Nausea And Vomiting Quiz

Olanzapine is a medication that works on multiple receptors in the brain, including dopaminergic, serotonergic, muscarinic, and histaminic receptors. These receptors play a role in regulating nausea and vomiting (N/V). By affecting these receptors, olanzapine can help alleviate N/V symptoms. Therefore, the statement that "Olanzapine works for N/V because it works on multiple dopaminergic, serotonergic, muscarinic, and histaminic receptors" is true.

5-HT3 antagonists are a class of drugs that work by blocking the action of serotonin (5-HT3) receptors. These receptors are found in both the gastrointestinal (GI) tract and the medulla, which is a part of the brainstem. By blocking these receptors, 5-HT3 antagonists can prevent the activation of enterochromaffin cells in the GI tract, which are involved in the release of serotonin. Additionally, blocking serotonin receptors in the medulla can help to reduce nausea and vomiting, making 5-HT3 antagonists useful in the treatment of these symptoms. Therefore, the statement that 5-HT3 antagonists work by blocking enterochromaffin cells in the GI and blocking serotonin receptors in the medulla is true.

High risk is when the Aprepitant 40mg would be used.

Dexamethasone, a medication commonly used to reduce inflammation, can cause temporary burning sensations in the perineal area, vagina, and kidneys when administered intravenously. To minimize discomfort, it is recommended to administer the medication at a slow rate. Therefore, the statement "Dexamethasone can cause transient perineal, vaginal, and renal burning so it should be at a slow rate for IV administration" is true.

Dexamethasone is a corticosteroid medication that is commonly used to treat inflammation and suppress the immune system. It has been found to be effective in reducing nausea and vomiting (N/V) in both acute and delayed cases. This is especially useful in patients undergoing chemotherapy or radiation therapy, as these treatments often cause severe nausea and vomiting. Therefore, the statement that dexamethasone is used in acute and delayed N/V is true.

Dexamethasone interacts with Warfarin and the INR should be checked during concomitant use. Dexamethasone can increase the effects of warfarin sou counsel the patient to watch for dark stools.

Aprepitant is a medication commonly used to prevent postoperative nausea and vomiting (PONV). It belongs to a class of drugs known as neurokinin-1 receptor antagonists. The timing of administration is crucial for its effectiveness. Giving Aprepitant within 3 hours prior to the induction of anesthesia ensures that the drug reaches peak concentration in the body by the time surgery begins. This allows it to effectively block the neurokinin-1 receptors and prevent the occurrence of PONV. Therefore, the statement "When used for PONV, Aprepitant should be given within 3 hours prior to induction" is true.

NK1RAs block binding of Substance P in the CNS and GI to treat N/V.

They are approved for CINV and PONV.

Acute N/V (nausea and vomiting) refers to the sudden onset of these symptoms. The correct answer, 24 hours, suggests that acute N/V typically occurs within the first day after a triggering event or condition. This timeframe aligns with common causes of acute N/V such as food poisoning, viral gastroenteritis, or adverse reactions to medications. It is important to note that this is a general guideline and individual experiences may vary.

Lorazepam is the drug of choice for anticipatory N/V because it is a benzodiazepine that acts as an anxiolytic and antiemetic. It helps to reduce anxiety and prevent nausea and vomiting that can occur before a chemotherapy session or surgery. By calming the patient's nerves, Lorazepam can effectively alleviate anticipatory N/V symptoms. Olanzapine, Metoclopramide, and Aprepitant may also be used to treat N/V, but Lorazepam is specifically recommended for anticipatory N/V.

Palonsetron is the correct answer because it is a 5HT-3 receptor antagonist that is used for both acute and delayed nausea and vomiting (N/V). It is commonly prescribed to prevent and treat N/V caused by chemotherapy and radiation therapy. Palonsetron works by blocking the action of serotonin, a neurotransmitter that triggers N/V. It has a longer half-life compared to other 5HT-3 receptor antagonists, making it effective in preventing delayed N/V as well.

Palonsetron does not need to be given daily due to long half life.

The typical dose and route for Promethazine for CINV is 12.5-25mg, which can be administered intravenously, orally, intramuscularly, or rectally every 4-6 hours according to a schedule or as needed.

IV 5HT-3 antagonists should be given 30 minutes prior to chemotherapy, while PO (oral) 5HT-3 antagonists should be given 60 minutes prior to chemotherapy.

Zofran 32 mg is too high. Dexamethasone when used with an NK1RA, the dose needs to be 12mg.

Used in combo with 5-HT3 and steroids for prevention of highly emetogenic chemotherapy.

