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NURS2514 > Week 2: GI Tract - Antiemetics > Flashcards

Week 2: GI Tract - Antiemetics Flashcards

1
Q

What are the 5 classes of antiemetics?

A
  • Serotonin Receptor Antagonists
  • Glucocorticoids
  • Dopamine Antagonists
  • Cannabinoids
  • Antihistamines/anticholinergics
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2
Q

What is an example of a serotonin receptor antagonist? (2)

A
  • Ondansetron
  • Trade name is Zofran
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3
Q

What is the MOA of Ondansetron?

A
  • Acts on serotonin blocking receptors, making them less available to serotonin
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4
Q

What are the indications of ondansetron? (5)

A

Nausea associated with;
- chemotherapy
- Radiation
- Anesthesia
- Viral gastritis
- Pregnancy

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5
Q

How is ondansetron administered? (2)

A
  • Often used with dexamethasone to increase its effectiveness
  • PO/IV?IM administration
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6
Q

Serotonin receptor antagonists diagram

A
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7
Q

What are the adverse effects of ondansetron? (7)

A
  • HA
  • constipation
  • Diarrhea
  • Dizziness
  • urinary retention
  • Muscle pain
  • QT PROLONGATION
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8
Q

What are nursing considerations for ondansetron? (2)

A
  • Monitor EKG in patients at risk
  • Monitor for effectiveness
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9
Q

Which antiemetic is a glucocorticoid?

A

dexamethasone
- mechanism unknown

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10
Q

How is dexamethasone administered? (3)

A
  • Can be used alone or combined with other antiemetics (ondansetron)
  • PO/IV
  • When used briefly for symptom management of nausea, there are no negative effects

Good for fast relief but not long term

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11
Q

What are the indications of dexamethasone?

A
  • Nausea associated with chemotherapy
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12
Q

Which antiemetic is an example of a dopamine antagonist? (2)

A
  • Metoclopramide
  • Trade name is Maxeran
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13
Q

Metoclopramide is a _____ drug

A

prokinetic

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14
Q

What is the MOA of metoclopramide? (2)

A
  • Blocks dopamine and serotonin receptors in the CTZ
  • Enhances upper GI tract response to Acth (increases peristalsis)
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15
Q

What are the indications of metoclopramide? (5)

A

Nausea caused by:
- post operation
- Cancer medications
- Opioids
- Toxins
- Radiation

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16
Q

What are the adverse effects of Metoclopramide? (2)

A

High doses: diarrhea and sedation are common
Long term use: risk of tardive dyskinesia

17
Q

What is tardive dyskinesia?

A
  • repetitive, involuntary movements of arms, legs, facial muscles
18
Q

What are contraindications of metoclopramide? (3)

A
  • Patients with GI obstruction
  • Perforation
  • Hemorrhage
19
Q

Which medication is an antiemetic in the cannabinoid class?

A

Nabilone

20
Q

What is the MOA of nabilone?

A
  • Mechanism is likely activation of receptors around the vomiting center
21
Q

What are the indications for nabilone?

A
  • used to suppress chemo induced nausea and vomiting
22
Q

Why are cannabinoids considered second line drugs?

A
  • due to psychotomimetic effects and potential for abuse
23
Q

What are nursing considerations for nabilone?

A
  • Monitor for drowsiness
24
Q

What are CNS side effects for nabilone? (2)

A
  • temporal disintegration
  • Dissociation (avoid in pts with psych disorders)
25
Q

What are CVS side effects for nabilone? (2)

A
  • Tachycardia
  • HTN (avoid in pt with CVD)
26
Q

Which medication is an antihistamine used as an antiemetic? (2)

A
  • dimenhydrinate
  • aka gravol
27
Q

What is the MOA of dimenhydrinate?

A
  • Block H1 receptors in the GI tract and muscarinic receptors in the vestibular system (anticholinergic)

It blocks acth, which is the main nt for rest + digest

28
Q

What are the indications for dimenhydrinate? (4)

A

Nausea associated with:
- Motion sickness
- radiation sickness
- Post-op nausea
- drug-induced nausea

29
Q

What are the adverse effects of dimenhydrinate? (5)

A
  • drowsiness
  • dry mouth
  • constipation
  • avoid with other CNS depressants
  • Should not be taken with hx of glaucoma or chronic lung disease, difficulty urinating
30
Q

What are nursing considerations for dimenhydrinate? (4)

A
  • GI assessment
  • Assess alertness (safety)
  • Vital signs (check often with CVD)
  • Monitor for signs of retention (bowel and bladder)
31
Q

Which medication is an antiemetic in the muscarinic antagonist class?

A

Scopolamine

32
Q

What is the MOA of scopolamine? (2)

A
  • Blocks nerve impulses between vestibular apparatus in inner ear and vomiting center
  • MOST effective drug for preventing and treating motion sickness
33
Q

How is scopolamine administered?

A
  • PO/SC?transdermal dosing
34
Q

What are the indications of scopolamine?

A
  • Motion sickness
35
Q

What are the adverse effects of scopolamine? (6)

A

Common:
- Dry mouth
- Blurry vision
- Drowsiness
Less Common:
- urinary retention
- constipation
- disorientation

36
Q

What are nursing considerations of scopolamine? (3)

A
  • GI assessment
  • Monitor for signs of retention (bowel and bladder)
  • Assess alertness (safety)

NURS2514 (32 decks)

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