Chapter 4 - Nausea And Labrynth Disorders Flashcards Preview

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Flashcards in Chapter 4 - Nausea And Labrynth Disorders Deck (50)
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1

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

2

What is the mechanism of antihistamines in nausea and vomiting?

Block muscarinic receptors
And inhibit cholinergic transmission to the vomiting centre

3

Give some examples of sedating antihistamines

Chlorphenamine
Promethazine
Diphenhydramine
Cinnarizine
Cyclizine

4

Give some examples of non-sedating antihistamines

Fexofenadine
Cetirizine
Loratadine
Acarvistine

5

List some antimuscarinic side effects associated with antihistamines

Sedation
Dry mouth
Constipation
Blurred vision
Urinary retention

6

Which antipsychotics can be used in nausea and vomiting?

Chlorpromazine
Prochlorperazine

In palliative care, haloperidol and levopromethazine

7

When is buccal gem licensed OTC?

Nausea and vomiting associated with previously diagnosed migraine in over 18 year olds

8

What is the mechanism of phenothiazines in nausea and vomiting?

Block the CTZ
They act centrally

9

Give examples of prokinetic agents used in nausea and vomiting

Metoclopramide
Domperidone

10

What is the mechanism of prokinetic agents in nausea and vomiting?

Inhibit the CTZ
Also acts on the GIT

11

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

12

What is the maximum duration of use of metoclopramide?

5 days

13

Why is the maximum use of metoclopramide 5 days?

Risk of EPSEs

14

What is the minimum age of metoclopramide?

18 years

15

Why doesn’t domperidone act centrally?

It doesn’t cross the BBB

16

At what weight is domperidone unlicensed?

Less than 35kg

17

Which class of antiemetics shouldn’t be co-prescribed with a prokinetic agent?

Antimuscarinics

This increases antimuscarinic side effects
Concurrent use can lead to confusion in the elderly
The GI effects of prokinetics are antagonised by antimuscarinics

18

Give examples of 5HT3 receptor antagonists

Onsansetron
Granisetron

19

When are 5HT3 receptor antagonists used in nausea and vomiting?

Cytotoxic induced nausea and vomiting
Postoperative nausea and vomiting

20

When is dexamethasone used in nausea and vomiting?

Chemotherapy induced nausea and vomiting

21

What are the different classes of antiemetics?

Antihistamines
Prokinetics
5HT3 receptor antagonists
Neurokinin 1-receptor antagonists
Dexamethasone
Nabilone

22

Give examples of neurokinin 1-receptor antagonists

Aprepirant
Fosaprepitant

23

When are neurokinin 1-receptor antagonists used?

Moderately emetogenic chemotherapy

24

What is nabilone and when is it used?

A synthetic cannabinoid

It is used as add on treatment for chemotherapy induced nausea and vomiting

25

When does nausea and vomiting in pregnancy usually resolve?

16-20 weeks

26

Which antiemetics can be used in pregnancy?

Antihistamines e.g. promerhazine, certirizine, chlorphenamine

27

What is the most effective drug for motion sickness?

Hyoscine

28

What options are available for motion sickness?

Hyoscine
Promethazine
Cinnarizine
Cyclizine
Ginger
Acupressure

29

Which antiemetics should be used in gastric stasis/drug induced nausea and vomiting?

Metoclopramide
Domperidone if EPSEs are a problem

30

What antiemetic would you give for nausea and vomiting associated with diseases of the inner ear?

Cyclizine