The PO dosing of Palonsetron is in a combo product.

Metoclopramide has a black box warning for irreversible tardive dyskinesias. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and extremities. It is a potentially irreversible condition that can occur with the long-term use of certain medications, particularly antipsychotics and metoclopramide. The black box warning is the strongest warning issued by the FDA, indicating the serious and potentially life-threatening risk associated with the use of metoclopramide. Therefore, it is important for healthcare providers to carefully consider the risks and benefits before prescribing metoclopramide to patients.

The three drugs should be taken 1 hour prior to chemo.

Ondansetron 32mg can cause QT prolongation. This is the correct dosing for dexamethasone in combo with any NK1RA.

Granisetron is a medication commonly used for the prevention and treatment of postoperative nausea and vomiting (PONV). The recommended dose of Granisetron for PONV is 0.5-1mg administered intravenously at the end of surgery. This dose helps to control nausea and vomiting that may occur after the surgical procedure. Administering the medication at the end of surgery allows for optimal effectiveness in preventing PONV.

Promethazine is a medication commonly used for the prevention and treatment of postoperative nausea and vomiting (PONV). The correct dosing for Promethazine in PONV is 12.5-25mg IV at the end of surgery. This means that the medication should be administered intravenously in a dosage range of 12.5 to 25 milligrams at the conclusion of the surgical procedure. This timing allows for the medication to take effect and help prevent or alleviate any nausea and vomiting that may occur after surgery.

Can also be take 1 dose prior to chemo

Droperidol is the correct answer because it has a black box warning for QT prolongation. A black box warning is the strongest warning issued by the FDA, indicating that a drug carries a significant risk of serious or life-threatening side effects. QT prolongation is a condition that affects the heart's electrical activity and can lead to a potentially dangerous irregular heartbeat. Therefore, it is important to be cautious when prescribing or using droperidol due to this known risk.

Must dilute with 10mL NS if giving IV. Try to use oral if possible.

Dolasetron is only available PO.

Prochlorperazine is a medication commonly used for the prevention and treatment of postoperative nausea and vomiting (PONV). The correct dosing for Prochlorperazine in PONV is 5-10mg intravenously (IV) at the end of surgery. This timing ensures that the medication is administered after the surgical procedure is completed, reducing the risk of PONV during the immediate postoperative period. The dose range of 5-10mg allows for individualized treatment based on the patient's needs and response to the medication. IV administration is preferred for faster onset of action and reliable absorption.

Dexamethasone works synergistically with Metoclopramide and 5-HT3 antagonists to increase effectiveness by 20-30%. This means that when Dexamethasone is combined with these medications, their overall effectiveness is enhanced and they work better together than if used individually. The combination of Dexamethasone with Metoclopramide and 5-HT3 antagonists leads to a greater therapeutic effect, potentially improving patient outcomes.

ALL patients should have a PRN option. If one fails, try another or add. Use IV or PR formulations for uncontrolled N/V.

The receptors that 5-HT3 antagonists work on will eventually become saturated and the response will plateau and you will not get any greater response with increasing the dose. You will however increase the side effects risk.

To avoid QT prolongation, the dose of ondansetron should not exceed 32 mg/dose. QT prolongation is a condition where the heart takes longer than usual to recharge between beats, which can lead to abnormal heart rhythms. Ondansetron is a medication commonly used to prevent nausea and vomiting. However, it has been associated with QT prolongation at higher doses. Therefore, to minimize the risk of this side effect, the recommended maximum dose of ondansetron is 32 mg per dose.

They are effective for acute CINV, with the exception of Palonsetron which is effective for both acute and delayed CINV.

The typical dose and route for prochlorperazine for CINV is 10mg IV/PO q6h scheduled or PRN. This means that the recommended dose is 10mg, which can be administered either intravenously or orally every 6 hours as scheduled or as needed. This dosage regimen allows for flexibility in the administration of the medication based on the patient's symptoms and response to treatment.

The correct dosing and route for Fosaprepitant for CINV is 150mg IV. This means that Fosaprepitant should be administered intravenously at a dose of 150mg.

Dolasetron is a medication used to prevent postoperative nausea and vomiting (PONV). The correct dose of Dolasetron in PONV is 12.5mg IV at the end of surgery. This dose is administered intravenously and is effective in reducing the incidence of PONV. Higher doses, such as 100mg or 125mg, are not necessary and may increase the risk of side effects. A lower dose of 25mg may not provide sufficient antiemetic effect. Therefore, the recommended dose is 12.5mg IV at the end of surgery.

