Nausea and Vomiting andGI Infections

Question 1

what are the 4 steps of management of C.diff infection?

Answer 1

1. stop giving abx if possible
2. isolate patient
3. givespecific anti C.diff abx
4. other measures e.g. probyotics

Question 2

what are specific anti-C.diff abx?

Answer 2

metronidazole
vancomycin
fidaxomicin

Question 3

name 2 abx that increase risk of C.diff

Answer 3

co-amoxiclav

clarithromycin

Question 4

antibiotic-associated colitis is caused by what bacteria?

Answer 4

Gr+ anaerobe C.difficile

Question 5

what class of drug is cyclizine and what is it good for treating?

Answer 5

antihistamine (H1 receptor antagonist)

good for drug-induced vomiting

Question 6

what type of N&V might you use antimuscarinics such as hyoscine for?

Answer 6

motion sickness and
postoperative vomiting.
good at reducing secretions if people are vomiting up a lot of secretions due to bowel obstruction

Question 7

what mgiht be a good choice of antiemetic in someone vomiting induced by radiotherapy, drugs and surgery?

Answer 7

dopamine receptor antagonists e.g. metoclopramide, prochlorperazine, domperidone

Question 8

what groups of patients should you avoid metoclopramide in?

Answer 8

young women because it can cause extra-pyramidal side effects and in parkinsons patients because it’s a dopamine antagonist

Question 9

what situations is ondansetron a good choice as an anti-emetic?

Answer 9

acute vomiting induced by chemotherapeutic agents (e.g. cisplatin and for post-operative vomiting)
can be used for prophylaxis before surgery when consequences of vomiting or retching could be particularly harmful e.g. after eye surgery.

Question 10

what is a side effect of ondansetron which means you may not want to give it to someone with colicky pain?

Answer 10

it’s constipating

Question 11

what are weak anti-emetics but produce addivitve effects wehn given with other anti-emetic drugs?

Answer 11

corticosteroids

Question 12

what anti-emetics are safe in pregnancy?

Answer 12

promethazine
metoclopramide
pyridoxine

Question 13

which two anti-emetics should you not give together as they prevent eachother working?

Answer 13

cyclizine and metoclopramide

Question 14

why is it not a good idea to use metoclopramide when there is constipation or bowel obstruction?

Answer 14

not good when there is constipation and partial bowel obstruction because it is a pro-kinetic so could worsen colic and increase risk of perforation