GI Meds + Intro to Vasopressors - Final Wrapup Flashcards Preview

Spring 2020 - Pharmacology 1 > GI Meds + Intro to Vasopressors - Final Wrapup > Flashcards

Flashcards in GI Meds + Intro to Vasopressors - Final Wrapup Deck (87)
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1

What are the Nausea & Vomiting Pathways?

Medulla

Chemoreceptor Trigger Zone

Vestibular Neural Pathway

Reflex & Midbrain Afferent Pathway

2

What is considered Early PONV?

2-6 Hrs

3

What is considered Late PONV?

6 - 24 Hrs

4

What is Considered Delayed PONV?

> 24 Hrs.

5

What is the population most at risk for PONV?

Non Smoking Female who is younger than 50 years old w/ a PONV hx. 

6

How do risk factors relate to incidence of PONV?

Each risk factor = 20%

No risk factors = 10%

7

Which drugs can cause PONV?

Anesthetic Gas, N2O, and Opioids

8

What are the PONV risk factors for Kids?

> 3 years old

Strabismus Surgery

Surgery > 30 Min

Family Hx

9

What are some Anesthesia Considerations to reduce PONV?

Use Propofol

Regional Anesthesia

NSAIDs over Opiates

10

Should Neostigmine be reduced due to it's PONV side effect?

No, Not Recommended

11

What do you do if PONV pretreatment does not work?

Try medication w/ different MOA

12

Which meds are recommended for Post Discharge N/V?

Dexamethasone

Scopolamine Patch

&

Rescue Meds
(Zofran, Phenergan)

13

Which meds are more effective when given BEFORE Induction?

Dexamethasone

Scopolamine Patch

Aprepitant

Amisulpride (Barhemsys)

 

14

Out of Zofran, Droperidol, and Dexamethasone, which drug is most effective for PONV?

All Equally Effective

15

Which drugs are classified as 5HT3 Antagonists?

5HT3 = Serotonin

Drugs that end in -setron

16

How are 5HT3 metabolized?

CYP450

17

What is the Half Life of Ondansetron?

4 Hrs

18

What is the Half Life of Granisetron?

9 - 11 Hrs

19

What is the Half Life of Dolasetron?

Prodrug

7 - 9 Hrs

20

What is the Half Life of Palonosetron?

40 Hrs

21

What are the Side Effects of 5HT3 Antagonists?

Generally Mild

QTc Prolongation

22

How might Dexamethasone work?

  • Glutocorticoid Receptors in brain reduce emetic activity
  • ↓Prostaglandin Synthesis to reduce GI contraction
  • ↓Serotonin Activity
  • ↓Anti-Inflammatory & Pain Effects
  • ↑ Endorphins
  • Augments other Antiemetics

23

What are the Side Effects of Dexamethasone?

  • Low Risk for Single Dose
  • Long Term use:
    • Impaired wound healing
    • ↑Glucose
    • HTN
    • AMS

24

Which D2 Antagonist is classified as Butyrophenone?

Droperidol

25

What effects does Droperidol have?

Anti-Emetic

Anti-Histamine

Anti-Serotonergic

26

Why is Droperidol normally given Post-Operatively vs Pre-Operatively?

Onset: 5-10 min

Peaks @ 1 Hr.

27

What are the Side Effects of D2 Blockers?

Dysphoria

Hypotension

Extrapyramidal Symptoms

Sedation

QT Prolongation

28

What is Droperidol's Black Box Warning?

QT Prolongation & Sudden Cardiac Death

Rare

Must have ECG Monitoring for 3 hours

29

Which drugs are classified as D2 Phenothiazines?

Promethazine & Prochlorperazine

30

How do Phenothiazines compare to Butyrophenone D2 blockers?

More Highly Sedating & Highly Antihistaminergic

Also Available in Tabs, Gels, Suppository, Liquid