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Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics01:11

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics

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All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
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Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists01:28

Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists

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Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Netupitant/Palonosetron.

Dennis J Cada1, James Leonard2, Danial E Baker3

  • 1Founder and Contributing Editor, The Formulary , Washington State University , Spokane, Washington.

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Summary

The Formulary Monograph Service provides monthly drug monographs and utilization evaluations for Pharmacy & Therapeutics Committees. This service aids in informed drug selection and safe medication use for healthcare facilities.

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Area of Science:

  • Pharmaceutical Science
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Pharmacy & Therapeutics Committees require timely, evidence-based drug information.
  • New drug approvals and late-stage trial data necessitate continuous evaluation.
  • Drug utilization evaluations (DUE/MUE) are crucial for optimizing medication use and patient safety.

Purpose of the Study:

  • To describe the offerings of The Formulary Monograph Service.
  • To highlight the value of monthly drug monographs and DUE/MUE for healthcare professionals.
  • To inform potential subscribers about the scope and accessibility of the service.

Main Methods:

  • The service provides 5-6 detailed monographs on new or late-phase drugs monthly.
  • Includes 1-page summary monographs for pharmacy and nursing in-services.
  • Offers a comprehensive drug utilization evaluation/medication use evaluation (DUE/MUE) each month.
  • Monographs are available in print and online, with customization options.

Main Results:

  • Subscribers receive in-depth information on emerging and recently approved medications.
  • Monthly DUE/MUE provides actionable insights into drug use patterns.
  • Drug class reviews are also included, enhancing formulary management.
  • April 2015 topics included edoxaban, diclofenac sodium injectable, olaparib, antihemophilic factor porcine, and blinatumomab, with an edoxaban Safety MUE.

Conclusions:

  • The Formulary Monograph Service supports informed decision-making for drug formulary management.
  • The service facilitates evidence-based practice and enhances medication safety.
  • It provides a comprehensive resource for pharmacy professionals and committees.