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Pharmacology > Emetics > Flashcards

Emetics Flashcards

(65 cards)

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1
Q

Central SC Apomorphine

A

D2 in chemoreceptor trigger zone

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2
Q

Peripheral

A

Rapid - Saturated NaCl when there’s actual vomiting
Slow - Tr.?? Ipecacuanha

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3
Q

Emetics used

A

Emetic doses - To evacuate the stomach in cases of oral poisoning
Sub emetic doses - Increase secretions as a nauseamt expectorant

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4
Q

CTZ stimulants on

A

D2 and serotonin receptors

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5
Q

Motion sickness stimulants in the vomiting centre (meaning they pass bbb) on

A

M1 and H1 receptors

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6
Q

H1 receptor blockers - antihistaminics

A

Block H1 in vomiting centre and useful even in motion sickness

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7
Q

Long acting antihistaminics

A

In sea sickness

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8
Q

Anti Hs

A

Dimenhydrinate
Diphenhydramine
Promethazine
Meclizine
Cyclizine

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9
Q

M1 blockers

A

Hyoscine halph an mg half an hour before journeys

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10
Q

Hyoscine orally or transdermal patch

A

Useful in motion sickness

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11
Q

Long acting

A

Used in airsickness

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12
Q

Dopamine receptor blockers

A

In all vomiting except vomiting induced by motion sickness

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13
Q

D2 blockers

A

Metoclopramide
Domperidone
Phenothiazine
Butyrophenones

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14
Q

Metoclopramide

A

Central - block D2
Peripheral - stimulate serotonin in enteric ganglia to releas e ach for gastric motility for gastric emptying as prokinetic so can be blocked by atropine

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15
Q

Domperidone

A

Central - D2 blocking
Peripheral - prokinetic

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16
Q

Phenothiazines

A

Chlorpromazine

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17
Q

Butyrophenones - schizophrenia treatment

A

Droperidol
Haloperidol

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18
Q

Serotonin blockers (orally and IV)

A

Ondan and granisetron

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19
Q

Vomiting induced by chemotherapy

A

Single dose IV serotonin blocker 30 minutes before chemo

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20
Q

Greater affinity and longer 40 hour half life

A

Palonosetron - post operative nad post radiation nausea and vomiting

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21
Q
A
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22
Q

Neurokinin (substance P) blocker

A

Aprepitant
If not we vomit while in severe pain

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23
Q

Prevent chemotherapy vomiting

A

Netupitant(300mg) as combo product with palonosetron (0.5mg)

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24
Q

Glucocorticoids

A

Dexamethazone VduetoCC - increase serotonin antagonism

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25
Cannabinoids
Dronabinol VduetoCC but all the side effects so uncommon
26
CNS and CVS side effects
Dronabinol
27
CNS - like some opiod
Euphoria Uncontrollable laughter Weak mental conc. Impaired reflexes
28
CVS
VD and tachycardia
29
Somehow attenuates adverse effects of dronabinol
Phenothiazine with synergistic effect
30
Pyridoxine
In vomiting of pregnancy
31
Benzodiazepines- lorazepam, diazepam
Anticipation vomiting Or anxiety vomiting
32
Prokinetics
Metoclopramide Domperidone Itopride Erythromycin
33
Metoclopramide - orally, rectally, IM IV
10mg 3 - 4 times per day Treats: Gastric hypomotiluty like duabetic gastroparesis GERD Hiccups Non motion sickness vomiting
34
Adverse metoclopramide
Dizziness and nervousness Extrapyramidal manifestation so parkinsonism and ataxia Hyperprolactinemia so galactorrhea in females Increased absorption of concomitantly administered drugs minus digoxin
35
Structurally related to metoclopramide
Alizapride ( D2 antagonist too, prokinetic, antiemetic, for nausea and vomiting - postoperative
36
Domperidone (Motelium)
Works centrally like metoclopramide and peripherally but through blockage of alpha receptors
37
Is domperidoen antagonised by atropine?
No Plus limited bbb so rare extrapyramidal manifestations unlike metoclopramide
38
2 similar with Hyperprolactinemia
Metoclopramide and domperidone
39
Itopride and Mosapride
Ganaton and Gasmovac: Serotonin receptor that release ach. So prokinetic in GERD with PPIs
40
Erythromycin- know antibiotic (macrolide)
Stimulates motility Rapid tolerance
41
Intestinal evacuants
Purgatives Cleansing enema Glycerin suppository : irritates walls and softens stool for both adults and kids (especially) alike
42
Purgatives
Mild (laxatives) - formed stool Potent (cathartic) - fluid stool
43
Uses of purgatives
Avoid straining in some patients Before operations and Xray abdomen Before and after antihelminthes - Tinea solium Constipation - acute (MgSO4 or irritant purgative) and chronic (liquid paraffin or dioctyl Na sulfosuccinate plus Bran) Drug and Food poisoning saline MgSO4plus charcoal
44
Physical purgatives
Bulk forming Lubricant Surfactant
45
Bulk forming
Stretch wall so reflex peristalsis Onset is 1 to 3hr so taken in the morning
46
Examples of bulk formers
Food with unabsorbed residues - veggies and bran
47
Bran is suitable for
Vhronic constipation
48
Methyl cellulose
Form hydrophilic granules
49
Plantagenet seeds and agar
Imbibe water
50
Saline purgatives like MgSO4 - 15g before breakfast
Takes the water and forms non absorbable osmotic salts Release cholec. for bile then peristalsis
51
Lactulose
Not digested and not absorbed do retains water in the bowel luke MgSO4 Lactulose splited by colon bacteria so lactic acid for decreased ph
52
Decreased ph of from lactilose
Forms soft stool Decreases proteolytic bacteria
53
Polyethylene glycol
Safe in renal and hepatic diseases plus pregnancy
54
Lubricant purgatives
Liquid paraffin Only
55
Liquid paraffin
Is a synthetic mineral oil that's not absorbed orally Softens and lubricates hard fecal masses and mucosa of large intestine Has 8 to 10 hr onset so given at night Is useful kn chronic constipation
56
Disadvantage of liquid paraffin
Decreases the absorption of fat sol. vit. so complications of inadequacy of that and oral contraceptives (it absorbs all of them instead) Oral bad consistency so add fruit juice Leakage from anal sphincter because it's so oily Lipoid pneumonia
57
Puritis ani Analysis polyp Delays healing of anorectal operations like piles and fissures
Liquid paraffin
58
Surfactants - surface acting agents
Dioctyl Na Sulfosussinate Or Docusate sodium -decreases surface tension so increases permeability ro water softening stool -Given at night
59
Irritant purgatives
Colic Diarrhea Dehydration Decreased absorption of drugs and nutrients Pelvic congestion affecting menses Abortion on pregnancy May be excreted in milk affecting the child
60
Irritants are either
Mild - castor oil Moderate - anthracite, phenolphthalein, bisacodyl
61
New drugs
Chloride secretion activators like: Lubiprostone, linaclotide and plecanatide Serotonin receptor agonists like: Tegaserod and prucalopride
62
Red discolouration of alkaline urine plus enterohepatic circulation so long 3 to 4 days duration
Phenolphthalein
63
Red discolouration or urine Mucosa pigmentation of large intestine
Anthracine derivatives: aloe, senna and cascara
64
Related to phenolphthalejn but no enterohepatic circulation
Bisacodyl Given both oral (absorbed) as a purgative and rectal suppository
65
Related to bicasodyl
Na picosulphate

Pharmacology (27 decks)

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