The correct answer is 4mg IV at end of surgery. Ondansetron is commonly used to prevent postoperative nausea and vomiting (PONV). The recommended dose for PONV is 4mg administered intravenously at the end of surgery. This timing ensures that the medication is in the patient's system when they wake up, reducing the likelihood of experiencing nausea and vomiting as a result of anesthesia. Higher doses (8-16mg) may be used in certain cases, but the standard dose is 4mg.

It is used for this purpose but it is not FDA approved for this purpose.

Dexamethasone is a corticosteroid commonly used to prevent postoperative nausea and vomiting (PONV). The recommended dose of Dexamethasone in PONV is 2.5-5mg IV at induction. This means that the medication should be administered intravenously (IV) at the beginning of the surgery to help prevent nausea and vomiting from occurring during the postoperative period. The dose range of 2.5-5mg is considered effective in reducing the incidence of PONV.

This drug also has a long half life (180 hours)!

The risk factors for Chemotherapy Induced Nausea and Vomiting (CINV) include being under the age of 50, being female, having infrequent alcohol use, having a history of motion sickness, and having prior exposure to chemotherapy. These factors have been found to increase the likelihood of experiencing nausea and vomiting as a side effect of chemotherapy treatment.

Palonosetron is a medication used to prevent post-operative nausea and vomiting (PONV). The correct dose of Palonosetron in PONV is 0.075mg IV at induction. This means that the medication should be administered intravenously at the beginning of the surgery. This dose is effective in preventing nausea and vomiting that may occur after the surgery. It is important to administer the correct dose at the right time to ensure its effectiveness in managing PONV.

A way to help you remember: IV starts at 8 and you add 8 for the max (16). PO starts at the max of IV (16) and you add 8 again for the max (24)

Palonsetron, Olanzapine, Aprepitant, and Dexamethasone can be used for delayed N/V. These drugs are commonly prescribed to prevent and treat delayed nausea and vomiting, which can occur after chemotherapy or surgery. Palonsetron is a serotonin receptor antagonist that helps in reducing nausea and vomiting. Olanzapine, an antipsychotic medication, has antiemetic properties and is effective in managing delayed N/V. Aprepitant is a neurokinin-1 receptor antagonist that works by blocking the signals that trigger nausea and vomiting. Dexamethasone, a corticosteroid, helps in reducing inflammation and suppressing the immune system, thereby alleviating symptoms of delayed N/V.

Reduces the effectiveness of oral contraceptives so patients need to use back up birth control for at least one month after using aprepitant or fosaprepitant. Aprepitant can increase the INR with Warfarin. The coritcosteroid DDI is why the dexamethasone dose needs to be decreased.

Granisetron is a medication commonly used for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV). The correct dosing and route for Granisetron for CINV are as follows: 2mg PO (oral administration), 1mg IV (intravenous administration), and 3.1mg/hr topically (patch). These routes and doses are appropriate for managing CINV and can provide effective relief for patients undergoing chemotherapy.

Lorazepam, Promethazine, Prochlorperazine, and Dronabinol are all drugs that can be used for acute N/V. Lorazepam is a benzodiazepine that can help relieve nausea and vomiting by reducing anxiety. Promethazine and Prochlorperazine are both antiemetic medications that can help control nausea and vomiting. Dronabinol is a synthetic form of THC, the active component of marijuana, and is used to treat chemotherapy-induced nausea and vomiting. Therefore, the correct answer is Olanzapine, which is an antipsychotic medication and is not typically used for acute N/V.

The neurotransmitters involved in N/V (nausea/vomiting) include dopamine, histamine, endorphins, serotonin, acetylcholine, substance P, and GABA. Nausea and vomiting can be caused by a variety of factors, including imbalances in these neurotransmitters. Dopamine, histamine, serotonin, and substance P are known to play a role in the chemoreceptor trigger zone (CTZ) in the brain, which is responsible for initiating the vomiting reflex. Endorphins, acetylcholine, and GABA can also contribute to nausea and vomiting by affecting the gastrointestinal tract and the central nervous system. Norepinephrine and glutamate are not typically associated with N/V.

Carboplatin, cyclophosphamide, and cisplatin are known to cause significant delayed nausea and vomiting (N/V) as side effects. These drugs are commonly used in chemotherapy treatments for various types of cancer. The delayed onset of N/V can occur several hours to days after the administration of these drugs and can significantly impact the patient's quality of life. Doxorubicin, vincristine, and etoposide, on the other hand, are not typically associated with significant delayed N/V.