Pharm: Random Topics: Emesis with chemo Flashcards Preview

Clinical Medication: HEENT > Pharm: Random Topics: Emesis with chemo > Flashcards

Flashcards in Pharm: Random Topics: Emesis with chemo Deck (10):
1

Vomiting risk of chemo drugs
High:
Mod:
Low:
Min

•High: cisplatin, cyclophosphamide >1500
•Mod: -rubicin, cyclophaphamide <1500
•Low: -taxel, mitoxantrone, methotrexate
•Min: -tine, beva/rituximab

2

Serotonin (5HT) anatagonists
-
-
-
-
SE

• Ondansetron (zofran), dolasetron (anzemet), granisetron (granisol),
palonosetron (aloxi)-longest half life

SE: QT prolongation, correct hypo kalemia and magnesemia prior

3

Corticosteriods

dexamethasone, methylprenisolone (deop-medrol)

4

Neurokinin 1 receptor antagonist

Aprepitant (EMDEND) can pass thought the BBB to bind to Substance P and NK receptors, used to decreased N/V

5

DA receptor antagonist
drug:
SE:

• Metoclopramide (reglan)
• SE: extrapyridimal symptoms, sedation, restlessness, fatigue- doesn't use a lot due to se

6

➢ Phenothiazines

Phenothiazine: Blocks H1, not histamine
Peochlorperazine (compazine): Inhibits chemotrigger zone

just know its avb

7

➢Cannabiniods

•Dronabinol (marinol)
•Nabilone (cesamet)

8

➢Guideline Overview

➢Guideline Overview

9

Time of onset for N/V:
acute:
delayed:
anticipatory:

-Acute= initial 24hrs after chemo
-Delayed= later than 24hrs after chemo
-Anticipatory=days to hours before chemo

10

Tx for prophylaxis:

Acute:
Delayed:
Anticipatory:

1. Acute
• High= 5-HT antagonist+corticosteroid+aprepitant(EMEND)
• Anthracycline & cyclophosphamide (AC)= 5-HTantagonist+dexamethasone +aprepitant(EMEND)
• Moderate other than AC= 5-HT antagonist+corticosteroid
• Low= corticosteroid
• Minimal= none

2. Delayed
• High= corticosteroid+aprepitant(EMEND)
• Anthracycline & cyclophosphamide (AC)= dexamethasone or aprepitant(EMEND)
• Moderate other than AC= corticosteroid or 5-HT antagonist
• Low= none
• Minimal= none

3. Anticipatory
-just add Lorazepam