Antiemetics

  • Demonstrate awareness of the physiology of nausea & vomiting and the main receptors involved
  • Recall the risk factors for Post-Operative Nausea and Vomiting and classify them according to patient/surgical/anaesthetic factors
  • Recall the pertinent pharmacokinetic and pharmacological properties of OndansetronCyclizineDexamethasone and Prochlorperazine
  • Compare and contrast the properties of these drugs and their clinical uses in anaesthetic practice
  • Use this knowledge and understanding to select a appropriate antiemetics for intraoperative use and as rescue agents in Recovery

Physiology of Vomiting

Ondansetron

Cyclizine

Prochlorperazine

Dexamethasone

Quiz

1
Created on By Anaestheasier

Antiemetics

1 / 15

Which of the following statements regarding the nausea/vomiting process is false?

2 / 15

Prochlorperazine’s antiemetic activity is primarily in which region?

3 / 15

Which of the following antiemetics would most likely precipitate seizure activity in a patient with known history of epilepsy?

4 / 15

Which of the following is not a recognised side-effect of D2 receptor antagonists?

5 / 15

You are anaesthetising a 45-year-old female for a laparoscopic cholecystectomy. She has a background of PONV, motion sickness, anxiety and told you she did not eat anything for 18 hours prior to coming in today. You gave her 8mg ondansetron at induction and 6.6mg Dexamethasone. You are giving her 50mg of Cyclizine as a bolus. What is the most likely clinical effect?

6 / 15

Which of the following does not have an antiemetic effect?

7 / 15

A 23-year old lady is undergoing a diagnostic laparoscopy to investigate subfertility. She is a non-smoker and ASA1 but is very anxious.

She is given Propofol, Fentanyl and Rocuronium at induction. Anaesthesia is maintained with Sevoflurane and Nitrous Oxide. You give supplimentary morphine boluses for analgesia. At the end of the procedure, you use neostigmine/glycopyrrolate to reverse her neuromuscular blockade.

How many risk factors for post-operative nausea and vomiting can be identified from the information above?

8 / 15

Which of the below antiemetics acts via 5-HT3 receptors?

9 / 15

Which of the following is not a risk factor for post-operative nausea and vomiting?

10 / 15

A 56-year-old patient with Parkinson’s Disease is in the recovery unit following his General Anaesthetic for a Laparoscopic Inguinal Hernia Repair. He has had 4mg Ondansetron and 3.3mg Dexamethasone intra-operatively. Which of the following would be contraindicated for this patient?

11 / 15

Which scoring system can be used to predict risk of PONV?

12 / 15

Which of the following drugs exerts their effects via 5-HT3 receptors in the chemoreceptor trigger zone and the GI tract?

13 / 15

Which of the following statements is true of Cyclizine?

14 / 15

A 53-year-old male is recovering from his anaesthetic for a strangulated inguinal hernia. He has a background of Parkinsonism, hypertension, T2DM and depression. He was given 4mg Ondansetron and 50mg Cyclizine at induction, but is complaining of severe nausea.

Which of the below agents is most appropriate to give now?

15 / 15

Which of the following is the most common side-effect of Ondansetron?

Your score is

The average score is 73%

0%

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