Seegars - Drugs for Nausea & Vomiting

Question 1

drug endings of serotonin receptor agonists

Answer 1

-setron

Question 2

drug endings of neurokinin receptor agonists

Answer 2

-pitant

Question 3

only 5-HT receptor agonist that is not an antiemetic

Answer 3

alosetron

Question 4

most worrisome AE of 5-HT receptor agonists

Answer 4

QT prolongation & torsades

Question 5

5-HT RA with longest T1/2

Answer 5

Palonsetron (40h)

Question 6

only NK1 RA that can be given IV

Answer 6

fosaprepitant

Question 7

NK1 RAs are used with what other drugs for CINV

Answer 7

• glucocorticosteroids

- 5-HT RAs

Question 8

therapeudic uses of NK1 RAs

Answer 8

• CINV

- prophylaxis for PONV (3 hrs prior to induction)

Question 9

H1 RAs

Answer 9

• diphenhyramine
• dimenhydrinate
• hydroxyzine
• promethazine
• meclizine
• cyclizine

Question 10

AEs of blocking H1 receptors

Answer 10

varying levels of anticholinergic properties

Question 11

only indication for meclizine & cyclizine

Answer 11

motion sickness/vertigo

Question 12

promethazine black box warnings

Answer 12

-resp distress in kid

Question 13

D2 RAs

Answer 13

• chlorpromazine
• perphenazine
• prochlorperazine
• haloperidol
• trimethobenzamine
• metoclopramide

Question 14

D2 RA that is off-lable/2nd line tx for CINV

Answer 14

haloperidol

Question 15

D2 RA that enhances GI motility and increases LES tone

Answer 15

metoclopramide

Question 16

AEs of D2 RAs

Answer 16

• classic anticholingergic effects

- extrapyramidal side effects (dyskinesias)

Question 17

drug interactions of D2 RAs

Answer 17

• other drugs with anticholinergic effects
• antiarrhythmics
• antiHTNs

Question 18

muscarinic (M1) receptor antagonists

Answer 18

scopolamine

Question 19

unique mode of delivery of scopolamine

Answer 19

patch > worn for 72 h

Question 20

drug used for motion sickness

Answer 20

scopolamine

Question 21

AEs of M1 RAs

Answer 21

classic anticholinergic effects

Question 22

cannabinoid receptor agonists

Answer 22

• droabinol

- nabilone

Question 23

cannabinoid RAs are reserved for tx of what?

Answer 23

CINV that doesn’t respond to other drugs (its a scheduled drug!)

Question 24

MOA: cannabinoid RAs

Answer 24

-stim central (CB1) and peripheral (CB2) cannabinoid receptors in VC/CTZ

Question 25

pharmicokinetics of cannabinoid RAs

Answer 25

- short onset time | - long DOA (24h)

Question 26

highly emetogenic 3 drug regimen (ASCO guidelines)

Answer 26

- 5-HT RA - NK1 RA - corticosteroid (dexamethazone/methyorednisolone)

Question 27

when do you give the 3 drug ASCO guideline therapy?

Answer 27

- prior to chemo | - up to 3-5 days post chemo

Question 28

moderately emetogenic 2 drug regimen (ASCO guidelines)

Answer 28

- 5-HT receptor antagonist | - corticosteroid

Question 29

mild emetogenic 1 drug regimen (ASCO guidelines)

Answer 29

corticosteroid

Question 30

3 MC drugs given for PINV

Answer 30

- any 5-HT RA - metoclopramide - diphenhydramine