nausea and vomiting pharm

Question 1

Serotonin (5-HT3) Receptor Antagonists

Answer 1

• strong antiemetic
• end with “setron”
• risk of serotonin syndrome when combined with other 5HT affecting drugs
• dose dependent QT prolongation

Question 2

Dolasetron

Answer 2

• Serotonin (5-HT3) Receptor Antagonists

- high risk of dose dependent QT prolongation (Torsades)

Question 3

Granisetron

Answer 3

-Serotonin (5-HT3) Receptor Antagonists

Question 4

Ondansetron

Answer 4

-Serotonin (5-HT3) Receptor Antagonists

Question 5

Palonosetron

Answer 5

-Serotonin (5-HT3) Receptor Antagonists

Question 6

Neurokinin (NK1) Receptor antagonists

Answer 6

• end with “pitant”
• moderate antiemetic
• chemotherapy induced NV
• mild GI and CNS AE

Question 7

Aprepitant

Answer 7

• Neurokinin (NK1) Receptor antagonists

- PROPHYLAXIS of post-op NV

Question 8

Fosaprepitant

Answer 8

-Neurokinin (NK1) Receptor antagonists

Question 9

Netupitant

Answer 9

• Neurokinin (NK1) Receptor antagonists

- moderate CYP450 inhibitor

Question 10

Fosnetupitant

Answer 10

-Neurokinin (NK1) Receptor antagonists

Question 11

Rolapitant

Answer 11

• Neurokinin (NK1) Receptor antagonists

- moderate CYP450 inhibitor

Question 12

Histamine (H1) Receptor Antagonists

Answer 12

• weak antiemetic
• anticholinergic activities
• can cause dry mouth, drowsiness, constipation, urinary retention….

Question 13

Diphenhydramine

Answer 13

-Histamine (H1) Receptor Antagonists

Question 14

Dimenhydrinate

Answer 14

-Histamine (H1) Receptor Antagonists

Question 15

Hydroxyzine

Answer 15

-Histamine (H1) Receptor Antagonists

Question 16

Promethazine

Answer 16

-Histamine (H1) Receptor Antagonists

Question 17

Meclizine

Answer 17

• Histamine (H1) Receptor Antagonists
• oral only!
• only indicated for motion sickness/vertigo

Question 18

Cyclizine

Answer 18

• Histamine (H1) Receptor Antagonists
• oral only!
• only indicated for motion sickness/vertigo

Question 19

Doxylamine

Answer 19

• Histamine (H1) Receptor Antagonists
• REQUIRES VIT B6
• Indicated for pregnant pt

Question 20

Dopamine (D2) Receptor Antagonists

Answer 20

• weak-moderate antiemetic

- anticholinergic activity

Question 21

Chlorpromazine

Answer 21

• Dopamine (D2) Receptor Antagonists

- phenothiazine

Question 22

Perphenazine

Answer 22

• Dopamine (D2) Receptor Antagonists
• phenothiazine
• oral only!

Question 23

Prochlorperazine

Answer 23

• Dopamine (D2) Receptor Antagonists

- phenothiazine

Question 24

Metoclopramide

Answer 24

• Dopamine (D2) Receptor Antagonists

- stimulates ACh in GI, generates peristalsis (diabetic gastroparesis)

Question 25

Haloperidol, olanzipine, trimethobenzamide

Answer 25

- Dopamine (D2) Receptor Antagonists | - mostly used in psych

Question 26

Scopolamine

Answer 26

- M1 muscarinic receptor antagonist - 72hr active transdermal patch - weak antiemetic, used for motion sickness - SIGNIFICANT anticholinergic activity

Question 27

Cannabinoid (CB) Receptor AGONISTS

Answer 27

- synthetic derivatives of THC - decreases excitability of neurons - strong antiemetic - indicated for treatment resistant CINV

Question 28

Dronabinol

Answer 28

- Cannabinoid (CB) Receptor AGONISTS - Schedule III - large first pass effect

Question 29

Nabilone

Answer 29

- Cannabinoid (CB) Receptor AGONISTS - Schedule II - Metabolized into multiple active compounds