Nausea/Vomiting drugs Flashcards Preview

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Flashcards in Nausea/Vomiting drugs Deck (33):
1

What are the receptors targeted by anti emetic drugs

-5-HT3 . . serotonin type-3
-H1
-M1
-D2
-NK1

2

Which of the classes of drugs for vomiting is the only AGONIST

Cannabinoid Receptor Agonist

3

What do Serotonin receptor antagonists end with

Setron

4

Tell me about serotonin receptor antagonists

-Very strong and effective
-Indicated for chemo induced N/V (CINV)
-also Radiation induced, Post-operative, and Pregnancy

5

Most worrisome adverse effect of Serotonin antagonists

-Dose-dependent QT prolongation and Torsade's
-Use extreme caution when other QT-prolonging agents (anti-arrhythmics)

6

Most 5-HT3 receptors have short half-lives . . which is the one that has long half life that lasts 24-40 hours

Palonsetron

7

What do NK1 antagonists end with

Pitant

8

Indications for NK1 antagonists

-moderate antiemetic agents so only used for Chemo and with another agent

9

What are the NK1 antagonists that are used for prophylaxis of post-operative N/V

-only aprepitant and fosaprepitant
-up to 3 hours prior to anesthesia induction

10

Which of the NK1 antagonists have moderate-major active metabolites and longer half lives

Netupitant/Rolapitant

11

What are the H1 receptor antagonists

-Diphenhydramine
-Dimenhydrinate
-Hydroxyzine
-Promethazine
-Meclizine
-Cyclizine

12

Describe the H1 receptor antagonists

-weak antiemetics
-Never used by themselves for chemo
-usually just used for normal run of the mill N/V

13

What are the adverse effects of H1 antagonists

Classic anticholinergic effects
-Dry mouth
-Urinary retention
-Blurred vision
-Sedation

14

H1 antagonists for motion sickness

-Meclizine
-Cyclizine

15

What are the antiemetic D2 antagonists?

-Chlorpromazine
-Perphenazine
-Prochlorperazine
-Metoclopramide

16

what is the D2 antagonist used to stimulate ACh actions in GI, enhanding GI motility and increasing LES tone

Metoclopramide

17

Adverse effects of dopamine receptor antagonists

Classic anticholinergic effects

18

M1 receptor antagonist

Scopolamine

19

Weak antiemetic transdermal patch for motion sickness

Scopolamine

20

Cannabinoid receptor Agonists

-Dronabinol
-Nabilone

21

Strength of Cannabinoid receptor agonists

Strong Antiemetic agents

22

Use for cannabinoids

commonly reserved for TREATMENT RESISTANT clinical scenarios

23

Cannabinoids can be used for appetite stimulation in what patients

-Anorexic patients due to severe disease (Cancer or AIDS)

24

Drug interactions for Cannabinoids

-CNS depressants
-Cardiovascular and sympathomimetics

25

Drug regimen with High Emetogenic chemo

-5 HT3 antagonist
-NK1 antagonist
-Corticosteroid (dexamethasone)

26

In high emetogenic chemo, what do you add on in treatment resistant patients

cannabinoid

27

Drug regimen with moderate emetogenic chemo

-5 HT3 antagonist
-Corticosteroid (dexamethasone)

28

What do you add in moderate emetogenic chemo in treatment resistance

-Add NK1 antagonist
-if still resistant . . add canabinoid

29

Drug regimen with low emetogenic chemo

-Corticosteroid (dexamethasone)

30

Non chemo application: motion sickness

Scopolamine (Patch) or Dimenhydrinate (oral)

31

Non chemo application: vertigo

-Meclizine or Cyclizine

32

Non chemo application: Diabetic Gastroparesis

Metoblopramide

33

Non chemo application: pregnancy induced emesis

STEPPED THERAPY (not adding on but try one . . then try another)
-5-HT antagonist or Histamine antagonist
-Dopamine antagonist
-Steroid or different dopamine antagonist