GI deck 3

Question 1

Antiemetics may be used to provide

Answer 1

Symptom relief for nausea and vomiting

Prevention of fluid and electrolyte disturbances

Question 2

Drug class of antiemetics

Answer 2

Antihistamines
Phenothiazines
Sedative hypnotics
Anticholinergics
Cannabinoids
5-HT3 receptor antagonists
Substance P/neurokinin 1 (NK1) receptor antagonist

Question 3

Antihistamines MOA

Answer 3

have strong anticholinergic effects as well as histamine1-blocking effects

Question 4

phenothiazines MOA

Answer 4

block dopamine receptors in the chemoreceptor trigger zone

Question 5

Cannabinoids MOA

Answer 5

work in the central nervous system (CNS) to prevent nausea and vomiting associated with cancer chemotherapy

Question 6

5-HT3 MOA

Answer 6

receptor antagonists: block serotonin on vagal nerve terminals and in the chemoreceptor trigger zone

Question 7

Anticholinergic example

Answer 7

scopolamine

Question 8

antihistamine precautions

Answer 8

have anticholinergic properties

Question 9

Phenothiazines

Produce and are contraindicated in

Answer 9

Produce extrapyramidal symptoms (EPS)

Contraindicated in Parkinson’s disease

Question 10

Dronabinol use with caution in

Answer 10

in patients with seizure disorders

Question 11

5-HT3 receptor antagonists: may mask

Answer 11

progressive ileus

Question 12

Antihistamine ADR

Answer 12

Drowsiness

Anticholinergic effects of dry mouth, blurred vision, and urinary retention

Question 13

Phenothiazines ADR

Answer 13

Drowsiness

EPS, such as dystonia, akathisia, and tardive dyskinesia

Question 14

Most commonly used antiemetics

Answer 14

antihistamines and phenothiazines

Question 15

Promethazine: fatal ____

Answer 15

respiratory depression in children younger than 2 years of age

Question 16

Scopolamine ADR

Answer 16

Dry mouth

Withdrawal symptoms

Question 17

Cannabinoid dronabinol ADR

Answer 17

dronabinol
Euphoria, depression, dizziness, paranoid thoughts, somnolence, and abnormal thoughts

Cardiac effects: palpitations, tachycardia, and hypotension
Seizure and seizure-like activity have been reported

Question 18

Scopolamine is commonly delivered in the form of a

Answer 18

patch - used behind the ear for motion sickness. 24 hours before nausea inducing events. Sometimes pre surgery as well.

Question 19

5-HT3 receptor antagonists

ADR

Answer 19

Constipation, headache, fatigue, dizziness, and diarrhea

Rare cases of tachycardia, bradycardia, hypotension, and heart rate-corrected QT interval prolongation

Question 20

Dronabinol is only used for

Answer 20

chemotherapy-associated nausea and vomiting, and for appetite stimulation.

Question 21

5-HT3 Example and what you should be aware of

Answer 21

Zofran

prolonged QT interval

Question 22

Antiemetics addive ___ and ___

Answer 22

Additive CNS depression when combined with CNS depressants

Additive anticholinergic effects

Question 23

Phenothiazines and lithium: may

Answer 23

Phenothiazines and lithium: may increase EPS

Phenothiazines and lithium: may mask lithium toxicity

Question 24

Motion sickness drug used

Answer 24

Antihistamines

Dimenhydrinate and meclizine

Question 25

Vomiting caused by gastroparesis drug uese

Answer 25

Prokinetic drugs

Question 26

Aprepitant used in conjunction

Answer 26

with other antiemetic to prevent N&V associated with chemo

Question 27

Antiemtics monitoring short term

Answer 27

use requires minimal monitoring

Question 28

Antiemetics monitoring long term

Answer 28

use of promethazine requires complete blood count to monitor for bone marrow depression and blood dyscrasias (week 4 and week 10 of therapy).

Question 29

Anitemetics should be taken

Answer 29

1 to 2 hours before departure to treat motion sickness

Question 30

Dronabinol (Marinol): may cause

Answer 30

euphoria and behavior changes

Question 31

Antiemetics lifestyle changes

Answer 31

Hydration | Electrolyte replacement solutions

Question 32

H2RAs: reversible competitive

Answer 32

blockers of histamine at histamine2 receptors Highly selective Reduce gastric acid secretion by 35% to 50%

Question 33

H2RA is a great choice

Answer 33

for addressing acid related problems. It works by blocking histamine which controls the potency of gastric acid secretion. good for chronic acid problems. They are not acid neutralizing

Question 34

Commonly H2RA

Answer 34

Ranitdine | Famotidine

Question 35

Ranitidine is

Answer 35

5 to 12 times more potent than cimetidine

Question 36

Famotidine is

Answer 36

30 to 60 times more potent than cimetidine

Question 37

H2RA precautions and contraindications

Answer 37

Cautious use in renal impairment

Question 38

Hepatocellular injury may occur with

Answer 38

nizatidine

Question 39

Occasional reversible hepatitis or hepatocellular disorders have occurred with

Answer 39

rantidine

Question 40

H2RA pregnancy category

Answer 40

B

Question 41

Ranitidine and famotidine use is approved in

Answer 41

children

Question 42

H2RA ADR

Answer 42

Antiandrogenic reactions Gynecomastia and impotence Cimetadine the worst offender CNS adverse reactions Agranulocytosis, granulocytopenia, thrombocytopenia, and aplastic anemia

Question 43

H2RA monitoring

Answer 43

liver function with high-dose or long-term use

Question 44

H2RA clinical use and dosing and no empiric treatment of

Answer 44

Gastroesophageal reflux disease (GERD) Twice daily dosing No empiric treatment of infants with GERD with H2RAs

Question 45

are H2RA used in peptic ulcer disease

Answer 45

no

Question 46

h2ra decreased dosing for

Answer 46

renal dysfunction

Question 47

h2ra patient education

Answer 47

Take with meals. | Separate antacids by 30 minutes to 1 hour.

Question 48

H2RA may cause

Answer 48

H2RAs may cause drowsiness or dizziness. | Cimetadine may cause gynecomastia and impotence in men

Question 49

Smoking decreases absorption of

Answer 49

H2RA

Question 50

ETOH can increase

Answer 50

gastric irritation