N/V Therapeutics

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Question

Answer

What drugs cause N through gastric statis (3):

TCA (amitriptaline); anticholinergics; phenothiazines

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Meds that cause N:

DA agonists, opioids, digoxin, nicotine, chemo (2 MOAs-Seratonin acute and nonseratonin delayed)

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Metabolic causes of N:

uremia, hypoxemia, hyPERcalcemia, DKA, prego, toxin

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Receptors involved in CTZ:

dopamine, seratonin, muscarinic, and histaminic

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Receptors involved in labyrinths:

Muscarinic, histaminic

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Labrinths is what kind of N?

Due to motion sickness

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Peripheral afferents stimuli include?

any direct to GI irritation (Nsaids, ASA, local radiation, iron pills, Abx, toxin)

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Receptor involved in peripheral afferents?

seratonin

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Cerebral cortex has what stimuli?

odors and taste

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Scopalamine: indication; MOA; Counsel: ADR

prevent motion sickness and salivation; anticholinergic; apply 4H before wanted effect to 72Hl and causes DRYNESS

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List the antihistamine drugs:

diphenhydramine; dimehydrinate, meclizine, promethazine, trimethobenzamide

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PO formulations of AH are for?

motion sickness

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IV formulations of AH are for?

generalized N

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DOC AH is?

Promethazine

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ADR?

Burning with peripheral admin and NOT if <2y.o

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Dopamine antagonists are?

Phenothiazines, butyrphenones (haloperidol) benzamides (metoclopramide)

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Indication of metocloprimide?

PCNV prevention

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advantage of phenothiazine?

less sedating

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Advantage of haloperidol?

Long DOA

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Advantage of metocloprimade?

HD - PCNV prevention

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ADR of dopamine receptor antagonists?

EPS, dyskinesia (muscle tighness)

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Tx with?

Diphenhydramine

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What are the seratonin blockesr?

*setron

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Best use?

Cancer CINV/PCNV

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Best to use for delayed PCNV?

Ganisetron patch applied 24H before

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Longest DOA?

Palonosetron

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Advantage?

No EPS

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ADR?

H/A, LFT changes

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Corticosteroids DOC?

Dexamethasone

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Best indication?

Combo with seratonin antag and metocloprimide and for edema

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What are the BZD?

Lorazepam

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Indication?

Anticipatory N in COMBO with something. NEVER USE ALONE.

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Prittinant ADR?

Never with CYP drug; NK1 antagonists for prevention of CINV/PCNV

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Cannaboids example?

Nabilone (expensiive and last resort CINV)

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Compounded regimens, give them both?

ABH (ativan, benadrl, haldol)and RBD (dexameth, reglan, benadryl)

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Prego first line tx?

Vit B6

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If that didn't work?

Add doxylamine (or benadryl) (AH)

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If that didn't work?

Add promethazine (still AH) or dimenhydrinate

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If dehydrated?

Fluid replace; add AH-->methylpred or ondansetron (last)

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If NOT dehydrated?

Add meto or prometh

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Created by: talkglitter2486