Term
| What 4 areas provide input to the vomiting center? |
|
Definition
Chemoreceptor trigger zone (CTZ)
Vestibular Apparatus
Cerebral Cortex
Visceral GI tract afferent nerves
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|
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Term
| What drugs commonly induce N&V? |
|
Definition
| Antineoplastics, Opoids/Narcotics, Bronchodilators, Antibiotics, Cardiac Glycosides |
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Term
| What are 5 possible acute complications with N&V? |
|
Definition
Dehydration
Malnutrition
Aspiration
Electrolyte or acid base abnormalities
Esophageal Tears |
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Term
What laboratory tests are there for simple N&V?
complex? |
|
Definition
Simple: NONE
Complex: Electrolyte and Serum Creatinine |
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Term
| What is the 1st tx for N&V caused by gastroenteritis? |
|
Definition
| Usually short lived, but if needed compazine |
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Term
| What is the duration of tx for Chemo Induced N&V? |
|
Definition
| pretreat and continue for up to 72hrs |
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Term
T/F
Post-operative N&V is more common in children |
|
Definition
TRUE
2 times more common than adults |
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Term
| What are the risk factors for PONV? |
|
Definition
Female, Non-smoker, FH is motion sickness or PONV, Long surgeries or use of Nitrous Oxide,
Use of Opiods post-operatively |
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Term
| What dietary changes should be made in pregnant women to avoid N&V? |
|
Definition
Adding fiber for constipation
eat small frequent meals |
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Term
T/F
N&V can be a sign of toxic levels of a bronchodilator |
|
Definition
TRUE
and also cardiac glycosides |
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|
Term
| Most drugs affect which area of the brain? |
|
Definition
CTZ
Chemoreceptor Trigger Zone |
|
|
Term
What typically causes gastroenteritis?
How long does it typically last? |
|
Definition
|
|
Term
What is the most potent opoid?
|
|
Definition
|
|
Term
| People that are known to have PONV should be pretreated with_____. |
|
Definition
|
|
Term
T/F
compazine is useful in treating drug incuced N&V |
|
Definition
|
|
Term
| What drug is contraindicated for children <2yrs? |
|
Definition
|
|
Term
| What is the biggest concern in children with N&V? |
|
Definition
|
|
Term
Who is at higher risk for N&V?
a) 45 yo female, nonsmoker undergoing hysterectomy
b)67 yo male with local anesthesia
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|
Definition
| a) female, non smoker and long surgeries are risk factors for N&V |
|
|
Term
| What class of drugs are primarily used for PONV and CINV? |
|
Definition
5HT3 receptor antagonists
(SSRI) |
|
|
Term
| What are the dosage forms of Compazine (Procholperazine)? |
|
Definition
IV 2.5-10mg
IM 5-10mg
Oral 5mg/ml
Rectal 5, 25 mg |
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Term
What are the biggest issues with Phenothiazines?
Can they be issued PRN? |
|
Definition
sedation
anticholinergic effects (dry mouth)
Extrapyramidal Symptoms (stiffness)
Yes, that is a way to avoid some of the ADE |
|
|
Term
What is a major issue for IV phenergan (promethazine)?
How is this problem avoided? |
|
Definition
Severe tissue damage
Must be diluted and have a good IV |
|
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Term
What are the phenothiazine drugs for N&V? (brand and generic)
What is the best one? |
|
Definition
Compazine (prochloperazine)
Phenergan (promethazine)
Thorazine (Chlorpromazine)
Torecan (Thiethylperazine) |
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|
Term
|
Definition
|
|
Term
What are the Benzamides for N&V? (brand and generic)
What is it primarily used for?
What are the ADE? |
|
Definition
metoclopramide (reglan)
CINV & Gastric motility (at higher doses)
EPS, Sedation, Diarrhea, Never used in Children |
|
|
Term
| What is the dosage of Ondansetron for PONV? |
|
Definition
|
|
Term
| Which is the best 5HT receptor antagonist? |
|
Definition
The are all equally effective
One may be chosen over the other for cost related issues only |
|
|
Term
What are the 5HT receptor antagonist drugs for N&V?
What are the ADE?
What are they primarily used for? |
|
Definition
Ondansetron (Zofran), Granistetron (Kytril), Dolansetron (Anzemet), Palonsetron (Aloxi)
ADE: QT prolongation esp with Aloxi, Torsades
CINV & PONV |
|
|
Term
What are the Butyrophenones used for N&V?
What are the ADE?
What type of N&V are they used for? |
|
Definition
Haliperidol (Haldol)
Droperidol (Inapsin)
QT prolongation
Only used for PreOp if other tx do not work |
|
|
Term
What are the Neurokinin Receptor Antagonists for N&V?
What are some ADE?
What type of N&V are they used for? |
|
Definition
Aprepitant and Fosaprepitant (Emend)
Inhibitor for CYP 3A4 drugs
Only for CINV |
|
|
Term
What are the Antihistamines use for N&V?
What are the ADE?
What are they used for, any exceptions? |
|
Definition
Diphenhydramine (Benadryl), Dimenhydramine (Dramamine), Meclizine (Antivert), Trimethobenzamide (Tigan), Scopolamine (Transderm Scoop)
Sedation, Dry Mouth
Motion Sickness except Tigan can be used for other forms of N&V |
|
|
Term
What Benzodiazepines are used for N&V?
What kind of N&V?
ADE? |
|
Definition
Lorazepam (Ativan)
Anticipatory N&V
Sedation |
|
|
Term
What Cannabinoids are used for N&V?
What kind of N&V?
How is it dosed? What age group has the best effects? |
|
Definition
Dronabinol (Marinol, THC) Nabilone (Cesamet)
CINV
given until CNS changes
Beneficial for younger age groups not effective in the elderly |
|
|
Term
What can be used to tx EPS?
Which is the best? |
|
Definition
Diphenhydramine (Benadryl)
Benztropine (Cogentin) -better |
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