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Questions and Answers
Which mechanism of action is characteristic of anticholinergic antiemetics?
Which mechanism of action is characteristic of anticholinergic antiemetics?
- Stimulating peristalsis in the GI tract.
- Blocking dopamine receptors in the chemoreceptor trigger zone (CTZ).
- Blocking acetylcholinesterase receptors in the vestibular nuclei and reticular formation. (correct)
- Blocking serotonin receptors in the GI tract, CTZ, and vomiting center.
What is a primary therapeutic effect of prokinetic antiemetics such as metoclopramide?
What is a primary therapeutic effect of prokinetic antiemetics such as metoclopramide?
- To inhibit the reticular formation, thalamus, and cerebral cortex.
- To reduce gastric secretions and smooth muscle spasms.
- To block histamine receptors in the vestibular and reticular systems.
- To stimulate peristalsis in the GI tract, enhancing gastric emptying. (correct)
Serotonin-blocking antiemetics are MOST commonly used for which condition?
Serotonin-blocking antiemetics are MOST commonly used for which condition?
- Motion sickness.
- Postoperative nausea and vomiting.
- Delayed gastric emptying.
- Chemotherapy-induced nausea and vomiting. (correct)
What is a significant adverse effect associated with dronabinol when used as an antiemetic?
What is a significant adverse effect associated with dronabinol when used as an antiemetic?
Why is the intravenous route NOT recommended for promethazine?
Why is the intravenous route NOT recommended for promethazine?
A patient is prescribed an anticholinergic antiemetic. Which of the following side effects should the nurse anticipate?
A patient is prescribed an anticholinergic antiemetic. Which of the following side effects should the nurse anticipate?
What is the MOST important nursing consideration when administering antiemetic drugs to a patient?
What is the MOST important nursing consideration when administering antiemetic drugs to a patient?
Which patient condition would require cautious use of antidopaminergic antiemetics?
Which patient condition would require cautious use of antidopaminergic antiemetics?
A patient receiving chemotherapy is prescribed ondansetron. What specific parameter should the nurse monitor to assess the drug's effectiveness?
A patient receiving chemotherapy is prescribed ondansetron. What specific parameter should the nurse monitor to assess the drug's effectiveness?
Which nursing action is MOST important when administering hydroxyzine?
Which nursing action is MOST important when administering hydroxyzine?
An older adult patient is prescribed an antiemetic drug. What consideration is MOST important for the nurse?
An older adult patient is prescribed an antiemetic drug. What consideration is MOST important for the nurse?
A patient reports persistent nausea but no vomiting. Which intervention is MOST appropriate for the nurse to investigate PRIOR to administering an antiemetic?
A patient reports persistent nausea but no vomiting. Which intervention is MOST appropriate for the nurse to investigate PRIOR to administering an antiemetic?
A patient is prescribed dronabinol. What potential interaction should the nurse be MOST concerned about when reviewing the patient's medication list?
A patient is prescribed dronabinol. What potential interaction should the nurse be MOST concerned about when reviewing the patient's medication list?
What is the therapeutic goal of antiemetic therapy?
What is the therapeutic goal of antiemetic therapy?
During assessment, a patient reports taking an antihistamine for nausea. Knowing this, the nurse should prioritize assessing for which of the following?
During assessment, a patient reports taking an antihistamine for nausea. Knowing this, the nurse should prioritize assessing for which of the following?
A patient receiving an antiemetic begins to exhibit muscle rigidity and tremors. Which type of antiemetic is MOST likely causing these symptoms?
A patient receiving an antiemetic begins to exhibit muscle rigidity and tremors. Which type of antiemetic is MOST likely causing these symptoms?
Which instruction is MOST crucial for the nurse to provide a patient being discharged with a prescription for an antiemetic that causes drowsiness?
Which instruction is MOST crucial for the nurse to provide a patient being discharged with a prescription for an antiemetic that causes drowsiness?
What assessment finding would MOST strongly indicate the need to withhold an antiemetic and contact the prescriber?
What assessment finding would MOST strongly indicate the need to withhold an antiemetic and contact the prescriber?
A patient with persistent nausea related to gastroparesis is MOST likely to benefit from which type of antiemetic?
A patient with persistent nausea related to gastroparesis is MOST likely to benefit from which type of antiemetic?
Following a surgery, a patient is prescribed an antiemetic. What nursing intervention is MOST important to prevent post-operative complications related to the medication's side effects?
Following a surgery, a patient is prescribed an antiemetic. What nursing intervention is MOST important to prevent post-operative complications related to the medication's side effects?
A patient is prescribed an antiemetic that blocks dopamine receptors. Which pre-existing condition would warrant careful monitoring due to potential exacerbation?
A patient is prescribed an antiemetic that blocks dopamine receptors. Which pre-existing condition would warrant careful monitoring due to potential exacerbation?
The nurse is caring for a patient receiving chemotherapy who reports anticipatory nausea before each treatment. Which antiemetic approach is MOST appropriate for this patient?
The nurse is caring for a patient receiving chemotherapy who reports anticipatory nausea before each treatment. Which antiemetic approach is MOST appropriate for this patient?
A patient prescribed metoclopramide reports new onset diarrhea. What action should the nurse take FIRST?
A patient prescribed metoclopramide reports new onset diarrhea. What action should the nurse take FIRST?
A patient is receiving IV promethazine and reports pain at the insertion site. What is the MOST appropriate nursing intervention?
A patient is receiving IV promethazine and reports pain at the insertion site. What is the MOST appropriate nursing intervention?
A patient is prescribed an antiemetic for motion sickness. Which instruction is MOST important for the nurse to provide regarding medication timing?
