Anti-tussives and Anti-ementics
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41 terms
Terms | Definitions |
|---|---|
 -Coughing results in sleep loss and contributes to debilitation-Prevent visceral herniation d/t inc.ed pressure -Reduce spread of infxn by droplet spray -Facilitate repare of tracheobronchial tree -Sometimes for nighttime trtmnt | Indications for antitussive agents in non-productive coughs |
| 2 opioid antitussives that non-specifically reduce the excitability of the cough center | Codeine Hydrocodon |
| -Respiratory depression -Constipation and miosis -Sedation/drowsiness/mental clouding -Addiction potential | ADRs for opioid antitussives |
| Non-opioid antitussive that non-specifically reduce the excitability of the cough center | Dextromethorphan |
| -Wide margin of safety w/some dose-related SEs -Confusion, excitation, nervousness, irritability -Nausea, dizziness, arrhythmias, respiratory depression -SE syndrome if used w/MAO I's | Dextromethorphan |
| Local anesthetic acting on the stretch R's in the respiratory passages, lungs and pleura to depress the cough reflex | Benzonatate |
| -Hypersensitivity rxn: bronchospasm, aryngospasm, CV collapse -C/I if hypersensitive to related drugs -Oropharyngeal anesthesia if capsules are chewed | Benzonatate ADEs |
| -Inc or modify secretions of mucus in the bronchi to facilitate upward expulsion of sputum -Inc secretion of mucus and thin out mucus -Known as an expectorant to tx productive coughs | Guaifenesin |
| -MoA: stomach irritant that reflexly affects CNS to inc bronchial secertions -ADRs: N/V, irritant to gastric mucosa -DOC for coughs that expel thick, tenacious secretions from the lungs w/difficulty | Guaifenesin |
| Breakdown of mucopolysaccharides in bronchial secretions to smaller components | Mucolytics: N-acetylcysteine |
| -MoA: sulfhydryl groups split disulfide bridges of mucopolysaccharides present in mucous secretions to lower viscosity of mucus -Given by spray -Spells and tastes bad | N-acetylcysteine |
| -Bronchopulmonary dz w/viscous mucous secretions (cystic fibrosis) -Tracheostomy care -Antidote for acetaminophen poisoning | Indications for N-acetylcysteine |
| Sticky substances that protect the lining of the respiratory tract from irritation | Demulcents (honey, syrups, hard candy) |
| 4 Antipsychotic anti-emetic agents (CPTP-azine) | Chlorpromazine Prochlorperazine Thiethylperazine Promethazine |
| -MoA: depresses excitability by blocking D2 R's, also peripherally blocks D2 R's in the GI tract -ADR: sedation, extrapyramidal sx, allergic | Antipsychotic anti-emetic agents |
| -Radiation and drug induced N/V -Only for pt.s receiving mildly emetogenic antineoplastic drugs -Post-operative N/V (just one) | Antipsychotic anti-emetic agents --Thiethylperazine for post-op |
| -Gangrene of extremities w/unintentional intra-arterial injections -NOT FOR KIDS less than 2, potential for fatal respiratory depression | Promethazine |
| -Preventing mildly emetogenic antineoplastic drug-induced emesis -Premedication/induction or adjunct in anesthesia maintenance postsurgical emesis -Some tranquilization effects | Droperidol |
| -MoA: block M R's in the vomiting center, vestibular n. and GI tract -ADR: sedation, blurred vision, reduced GI and bladder tone -Used for motion sickness | Scopolamine |
| 4 AntiHS1 anti-emetic agents (HDMP) | -Hydroxyzine -Diemnhydrinate -Meclizine -Promethazine (phenothiazine derivative) |
| -Used in motion sickness d/t anticholinergic axn -Block M R's in the vestibular n. and CTZ | AntiHS anti-emetic agents |
| -Indications: motion sickness, mild N/V -ADR's: sedation, blurred vision, dry mouth -AKA: dramamine | Dimenhydrinate |
| For vertigo and motion sickness (2) | Hydroxyzine Meclizine |
| -Blocks M R's -Binds to H1 HS R's as well -NOT GOOD FOR CHILDREN UNDER 2 | Promethazine |
| Blockers of 5-HT3 R's (OG-tron) | Ondansetron Granisetron |
| -MoA: Block 5-HT3 R's in the GI tract and vomit center -ADR: HA, diarrhea, constipation, asthenia and phlebitis -No extrapyramidal SE's | Ondansetron Granisetron |
| -Post-operative nausea and vomiting following highly emetogenic surgical procedures -N/V d/t administration of emetogenic agents -N/V a/w radiation thearpy -Not for motion sickness | Indications for 5-HT3 blockers |
| -Antiemetic MoA: depress vomit center by blocking D2 R's -Antitussive MoA: suppress laryngeal and pharyngeal reflexes to cough center in medulla -ADR: CNS depression, extrapyramidal and Reye's s/d in children | Trimethobenzamide (benzamide derivative) |
| -Postoperative N/V -Postoperative coughing | Indications for Trimethobenzamide |
| -Prokinetic MoA: stim motility of upper GI and sensitize gut to axn of ACh -Anti-emetic MoA: antagonist at D2 R's in vomit center and GI tract -ADR: CNS depression, extrapyramidal SEs | Metoclopramide (reglan) |
| -Symptomatic GER -dibetic gastric stasis -Radiologic examination of Gi tract -N/V a/w cisplatin therapy and other antineoplastic agents and radiation therapy | Indications for metoclopramide (reglan) |
| -Unknown MoA, binds vomit center R's, cannabinoid R agonist -Impairs cognitive and motor performance, induce dysphoria and psychotomimetic beh | Dronabinol |
| -N/V d/t use of highly emetogenic antineoplastic drugs -Anorexia a/w wt loss in AIDS pt.s | Indications for dronabinol |
| -MoA: selective, high affinity antagonist of NK1 R's -Potent inhibitor of CYP3A4 | Aprepitant |
| -Works in combo w/other antiemetics for acute and delayed N/V d/t initial and repeat courses of antineoplastic drugs -Esp useful for delayed vomiting | Aprepitant |
| Given IV as an adjunct therapy w/other antiemetics for highly emetogenic agents -Unknown MoA, inhibits proinflammatory PG's in CNS to block projections to emetic center | Glucocorticoids |
| Indicated for nausea and vomiting d/t emotional factors | Benzo.s (alprazolam, lorazepam) |
| What are the most effective agents for cytotoxic drug induced emesis? | 5-HT3 R antagonists (ondansetron) and metoclopramide |
| Which 4 classes are used for cytotoxic drug-induced emesis? | -*5-HT3 R antagonist -Centrally acting DA2 R antagonist (*metoclopramide) -NK1 R antagonist (delayed) -Cannabinoid R agonist |
| Which 2 classes of drugs are used for vestibular emesis (motion sickness)? | -HS1 R antagonist -M R antagonist |
| -Centrally acting DA R antagonists (2) | Metoclopramide Promethazine |
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