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What are the four sources of N/V?
- GI tract
- Vestibular system
- Chemoreceptor Trigger Zone
- Higher areas of the CNS
What is special about the chemoreceptor trigger zone?
It lacks the blood brain barrier
What are the two main receptors involved in nausea?
- Histamine 1 receptors
- Acetylcholine muscarinic type 1 receptors
What are the receptors that mediate N/V?
- Histamine (H1)
- Muscarinic cholinergic (M1)
______ is a prodrug to ondansetron, and should, therefore, be used prophylactically.
5-HT3 antagonists (dolasetron, granisetron, ondansetron) are not effective in what type of N/V?
What are the 3 primary indications for 5-HT3 antagonists (dolasetron, granisetron, ondansetron)?
- Radiation therapy
What is the single primary use for D2 antagonists?
What are the 3 D2 antagonists?
What is the black box warning for droperidol?
- Psychiatric symptoms (feelings of being trapped inside your body)
- Also a problem with prolonged QT syndrome
What is the black box warning for metoclopramide?
Extrapyramidal side effects
What can you do to combat extrapyramidal side effects?
Treat with diphenhydramine
What are the 4 H1/ACh antagonists?
What are the 3 indications for H1/ACh antagonists?
- Motion sickness
What is the primary indication for the ACh antagonist scopolamine?
What is the indication for the NK1/SP antagonist Aprepitant?
Aprepitant is metabolized by CYP 3A4 and could pose a harmful interaction with what?
Warfarin (can decrease INR)
What is the 1 mentioned benzodiazepine that is primarily used for anticipatory N/V?
- (Can also use diazepam)
What are the 3 phases of emesis?
Dexamethasone has an unknown MOA for relief of N/V. What indications is it useful for?