NVDC Tx I Flashcards Preview

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Flashcards in NVDC Tx I Deck (58)
1

What are the 2 groups of D2 R antagonists antimetics

substituted benzamides and phenothiazines

2

what is the substituted benzamide antimetics

metoclopramide

3

what are the phenothiazines antimetics

prochlorperazine

4

what are the antihistamines antimetics

diphenhydramine
promethazine

5

what are the antimuscarinic anitmetics

scoppolamine

6

what are the cannabinoid antimetics

dronabinol

7

what are the opiod antidiarrheal

loperamide

8

what are the mucosal protective agents for antidiarrhea

bismuth subsalicylate

9

what are the types of laxatives

bulk forming
osmotic
stimulant
stoof softners

10

what are the osmotic laxatives

saline and polyethylene glycol-electrolytes

11

what are the prokinetic (pro motility agents)

metoclopramide

12

what R are found in the vomiting center

Ach Muscarinic, histmaine, neurokinin1 and serotonin

13

MOA ondansetron

blocks central serotonin R in vomiting center and chemR trigger zone and on peripheral extrinsic vagal and spinal afferent nn

14

how is ondansetron taken and where is majoirty metabolized

PO or IV
hepatic metabolism

15

therapeutic use ondansetron

acute chemotherapy induced nausea and vomiting
post operative and post radiation

16

how cna you increase efficacy of ondansetron

when used in combination with corticosteroid and NK R antagonist

17

adverse effects ondansetron

HA, dizziness, constipation
QT prolongation

18

drug interactions with ondansetron

no significant ones

19

MOA metoclopramide and prochlorperazine

block D2-like R in CTZ and solitary tract nucleus

20

therapeutic use metoclopromide

chemo induced emesis

21

therapeutic use phenothiazine

general purpose antiemetic
antihistaminic and antichoinergic activities

22

adverse effects metoclopromide

cross bbb so restlessness, dystonias, parkinsonian Sx

23

adverse effects chronic use phenothiazine

hypotension, sedation, hyperprolactinemia, extrapyramidal movement disorders

24

MOA antihistamines

H1 antagonism with anticholinergic and antidopaminergic properties

25

therapeutic use of antihistamines

mostion sickness
post operative nausea and vomiting
suppress vertigo

26

adverse effects antihistamines

dizziness, sedation, confusion, drymouth and urinary retention

27

MOA scopolamine

prototypical cholinergic antagonis

28

therapeutic use scopalamine

motion sickness

29

adverse effects scopolamine

anticholinergic effects
better tolerated as transdermal patch

30

MOA cannabinoids

unknown, maybe stimulation of central CB1 R

31

therapeutic use cannabinoids

appetite stimulant and antiemetic

32

adverse effects cannabinoids

euphoria, dysphoria, sedation, hallucinations, dry mouth, increased appetite
tachycardia, conjunctival injection and orthostatic hypotension

33

What is prototype neurokinin R antagonist

aprepitant

34

MOA aprepitant

substance P is a peptide NT that is highly selective. crosses bbb

35

therapeutic use NK R antagonist aprepitant

used in combo with serotonin antagonists and corticosteroids for acute delayed nausea and vomiting

36

adverse effects NK R antagonists

fatigue, dizziness, diarrhea

37

drug interatctions NK R antagonists

CYP3A4
Will decrease INR in warfarin patients

38

prototype corticosteroids

dexamethasone

39

MOA dexamethasone

exact antiemetic mech unknown, may involve suppression of inflammation and PG production

40

therapeutic use dexamethasone

increase efficacy of serotonin antagonist for prevention acute and delayed nausea and vomiting in those having chemo.
post operative nausea and vomiting prevention

41

what are the benzodiazepines

lorazepam, alprazolam, diazepam

42

Acute nausea and vomiting definition from chemo

within 24 hours chemo

43

delayed definition chemo

nausea and vomtiing after 24 hours

44

anticipatory deficinition for chemo vomitiing

prior to chemo
learned, conditioned, usually by 4th cycle

45

risk factors for anticipatory vomiting and nause with chemo

<50y.o, nausea, vomiting after previous chemo, sweating, susceptibility to motion sickness

46

breakthrough emesis with chemo

emesis despite prophylactic antiemetic administration (need rescue agents)

47

refractory emesis with chemo

poor response to multiple antiemetic regimens

48

drug regimen for acute CINV highly emetogenic

day1: serotoni R antagonist + NK R antagonist+glucocorticoid
day 2: NKR antagonist+ glucocorticoid
day3: NKR antagonist
day4: glucocorticoid

49

moderate emetogenic chemo for acute CINV

day 1: 2 drug regimen of serotonin R antagonist+glucocorticoid
day 3: glucocorticoid

50

drug for acute CINV low emetogenic chemo

dexamethasone +
prochlorperazine or metoclopramide
or diphenhydramine
or lorazepam

51

anticipatory NV prophylaxis

alprazolam or lorazepam night before and morning of

52

rescue mediations for breakthrough/refractory CINV

prochlorperazine, promethazine, lorazepam, metoclopramide, serotonin antagonist, desxamethasone, cannabinoids

53

Post operative Tx for Nausea and vomitiing

serotonin antagonists, prochlorperazine, metoclopramide, haloperidol

54

when to administer dexamehtasone for post operative NV prevention

at time of anesthesia

55

what is used for mild to moderate motion sickness

promethazine

56

initial management for vomiting from pregnancy

dietary changes and lifestyle modificaion

57

persistant vomiting during pregnancy Tx

1st line: pyridoxine
dehydration Sx: IV and thiamine
ondansetron IV prn

58

when to use corticosteroids for pregnancy assoc nausea and vomiting

reserved for refractory Sx or hyperemesis gravidarum