Term
| complications of emesis-4 |
|
Definition
dehydraiton
electrolytes
nutrients
poor compliance with chemo |
|
|
Term
| what are the 2 big transmitters involved in emesis |
|
Definition
|
|
Term
| what are the 4 places for emesis trnasmitters |
|
Definition
GI
CTZ (chemotrigger zone)
cortex
NTS (nucelus tractor soleus) |
|
|
Term
| what other emesis center stimulates the NTS center? |
|
Definition
|
|
Term
| which zone has the hgihest amnt of emesis recptors? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 24 hrs after cehmo and be for up to 5 days |
|
|
Term
|
Definition
| learned resposne to chemo |
|
|
Term
|
Definition
| nausea thru prophylaxis tx |
|
|
Term
| risk factors for emesis-4 |
|
Definition
| young, female, combo chemo, intrinic emesis potency of chemo |
|
|
Term
| what factor can actually reduce emesis form chemo? |
|
Definition
|
|
Term
| which emesis category dont you use prophylaxis in? |
|
Definition
|
|
Term
| what drug has the highest potenial for delayed emesis and so needs tx for delayed an dacute? |
|
Definition
|
|
Term
| some antiemetic agents with lower therapeutic index-3 |
|
Definition
metoclopromide
benzos
canabinoids |
|
|
Term
| antiemetics wiht high therapeutic index-3 |
|
Definition
corticosteroids
5HT3 recpt antag
subtc P antag |
|
|
Term
|
Definition
block dopamine
prokinetic to increase gut motility
serotonin recpt antag |
|
|
Term
|
Definition
|
|
Term
| anti-emetic effect of metoclopromide is hgiherw hwen compared against-2 |
|
Definition
butryphenones
pehnothiazines |
|
|
Term
| anti-emetic effect of metoclopramide is lower when compared against? |
|
Definition
|
|
Term
| dose for metoclopramide for acute emesis? |
|
Definition
| 2 mg/kg IV before chemco and 2 hrs after |
|
|
Term
| dose for metoclopramide for delayed emesis |
|
Definition
| 20 mg PO q8h 3-5 d post chemo |
|
|
Term
| MOa of phenothiazine derivatives |
|
Definition
|
|
Term
|
Definition
| EPs, hypotension, sedation |
|
|
Term
| what are the pehnothiazine derivatives-2 |
|
Definition
promethazine
prochloperazine |
|
|
Term
|
Definition
|
|
Term
| which is more potent phenothiazines or butyrophenones |
|
Definition
|
|
Term
|
Definition
| EPS (less than phenothiaz!), hypotenion, sedation |
|
|
Term
| what are the butyrophenone derivates-2 |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| sedation, hypotension, hallucinations |
|
|
Term
| derivatives fo canabinoids-2 |
|
Definition
|
|
Term
|
Definition
anteretrograde amneisa
decrease anxiety |
|
|
Term
|
Definition
| amnesia, sedation, hypotension |
|
|
Term
| what is the bezo used for emesis |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| minimal if short duration |
|
|
Term
| what to watch for when giving corticosteroids-3 |
|
Definition
diabetes
take with meals/milk
demarginaiton (increase in WBC) |
|
|
Term
| MOA of 5HT3 recot antag-2 |
|
Definition
central serotonin antag
peripheral antag |
|
|
Term
| ADRs of 5HTH3 recpt antag-3 |
|
Definition
| headahce, transient trnasaminase elvvtion, constipation |
|
|
Term
| 5HT3 antagonists, oral and IV routes are similar effiacy, and simlar effiacy among all the different 5HT3 antags* |
|
Definition
|
|
Term
what is the 5HT3 antag with longest half life?
what metabolizes this? |
|
Definition
|
|
Term
| palonosetron (Aloxi) ADRs-3 |
|
Definition
| constipation, headahce, prolong QT interval |
|
|
Term
| dont repeat palonosetron (Aloxi) witin how mnay days? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| aprepitant (Emend) is indicated for prevention/tx for highly risk drugs |
|
Definition
|
|
Term
|
Definition
| nausea, consitpation, loss of appetite, elevated LFTs |
|
|
Term
Aprepitant is metab by?
so ocntrainidcated with?-3 |
|
Definition
CYP 3A4
terfenadine, cisapride, astemizole |
|
|
Term
| Aprepitant may lower plasma conc of?-3 |
|
Definition
| warfarin, phenytoin, oral contraceptive |
|
|
Term
|
Definition
| prevention of nauesea with lsowest dose |
|
|
Term
| *prophylactic is improtant fro delayed emesis (cyclophos, cisplatin, anthracyclines)*** |
|
Definition
|
|
Term
High risk Chemo drug:
prevention of acute emesis- 2 diff plans
(know the AC regi same for breast cancer pt) |
|
Definition
1) aprepitant, 5HT3 antag, and dexmethasone
2) 5HT3 anatg and dexmethasone |
|
|
Term
Prevention of anti-emetic high risk:
delayed emesis -3 |
|
Definition
aprepitant + dexmethasone (***dont give aprepitant day 2 and 3 if fosaprepitatng iven Day 1)
5HT3 antad + dex for 4 days
metoclopramide and dex for 4 days |
|
|
Term
prevention of emesis for mod risk drug
acute: |
|
Definition
5HT3 antag + dexmethasone
(esp if drug is cyclophosphamide) |
|
|
Term
| prevention of emesis for mod risk drug for deleayed -3 |
|
Definition
dexmethasone 8 mg for 3 days
metoclpmaide, 5HT3 antag |
|
|
Term
prevention for emesis for low risk drug:
acute-3 |
|
Definition
| dexmethasone, prochloperaizine, meotclopramide |
|
|
Term
| slide 38 has oral cancer meds that need rpophylaxis |
|
Definition
|
|
Term
| tx for anticipatory emesis-2 |
|
Definition
lorazpeam PO night before and morning of
aplprazolam TID night before |
|
|
Term
| slide 41-meds for breakthrough emesis!!! |
|
Definition
|
|
