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