Exam (elaborations)
NURS 517-Tx of N/V Questions answers latest update
- Course
- NURS 517
- Institution
- University Of Hawaii - Manoa
NURS 517-Tx of N/V Questions answers latest update
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NURS 517-Tx of N/VWhat are the Antihistamine's for Motion Sickness Nausea? - diphenhydramine
(Benadryl)
meclizine (Antivert) (Bonine)
dimenhydrinate (Dramamine)
How do the antihistamines work for motion sickness? - In this context, the
antihistamines block histamine-1 (H-1) receptors in the Chemoreceptor Trigger
Zone (CTZ) area of the brain, which is that part of the brain that detects noxious
stimuli and activates the nausea and the vomiting centers.
Kinetic:
Oral; All but Meclizine can also be given parenterally. Metabolized in liver and
excreted in urine.
Advantages and disadvantages of antihistamines in tx of motion sickness -
Advantages:
- Available orally; most useful for motion sickness prophylaxis.
- Useful as therapeutic and prophylactic drugs.
- Available over-the-counter; some brand name products are prescription only
(i.e., Antivert).
- Fairly rapid onset of action following oral administration.
- Long duration of action for meclizine (8-24 hrs.); the remainder have a duration
of action that ranges from 4-6 hrs.
, - Most available parenterally (I.M.); this is an advantage when treating patients
who cannot take oral medications because of vomiting.
- Commonly produce drowsiness; this may be an advantage in treatment of
nausea.
- May be safely used in pregnancy (Category B).
Disadvantages:
- Requires q 4-6 h dosing (except meclizine, q 12-24 hrs).
- All produce drowsiness, dizziness and occasionally confusion; these are typical
antihistamine effects. [THE SEDATIVE EFFECTS WILL BE ADDITIVE TO THE EFFECTS
OF OTHER CNS DEPRESSANT DRUGS.]
- All have varying degrees of anticholinergic adverse effects including blurred
vision, dry mouth, tachycardia, constipation and urinary retention.
- Requires precaution in patients with glaucoma and prostatic enlargement
(BPH).
- Requires precaution in children and in patients with a history of seizure
disorder; these groups are at increased risk for paradoxical CNS excitation and
seizures.
What is the Combined Phenothiazine-Antihistamine for motion sickness? -
promethazine (Phenergan)
promethazine (Phenergan) - Promethazine is a unique drug that has features of
both the phenothiazine class of drugs and the antihistamine class of drugs. As a
phenothiazine, promethazine blocks cholinergic receptors in the inner ear-
labyrinth-vestibular pathway and dopamine receptors in the brain (presumably in
the CTZ). As an antihistamine, it blocks H-1 receptors in the brain's inner ear as
well as in the CTZ.
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