Term
| causes of nausea and vomiting in adults 10 |
|
Definition
metabolic
neuro
CV disorder
GI disorder
infection
pregnancy
operations
drugs
chemo
emotions |
|
|
Term
| causes of nausea and vomiting in kids 14 |
|
Definition
pyloric stenosis
duodenal ulcer
stress ulcer
adrenal insufficiency
septicemia
disease of pancreas, liver, biliary tree
GI obstruction
increased ICP
overfeeding
rapid feeding
inadequate burping
laying down too soon after feeding |
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|
Term
|
Definition
| immediate need to vomit, gastric stasis |
|
|
Term
|
Definition
| rhythmic action of respiratory muscles (abdominal, inercostal, diaphragmatic) against closed glottis |
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|
Term
|
Definition
| forceful expulsion of gastric contentents caused by GI retroperistalsis, salivation, shivering, vasomotor changes |
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|
Term
| afferent sensory nerves send receptors for nausea and vomiting to 3 |
|
Definition
chemoreceptor trigger zone (CTZ)
cerebral cortex
visceral afferents from pharynx and GI |
|
|
Term
| afferent signals are intergrated by vomiting center in medulla and efferent impulses go to 5 |
|
Definition
salivation center
respiratory center
pharyngeal, GI, abdominal muscles |
|
|
Term
| NT involved in vomiting center, CTZ, GI tract 4 |
|
Definition
| ACH (M), histamine (H1), dopamine (D2), serotonin (5-HT3), opiate receptors |
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|
Term
| categories of drugs that help with nausea and vomiting 5 |
|
Definition
5-HT3 antagonist
dopamine antagonist
antihistamine
anticholinergics
cannabis |
|
|
Term
| 2 5-HT3 antagonists used in nausea and vomitin |
|
Definition
|
|
Term
| 5 dopamine antagonist used in nausea and vomiting |
|
Definition
chlori was a pro, a pro at doing meth, a pro chlori was, she drop it like it hot on the metro, chlori pride
chelrpromazine
promethazine
prochlorperazine
deoperidol
metoclopramide |
|
|
Term
| 2 antihistamines used in nausea and vomiting and their administrations |
|
Definition
meclizine (oral)
diphenhydramine (oral, IM, IV) |
|
|
Term
| 1 anticholinergic used in nausea and vomiting |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| antagonist of central/peripheral 5-HT3 on vagal afferents, NTS, postremia |
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|
Term
| what is the cause of post chemo nausea |
|
Definition
| serotonin released by enterochromaffin cells in SI in response to chemo may stimulate vagal afferents to vomiting reflex |
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|
Term
| odansetron administration 4 |
|
Definition
|
|
Term
|
Definition
most effective for chemo and upper abdominal irridation nausea
effective against hyperemesis of pregnacy
somewhat effective for post-op nausea |
|
|
Term
| how is palonostron different than odansetron |
|
Definition
| has t1/2 40h, longest of serotonins |
|
|
Term
| prochlorperazine, chlorpromazine, promethazine: MOA 3 |
|
Definition
D2 antagonist at CTZ
antihistamine
anticholinergic |
|
|
Term
| prochlorperazine, chlorpromazine, promethazine: use 2 |
|
Definition
most common general antinausea and antiemetic
NOT effective for nausea associated with chemo |
|
|
Term
| prochlorperazine, chlorpromazine, promethazine: SE |
|
Definition
| most common drug to cause drowsiness |
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|
Term
|
Definition
|
|
Term
| droperidol: administration 2 |
|
Definition
|
|
Term
|
Definition
surgical antiemetic
preop med when other tx not effective |
|
|
Term
|
Definition
alters cardiac conduction
sedation
acute dystonia |
|
|
Term
|
Definition
stimulate ACh release from enteric neurons increasing GI motility and LES pressure (prokinetic)
Blocks D3 receptors at CTZ
supresses inhibitor interneurons by antagonizing 5-HT3 receptor
stimulates 5-HT4 receptor
agonist of D2 receptors that inhibit cholinergic neurons |
|
|
Term
| metoclopramide: administration 3 |
|
Definition
|
|
Term
|
Definition
adjunct to PPI and H2 blocker for GERD
gastroparesis (increases gastric emptying)
antinausea
antiemetic |
|
|
Term
|
Definition
chronic use >12wk: tarditive dyskinesia
acute use: acute dystonia (reversible tarditive dyskinesia) or pseudoparkinsonism EPS symptoms |
|
|
Term
| MOA antihistamines for nausea and vomiting |
|
Definition
| H1 antagonist on vestibular afferents in brain stem |
|
|
Term
| use of antihistamines for nausea and vomiting |
|
Definition
|
|
Term
|
Definition
|
|
Term
