5HT3 (serotonin)
-NK1 (neurokinin)

Tx: Ondansetron (Zofran)

3

Which receptors are involved in the Cortex and Thalamus receptors [pain, anxiety, anticipation]?

-GABA
-H1

Tx: Benzodiazepines

4

Which receptors are associated with Vestibular system N/V?

-ACh
-H1

5

Serotonin 5-HT3

Ex. Ondansetron (Zofran)

-Lasts 4-9 hours
-Oral or IV
-Reduce dose in hepatic insufficiency*
-Most effective when given preventatively 30 mins before chemotherapy
-Efficacy enhanced with corticosteroid*
ADE: headache, constipation

Dolasetron - most pronounced QT interval prolongation

6

Substance P/Neurokinin 1 Receptor Antagonist

-Advantage: relief from delayed emesis

7

Antihistaminic- Anticholinergic Agents

Ex. Dimenhydrinate (Dramamine)
or
Diphenhydramine (Benadryl)

8

Which Antihistaminic-Anticholinergic is particularly good for vertigo?

Meclizine (Antivert)

9

Phenothiazines

1. Prochlorperazine (Compazine)

Use: breakthrough N/V from chemo

ADE: prolonged QT, sedation, tardive dyskinesia*

10

Phenothiazines: Chlorpromazine (Thorazine)

Dopaminergic blocker and alpha blocker

so... causes decreased BP. Also can affect body temperature

11

Butyrophenones

1. Haloperidol
2. Droperidol
-QT prolongation/Torsades de pointes (so, get an EKG beforehand)

12

Benzodiazepines

1. Alprazolam (Xanax)

2. Lorazepam (Ativan)

-give these before chemo

13

Cannabinoids

1. Dronabinol (Marinol)
-Rx

14

Which antiemetic is first line in pregnancy?

Pyridoxine

-can consider methylprednisolone in addition (but don't exceed 6 weeks)