N/V Blackboard Quiz

Risk of nausea/vomiting with cisplatin + cyclophosphamide chemo regimen

Very high risk (>90%)

Acute gastroenteritis nausea is primarily mediated by which receptor

5-HT3 receptors

Drug class with the greatest number of agents contraindicated or avoided in severe liver impairment and with many DDIs

NK1 receptor antagonists

Drug that antagonizes dopamine receptors in the CTZ and at high doses blocks serotonin receptors

Metoclopramide

Herbal supplement shown to reduce severity and duration of mild nausea/vomiting

Zingiber officinale (Ginger)

Delayed phase of chemotherapy-induced nausea and vomiting (CINV) is mainly driven by

Activation of NK-1 receptors in the CTZ and vomiting center

Best antacid choice for a patient on opioids worried about reflux from vomiting

Famotidine

Antiemetic most associated with extrapyramidal symptoms (EPS)

Perphenazine

Best antiemetic for nausea in a patient taking risperidone and sertraline

Ondansetron

Recommended day 1 regimen for highly emetogenic chemotherapy (cisplatin-based)

Olanzapine + fosaprepitant + palonosetron + dexamethasone

Drug associated with sedation and anticholinergic effects

Hydroxyzine

Most effective therapy for delayed chemotherapy-induced nausea/vomiting

Palonosetron + netupitant

Most common side effect of transdermal scopolamine patch

Sedation and dry mouth

Antiemetic recommendation for a pregnant patient with low perioperative emetic risk

No antiemetic needed

Best outpatient antiemetic for gastroenteritis in a patient with glaucoma

Ondansetron ODT

Which is NOT a method used to reduce anticipatory nausea/vomiting

Massage

Best antiemetic for motion sickness when minimal drowsiness is desired

Meclizine

Droperidol works by blocking which receptors

Dopamine receptors in the CTZ

Structure that detects toxins and triggers vomiting reflex

Chemoreceptor Trigger Zone (CTZ)

Which antiemetic should NOT be used alone for nausea/vomiting

Ativan (Lorazepam)

Drug class of choice for chemotherapy-induced nausea/vomiting

5-HT3 receptor antagonists

Drug associated with QT prolongation

Droperidol

Common liver drug metabolism reactions

Oxidation by CYP450 enzymes

Another common liver drug metabolism reaction

Glycosylation of nitrogen or oxygen atoms

Drug that interacts via CYP3A4 metabolism

Aprepitant

Drug of choice for nausea/vomiting due to motion sickness

Meclizine