A patient is prescribed an antiemetic for motion sickness. Which instruction is MOST important for the nurse to provide regarding medication timing?
What is the MOST important assessment parameter to evaluate fluid and electrolyte balance in a patient experiencing uncontrolled vomiting?
What is the MOST important assessment parameter to evaluate fluid and electrolyte balance in a patient experiencing uncontrolled vomiting?
A patient with nausea is prescribed an antiemetic. Which of the following nursing actions is MOST appropriate to prevent aspiration?
A patient with nausea is prescribed an antiemetic. Which of the following nursing actions is MOST appropriate to prevent aspiration?
A patient receiving chemotherapy is prescribed granisetron. What specific teaching point should the nurse include about potential adverse effects?
A patient receiving chemotherapy is prescribed granisetron. What specific teaching point should the nurse include about potential adverse effects?
Which situation would warrant the MOST immediate intervention after administering an antiemetic?
Which situation would warrant the MOST immediate intervention after administering an antiemetic?
The nurse is preparing to administer an antiemetic to a patient with a history of heart failure. Which assessment is MOST critical?
The nurse is preparing to administer an antiemetic to a patient with a history of heart failure. Which assessment is MOST critical?
Which factor is MOST important to consider BEFORE administering an antiemetic to a pregnant patient experiencing nausea and vomiting?
Which factor is MOST important to consider BEFORE administering an antiemetic to a pregnant patient experiencing nausea and vomiting?
What is the BEST way to assess the effectiveness of patient teaching regarding antiemetic use?
What is the BEST way to assess the effectiveness of patient teaching regarding antiemetic use?
Which dietary modification is MOST appropriate for a patient experiencing nausea and vomiting?
Which dietary modification is MOST appropriate for a patient experiencing nausea and vomiting?
When providing discharge instructions to a patient prescribed an antiemetic, the nurse should emphasize the importance of reporting which symptom immediately?
When providing discharge instructions to a patient prescribed an antiemetic, the nurse should emphasize the importance of reporting which symptom immediately?
Which of the following antiemetics has the potential to cause a false positive drug screen for marijuana?
Which of the following antiemetics has the potential to cause a false positive drug screen for marijuana?
Flashcards
Antiemetic Drugs
Antiemetic Drugs
Drugs used to relieve nausea and vomiting.
Anticholinergics
Anticholinergics
Blocks acetylcholinesterase receptors in the brain, preventing activation by nauseous stimuli; also dries GI secretions and reduces smooth muscle spasms.
Antihistamines
Antihistamines
Prevents cholinergic stimulation in the vestibular and reticular systems by blocking H1 receptors.
Antidopaminergic Drugs
Antidopaminergic Drugs
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Prokinetic Drugs
Prokinetic Drugs
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Serotonin-Blocking Drugs
Serotonin-Blocking Drugs
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Tetrahydrocannabinol (THC)
Tetrahydrocannabinol (THC)
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Goals of Antiemetic Therapy
Goals of Antiemetic Therapy
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Hydroxyzine
Hydroxyzine
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Promethazine
Promethazine
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Study Notes
- Antiemetic drugs relieve nausea and vomiting.
- Antiemetics control vomiting (emesis) and relieve or prevent nausea.
- They prevent motion sickness, reduce secretions before surgery, treat delayed gastric emptying, and prevent postoperative nausea and vomiting.
- Most antiemetics cause drowsiness.
- All antiemetic drugs work at some site in the vomiting pathways.
Anticholinergics
- Block acetylcholinesterase receptors in the vestibular nuclei and reticular formation.
- This action prevents areas in the brain from being activated by nauseous stimuli.
- They dry GI secretions and reduce smooth muscle spasms, reducing acute GI symptoms.
Antihistamines
- Prevent cholinergic stimulation in the vestibular and reticular systems.
- Nausea and vomiting occur when these systems are stimulated.
- They block H1 receptors, producing the same effect as anticholinergics.
Antidopaminergics
- Traditionally used for antipsychotic effects, they also prevent nausea and vomiting.
- They block dopamine receptors in the chemoreceptor trigger zone (CTZ).
- Many have actions similar to anticholinergic drugs and calm the central nervous system.
Prokinetic Drugs
- Metoclopramide acts as an antiemetic by blocking dopamine receptors in the CTZ.
- This action desensitizes the CTZ to impulses from the GI tract.
- Primarily stimulate peristalsis in the GI tract, enhancing the emptying of stomach contents into the duodenum and enhancing intestinal movements.
Serotonin-Blocking Drugs
- Granisetron and ondansetron block serotonin receptors in the GI tract, CTZ, and vomiting center.
- Commonly used for the prevention of chemotherapy-induced nausea and vomiting.
Tetrahydrocannabinol
- The major psychoactive substance in marijuana.
- Dronabinol (nonintoxicating doses) is occasionally used as an antiemetic.
- It has inhibitory effects on the reticular formation, thalamus, and cerebral cortex.
- Dronabinol prevents chemotherapy-induced nausea and vomiting and is associated with postural hypotension.
Adverse Effects
- Most adverse effects stem from the nonselective blockade of various receptors.
Goals of Antiemetic Therapy
- Minimize or prevent fluid and electrolyte disturbances.
- Minimize the deterioration of the patient’s nutritional status.
Important Considerations
- Hydroxyzine (antihistamine) is given orally or intramuscularly.
- Promethazine is administered orally or intramuscularly, intravenous is not preferred.
- Intra-arterial promethazine may cause severe tissue damage, possibly leading to amputation.
- Sedation is the most common adverse effect of promethazine.
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