Nausea and Vomiting Pharmacotherapy Learning Objectives
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Questions and Answers

Which non-pharmacologic treatment option is recommended for simple nausea and vomiting?

  • Hypnosis
  • Chemotherapy
  • Physical therapy (correct)
  • Radiation therapy

    • What is the recommended prophylactic treatment regimen for high emetic risk chemotherapy-induced nausea and vomiting?

  • Prochlorperazine
  • Ondansetron (correct)
  • Droperidol
  • Scopolamine

    • Which agent is considered the 'gold standard' for post-operative nausea and vomiting (PONV) prophylaxis?

  • Scopolamine
  • Ondansetron (correct)
  • Dexamethasone
  • Droperidol

    • What is the appropriate treatment for breakthrough chemotherapy-induced nausea and vomiting (CINV)?

    <p>Administer a different medication with a different mechanism of action (A)</p> Signup and view all the answers

    Which type of nausea and vomiting is usually self-limiting and often treated with over-the-counter (OTC) options?

    <p>Simple nausea and vomiting (D)</p> Signup and view all the answers

    What is the primary goal of treatment for nausea and vomiting?

    <p>To prevent or eliminate nausea/vomiting (C)</p> Signup and view all the answers

    Which medication is useful in anticipatory nausea and vomiting?

    <p>Benzodiazepine (D)</p> Signup and view all the answers

    What type of agents are useful in simple nausea and vomiting related to reflux or gastroparesis?

    <p>Histamine-2 receptor antagonists (B)</p> Signup and view all the answers

    Which non-pharmacologic treatment option is recommended for pregnancy-induced nausea and vomiting?

    <p>Yoga (C)</p> Signup and view all the answers

    Which type of receptor antagonist is useful for acute simple, chemotherapy-induced, and post-operative nausea and vomiting?

    <p>5HT3 receptor antagonist (A)</p> Signup and view all the answers

    What is the most common type of prophylactic treatment for post-operative nausea and vomiting (PONV)?

    <p>Ondansetron (C)</p> Signup and view all the answers

    What is the primary goal of treatment for nausea and vomiting?

    <p>Prevent or eliminate nausea/vomiting (A)</p> Signup and view all the answers

    Which non-pharmacologic approach is recommended for simple nausea and vomiting?

    <p>Yoga (C)</p> Signup and view all the answers

    Which pharmacologic agent is useful for simple nausea and vomiting related to reflux?

    <p>Histamine-1 receptor antagonist (B)</p> Signup and view all the answers

    During which phase of chemotherapy does anticipatory CINV occur?

    <p>Before chemotherapy administration (C)</p> Signup and view all the answers

    What is considered the 'gold standard' for PONV prophylaxis?

    <p>Ondansetron (B)</p> Signup and view all the answers

    Which type of nausea and vomiting often resolves on its own and can be treated with OTC options?

    <p>Simple nausea/vomiting (C)</p> Signup and view all the answers

    What is the preferred treatment for pregnancy-induced nausea/vomiting?

    <p>Combination of pharmacologic and non-pharmacologic options (B)</p> Signup and view all the answers

    What medication is recommended for breakthrough CINV?

    <p>Repeat the drug given for prophylaxis (A)</p> Signup and view all the answers

    Which agent is useful in refractory CINV?

    <p>Cannabinoids (B)</p> Signup and view all the answers

    Which neurotransmitter receptor antagonist is useful in CINV and PONV?

    <p>NK1 receptor antagonist (A)</p> Signup and view all the answers

    What is the main factor determining the choice of antiemetic agent?

    <p>Etiology of the nausea/vomiting (B)</p> Signup and view all the answers

    What is a common cause of simple nausea and vomiting?

    <p>Motion sickness (A)</p> Signup and view all the answers

    What is the primary function of the pancreas?

    <p>To secrete enzymes for breaking down food (D)</p> Signup and view all the answers

    Which cells are of interest in the exocrine function of the pancreas?

    <p>Acinar cells (B)</p> Signup and view all the answers

    What is the average daily volume of alkaline fluid secreted by the pancreas?

    <p>2-4L (D)</p> Signup and view all the answers

    Which condition involves an acute inflammatory process of the pancreas?

    <p>Pancreatitis (A)</p> Signup and view all the answers

    What is the leading cause of GI hospitalizations in the US?

    <p>Pancreatitis (C)</p> Signup and view all the answers

    Which type of cells are involved in the exocrine function of the pancreas?

    <p>Acinar cells (B)</p> Signup and view all the answers

    What is the anatomical location of the pancreas?

    <p>Behind the stomach (C)</p> Signup and view all the answers

    What is the function of pancreatic juice?

    <p>To aid in digestion (A)</p> Signup and view all the answers

    Which medication is associated with medication-induced pancreatitis?

    <p>Valproic acid (B)</p> Signup and view all the answers

    What is the preferred imaging modality for finding stones in the pancreas?

    <p>Trans-abdominal ultrasound (B)</p> Signup and view all the answers

    What is the recommended initial fluid replacement rate for acute pancreatitis?

    <p>200-500 ml/hr (A)</p> Signup and view all the answers

    When are antibiotics routinely recommended for pancreatitis?

