Antiemetics & Gut Motility Disorder Treatment

Question 1

Example of an anti-muscarinic.

Answer 1

Hyoscine hydrobromide

Question 2

Name three anti-histamines.

Answer 2

1. Cinnarizine
2. Cyclizine
3. Promethazine

Question 3

What are side effects of anti-histamines?

Answer 3

Drowsiness

Antimuscarinic effects

Question 4

What type of emesis are anti-muscarinics used to treat?

Answer 4

Motion sickness

Question 5

What are side effects of anti-muscarinics?

Answer 5

Constipation
Transient bradycardia
Dry mouth

Question 6

What type of emesis are anti-histamines used to treat?

Answer 6

Motion sickness

Vestibular disorders

Question 7

Which histamine receptors do the anti-histamines act as antagonists at?

Answer 7

H1 Histamine receptor

Question 8

How can anti-muscarinics be administered?

Answer 8

Orally

Topically via a patch

Question 9

Upon which region of the brain do the dopamine antagonists act?

Answer 9

Chemoreceptor trigger zone

Question 10

What are the three sub-classes of dopamine antagonists?

Answer 10

Phenothiazines
Domperidone
Metoclopramide

Question 11

Give 4 examples of phenothiazine dopamine antagonists.

Answer 11

Chlorpromazine
Perphenazine
Prochlorperazine
Trifluoperazine

Question 12

What type of emesis are the dopamine antagonists active against and which in particular are they not active against?

Answer 12

Active against CTZ triggered vomiting

Not active against stomach induced vomiting

Question 13

What are the phenothiazines also known as?

Answer 13

Antipsychotics

Neuroleptics

Question 14

Give a primary example of a 5HT3 antagonist.

Answer 14

Ondansetron

Question 15

Under what circumstances are 5HT3 antagonists used?

Answer 15

To treat N/V in postoperative patients and those receiving cytotoxins. Also used on cancer patients suffering from N/V as a side effect of their treatment

Question 16

Give 2 examples of neurokinin 1 receptor antagonists.

Answer 16

Aprepitant

Fosaprepitant

Question 17

When are neurokinin 1 receptor antagonists advised for use?

Answer 17

In chemotherapy associated N/V

Question 18

Give an example of a synthetic cannabinoid.

Answer 18

Nabilone

Question 19

When is nabilone used?

Answer 19

When a patient has been found to be resistant to primary antiemetic treatment; i.e. used second line

Question 20

What are common side effects of nabilone?

Answer 20

Drowsiness

Dizziness

Question 21

Give an example of a type of steroid used in anti-emesis.

Answer 21

Dexamethasone

Question 22

What are indications for the use of dexamethasone?

Answer 22

Cancer chemotherapy associated N/V

Question 23

What does dexamethasone cause when used in palliative care associated with cancer development?

Answer 23

Shrinkage of everything, including a metaplasia for example

Question 24

Name 2 other neuroleptics.

Answer 24

Haloperidol

Levomepromazine

Question 25

Outline the function of neuroleptics.

Answer 25

Reduction of nervous tension by depressing nervous function

Question 26

What type of laxative is (WTLI): Methylcellulose

Answer 26

Bulk

Question 27

WTLI: Bisacodyl

Answer 27

Stimulant

Question 28

WTLI: Dantron

Answer 28

Stimulant

Question 29

WTLI: Lactulose

Answer 29

Osmotic

Question 30

WTLI: Liquid paraffin

Answer 30

Softener

Question 31

WTLI: Arachis oil

Answer 31

Softener

Question 32

WTLI: Methylnaltrexone bromide

Answer 32

Peripheral opioid receptor antagonist

Question 33

WTLI: Ispaghula husk

Answer 33

Bulk

Question 34

WTLI: Macrogols

Answer 34

Osmotic

Question 35

If a patient presents to you with painful acute diarrhoea, what should you consider prescribing them?

Answer 35

``` ORT for diarrhoea Hyoscine butylbromoide (aka buscopan) or mebeverine - iow antispasmodics for pain If ORT doesn't work, anti motility drugs may be indicated ```

Question 36

What are the three pharmacological options considered for the treatment of chronic diarrhoea?

Answer 36

Anti motility agents Adsorbents Bulk forming drugs

Question 37

Give 4 examples of anti motility agents.

Answer 37

Codeine Co-phenotrope Loperamide (imodium) Morphine

Question 38

What is a contraindication of adsorbents?

Answer 38

Acute diarrhoea

Question 39

What are the indications for use of bulk forming drugs?

Answer 39

Control of diarrhoea associated with diverticular disease

Question 40

Give 3 examples of bulk forming drug.

Answer 40

Ispaghula Methyl cellulose Sterculia

Question 41

What is common practice on the treatment of gallstones?

Answer 41

Laparoscopy - lap chole

Question 42

What drug can be used to dissolve gallstones?

Answer 42

Ursodeoxycholic acid

Question 43

Name another drug that reduces the amount of free flowing billirubin.

Answer 43

Cholestyramine - reduces itch

Question 44

What type of drug is cinnarizine?

Answer 44

Anti-histamine

Question 45

What type of drug is chlorpromazine?

Answer 45

Phenothiazine dopamine antagonist

Question 46

What type of drug is hyoscine hydrobromide?

Answer 46

Anti-muscarinic

Question 47

What class of drug does ondansteron belong to?

Answer 47

5HT3 antagonists