Flashcards in Chapter 52 - Antiemetic and Antinausea Drugs Deck (31)
What is nausea?
Unpleasant feeling preceding vomiting
What is Emesis?
Forcible emptying of gastric/intestinal contents
What drugs are used to relieve nausea/vomiting?
6 pharmacologic managemetn of nausea/vomiting?
1. Dopamine antagonists
4. Prokinetic agents
5. Serotonin blockers
6. Tetrahydrocannabinoids (THC)
Causes of nausea/vomiting? (11, and they literally all start with M)
What is the MOA of anticholinergic drugs?
MOA = Mechanism of Action
1. bind to and block ACh receptors in inner ear labyrinth
2. block transmission of nauseating stimuli to CTZ
3. also block transmission of nauseating stimula from reticular formation to the VC
Indications of anticholinergic drugs?
motion sickness, pre-surgical secretion reduction, N/V
What is scopolamine and what is it used for?
Anticholinergic drug in transdermal patch form used for motion sickness
What is the MOA of antihistamine drugs (H1 receptor blockers)?
1. inhibit ACh by binding to H1 receptors
2. prevent cholinergic stimulation in vestibular/reticular areas, preventing N/V
Indications of antihistamine drugs?
motion sickness, nonproductive cough, allergy symptoms, sedation, N/V
3 Antihistamine drugs
1. dimenhydrinate (Dramamine(
2. diphenhydramine (Benadryl)
3. meclizine (Antivert)
Antihistamines Don't Deliver Madness
MOA of antidopaminergic drugs
block dopamine receptors on the CTZ
Indications of antidopaminergic drugs?
used for psychotic disorders, intractable hiccups (i find this funny), N/V
3 antidopaminergic drugs, and which is controversial/why?
1. prochlorperazine (Compazine)
2. promethazine (Phenergan)
3. droperidol (Inapsine): controversial use b/c associated cardiac dysrhythmia
MOA of prokinetic drugs
1. block dopamine in the CTZ
2. cause CTZ to be desensitized to ipulses it receives from the GI tract
3. stimulates peristalsis in GI tract, enhancing emptying of stomach contents
Indications of prokinetic drugs
GERD, delayed gastric emptying, N/V
Example of a prokinetic drug
long term use may cause irreversible tardive dyskinesia
MOA of serotonin blockers
block serotonin receptors in the GI tract, CTZ, and VC
Indication of serotonin blockers
N/V in pt's receiving chemotherapy and for postoperative n/v
4 examples of serotonin blocker drugs
1. dolasetron (Anzemet)
2. granisetron (Kytril)
3. ondansetron (Zofran)
4. palonosetron (Aloxi)
MOA of tetrahydrocannabinoids (THC)
1. major psychoactive substance in marijuana
2. inhibitory effects on reticular formation, thalamus, cerebral cortex
3. alter mood and body's perception of its surroundings
Indications of tetrahydrocannabinoids
N/V associated with chemo, and anorexia associated with weight loss in AIDS/cancer pts
-may also stimulate appetite
Example of tetrahydrocannabinoid drug
Common adverse effects
1. dizziness, h/a
2. drowsiness, sedation, fatigue
3. disorientation, confusion
4. dry mouth, blurred vision, dilated pupils, urinary retention
for other specific adverse effects, use table 52-5 on page 831. btw there's a lot.
Ginger: used for, adverse effects, and interactions
used for: n/v, caused by chemo, morning sickness, and motion sickness
adverse: anorexia, n/v, skin reactions
drug interactions: increase absorption of oral meds, increase bleeding risk with anticoagulants, not recommended during pregnancy
Nursing implications: what to assess?
N/V history, including causes
assess allergies, current meds (everything, literally everything), contraindications, potential drug interactions
Do antidiabetic/antiemetic drugs cause drowsiness?
Many of them do!
Warn pt's about driving
Taking antiemetics with alcohol can cause __________
severe CNS depression
When are antiemetics given for chemo?
30-60 minutes before chemo begins