    <p>After 7-10 days with confirmed infection (D)</p> Signup and view all the answers

    Which procedure is indicated for patients with refractory symptoms of chronic pancreatitis?

    <p>Whipple procedure (C)</p> Signup and view all the answers

    What is the primary goal of nutritional support in severe acute pancreatitis?

    <p>Preventing necrosis and infection (A)</p> Signup and view all the answers

    Which of the following is NOT a side effect of pancreatic enzyme supplementation?

    <p>Constipation (B)</p> Signup and view all the answers

    What is the best initial approach to pain management in acute pancreatitis?

    <p>Multimodal approach (A)</p> Signup and view all the answers

    Which vital signs are consistent with acute pancreatitis?

    <p>High temperature, high blood pressure, low heart rate, and low respiratory rate (A)</p> Signup and view all the answers

    What do you think is the etiology of this patient’s acute pancreatitis?

    <p>All of the above (D)</p> Signup and view all the answers

    Can you diagnose the patient with acute pancreatitis. Why or why not?

    <p>Yes, because of the diffuse enlargement of the pancreas and hazy stranding of fat on the CT scan (D)</p> Signup and view all the answers

    What is the overall fatality rate for acute pancreatitis?

    <p>5% (C)</p> Signup and view all the answers

    What laboratory values should you order to diagnose this patient with acute pancreatitis?

    <p>Lipase, Amylase, and Triglycerides (TG) (C)</p> Signup and view all the answers

    What laboratory values should you order to determine the etiology of acute pancreatitis?

    <p>Serum alcohol level, Liver function tests (LFTs), and Serum triglycerides (C)</p> Signup and view all the answers

    Which of the following medications is NOT associated with medication-induced acute pancreatitis?

    <p>Metformin (B)</p> Signup and view all the answers

    What imaging do you want to order?

    <p>All of the above (D)</p> Signup and view all the answers

    In acute pancreatitis, which imaging modality is more useful in finding stones?

    <p>Trans-abdominal US (C)</p> Signup and view all the answers

    What is the recommended initial fluid replacement rate in the management of acute pancreatitis?

    <p>200-500 ml/hr (D)</p> Signup and view all the answers

    Which of the following is NOT a goal of therapy in chronic pancreatitis?

    <p>Induce pancreatic necrosis (B)</p> Signup and view all the answers

    Which antibiotic is NOT routinely recommended for prophylaxis in acute pancreatitis?

    <p>Gentamicin (D)</p> Signup and view all the answers

    Which treatment is specifically indicated for gallstone-induced acute pancreatitis?

    <p>Endoscopic retrograde cholangiopancreatography (ERCP) (A)</p> Signup and view all the answers

    What is the primary purpose of using pancreatic enzymes in chronic pancreatitis?

    <p>Help with malabsorption and steatorrhea (A)</p> Signup and view all the answers

    What is the primary function of the pancreas gland?

    <p>Producing digestive enzymes and bicarbonate (C)</p> Signup and view all the answers

    Which cells of the pancreas are responsible for secreting pancreatic juice?

    <p>Acinar cells (B)</p> Signup and view all the answers

    What is the approximate daily volume of alkaline fluid secreted by the pancreas?

    <p>1.5-3 liters (B)</p> Signup and view all the answers

    Which condition is characterized by an acute inflammatory process of the pancreas?

    <p>Pancreatitis (B)</p> Signup and view all the answers

    What is the leading cause of GI hospitalizations in the United States?

    <p>Pancreatitis (C)</p> Signup and view all the answers

    Which type of cells are of particular interest in the exocrine functions of the pancreas?

    <p>Acinar cells (C)</p> Signup and view all the answers

    What is the approximate number of enzymes present in the pancreatic juice?

    <p>~20 enzymes (D)</p> Signup and view all the answers

    What is the main product of pancreatic juice?

    <p>Water, electrolytes, and enzymes (C)</p> Signup and view all the answers

    Which vital signs are consistent with acute pancreatitis?

    <p>Temp 97˚F, BP 86/54 mmHg (B)</p> Signup and view all the answers

    What imaging do you want to order?

    <p>CT scan of the abdomen (D)</p> Signup and view all the answers

    Can you diagnose the patient with acute pancreatitis? Why or why not?

    <p>Yes, because the patient has elevated lipase levels and a history of heavy alcohol consumption. (B)</p> Signup and view all the answers

    What laboratory values should you order to diagnose this patient with acute pancreatitis?

    <p>Amylase and lipase levels (C)</p> Signup and view all the answers

    What laboratory values should you order to determine the etiology of acute pancreatitis?

    <p>Lipase levels and triglycerides (A)</p> Signup and view all the answers

    What do you think is the etiology of this patient’s acute pancreatitis?

    <p>Chronic heavy alcohol consumption (D)</p> Signup and view all the answers

    Which reported symptoms are consistent with acute pancreatitis?

    <p>Abdominal pain, nausea, vomiting (C)</p> Signup and view all the answers

    Which items from the physical exam are consistent with acute pancreatitis?

    <p>LUQ pain, distended abdomen, reduced bowel sounds (A)</p> Signup and view all the answers

    You are the hospital pharmacist in central pharmacy. You see the following orders come through. Are these correct to verify.

    <p>Meropenem 500 mg IV q6hr (D)</p> Signup and view all the answers

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