Flashcards in Chapter 4 - Nausea And Labrynth Disorders Deck (50)
What is the lifestyle advice associated with nausea and vomiting?
Eat smaller, more frequent meals
Remain hydrated (with water, not juice)
Eat as tolerated
Eat light, bland foods
Ginger may help
What is the mechanism of antihistamines in nausea and vomiting?
Block muscarinic receptors
And inhibit cholinergic transmission to the vomiting centre
Give some examples of sedating antihistamines
Give some examples of non-sedating antihistamines
List some antimuscarinic side effects associated with antihistamines
Which antipsychotics can be used in nausea and vomiting?
In palliative care, haloperidol and levopromethazine
When is buccal gem licensed OTC?
Nausea and vomiting associated with previously diagnosed migraine in over 18 year olds
What is the mechanism of phenothiazines in nausea and vomiting?
Block the CTZ
They act centrally
Give examples of prokinetic agents used in nausea and vomiting
What is the mechanism of prokinetic agents in nausea and vomiting?
Inhibit the CTZ
Also acts on the GIT
Which antiemetic affects the CTZ and the GI system, metoclopramide or prochlorperazine?
Metoclopramide, therefore it can be used in nausea and vomiting associated with gastric, hepatic and biliary disease
What is the maximum duration of use of metoclopramide?
Why is the maximum use of metoclopramide 5 days?
Risk of EPSEs
What is the minimum age of metoclopramide?
Why doesn’t domperidone act centrally?
It doesn’t cross the BBB
At what weight is domperidone unlicensed?
Less than 35kg
Which class of antiemetics shouldn’t be co-prescribed with a prokinetic agent?
This increases antimuscarinic side effects
Concurrent use can lead to confusion in the elderly
The GI effects of prokinetics are antagonised by antimuscarinics
Give examples of 5HT3 receptor antagonists
When are 5HT3 receptor antagonists used in nausea and vomiting?
Cytotoxic induced nausea and vomiting
Postoperative nausea and vomiting
When is dexamethasone used in nausea and vomiting?
Chemotherapy induced nausea and vomiting
What are the different classes of antiemetics?
5HT3 receptor antagonists
Neurokinin 1-receptor antagonists
Give examples of neurokinin 1-receptor antagonists
When are neurokinin 1-receptor antagonists used?
Moderately emetogenic chemotherapy
What is nabilone and when is it used?
A synthetic cannabinoid
It is used as add on treatment for chemotherapy induced nausea and vomiting
When does nausea and vomiting in pregnancy usually resolve?
Which antiemetics can be used in pregnancy?
Antihistamines e.g. promerhazine, certirizine, chlorphenamine
What is the most effective drug for motion sickness?
What options are available for motion sickness?
Which antiemetics should be used in gastric stasis/drug induced nausea and vomiting?
Domperidone if EPSEs are a problem