| scopolamide: administration 2 |
|
Definition
injectable bromide
transdermal patch |
|
|
Term
|
Definition
prevent and tx motion sickness
NO role in chemo nausea |
|
|
Term
|
Definition
| stimulate CB1 cannaboid receptors on neurons in vomiting center |
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|
Term
|
Definition
prophylactic for nausea in chrmo when other antiemetic uneffective
stimulate appetite in AIDS patients |
|
|
Term
|
Definition
central sympathomimetic activity
tachycardia
high |
|
|
Term
| antiemetics used in pregnancy 3 |
|
Definition
antihistamines
odanzatron
promethazine considered |
|
|
Term
| antiemetic used in severe nausea in chemo 3 |
|
Definition
metoclopramide
odanzetron
cannibis |
|
|
Term
| antiemetic used in moderate emesis in chemo 3 |
|
Definition
prochlorperazine
odanzetron
dronabinol |
|
|
Term
| antinausea and antiemetic used in severe chemo |
|
Definition
| combinations of ones for mild and moderate symptoms |
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|
Term
|
Definition
visceral hypersensitvity from alterations to neuroreceptor in afferent spinal neuron function
CNS odulation of afferent input in way that results in long term sensitization of pathways involved in visceral sensation
no structural or biochemical factors |
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|
Term
| IBS associated diseases 5 |
|
Definition
depression
anxiety
chronic fatigue syndrome
functional dyspepsia
fibromyalgia |
|
|
Term
|
Definition
lower abdominal pain
constipation
diarrhea
bloating |
|
|
Term
| tx of constipation predominate IBS 2 |
|
Definition
dietary fiber
psyllium if unable to tolerate dietary fiber |
|
|
Term
| DC tx of constipation predominate IBS and why, MOA, dosing |
|
Definition
tagsarod
heart attacks, severe diarrhea
12wk short term tx
5-HT4 agonist |
|
|
Term
| tx of diarrhea predominate IBS 3 |
|
Definition
psyllium
ipoeramide
avoid triggers |
|
|
Term
| triggers of diarrhea predominate IBS 7 |
|
Definition
caffiene
alcohol
sweeteners: sorbitol, fructose, mannitol
herbal medicines
tea (senna is laxative) |
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|
Term
| tx of IBS with abdominal pain and bloating 2 and MOA |
|
Definition
antispasmotics:
dicylomide
atropine-hyoscyamide-phenobarbitol-scopolamide: anticholinergic DOC for IBS effectiveness not proven |
|
|
Term
| adjnct tx for IBS 2, 2 effects |
|
Definition
TCA, SSRI
help with analgesia with eating
relieve depression |
|
|
Term
| components of bile acids 3 |
|
Definition
cholic acid
chenodeoxycholic acid
deoxycholic acid |
|
|
Term
| functions of bile acids 4 |
|
Definition
induce flow of bile
feedback inhibition of cholesterol synthesis
eliminate cholesterol (promote excretion)
disperase and absorb lipids and fat soluble vitamins |
|
|
Term
|
Definition
|
|
Term
| ursodeoxycholic acid: MOA |
|
Definition
cytoprotective on hepaticytes
functional gallbladder needed: modified by bile
degrades cholesterol monohydrate crystals in 40% |
|
|
Term
| ursodeoxycholic acid: use 2 |
|
Definition
cannot be used for bile acid therapy alone due to unfavorable surface area to size ratio
gall bladder dissolution
cholestatic liver disease |
|
|
Term
|
Definition
| loss of gland function (Exocrine and endocrine), inflammation, and pain |
|
|
Term
| function of pancreatic enzymes |
|
Definition
| protein and fat digestion |
|
|
Term
| how are pancreatic enzymes released |
|
Definition
CCK releasing monitor peptide from duodenum triggers CCK then is degraded by trypsin
CCK stimulates release of pancreatic enzymes |
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|
Term
| effects of chronic pancreatitis on physiology |
|
Definition
trypsin insufficiency increases CCK and causes pain due to continous stimulation of enzymes and increased intraductal pressure
decreased digestive enzymes cases protein maldigestion and seatorrhea when >90% pancreas lost leading to malabsorption and diarrhea |
|
|
Term
| goals of tx of chronic pancreatitis 2 |
|
Definition
prevention of malabsorption
pain relief |
|
|
Term
| 2 drugs used in chronic pancreatitis |
|
Definition
|
|
Term
|
Definition
| delivered to duodenum during 4h period with and after a meal |
|
|
Term
|
Definition
| decrease diarrhea and malabsorption due to pancreatitis |
|
|
Term
|
Definition
| delivered to duodenum and interrupts CCK mediated pain loop |
|
|
Term
| why would lipase and protease be coated or uncoated |
|
Definition
coated: treat malabsorption
uncoated: treat malabsorption and pain |
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