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* [[Perphenazine]] |
* [[Perphenazine]] |
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* [[Piracetam]] |
* [[Piracetam]] |
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| − | * [[ |
+ | * [[Sulpiride]] |
* non-pharmaceutical therapies with some evidence of efficacy include [[acupuncture]]{{cn}} and [[hypnosis]]{{cn}}. All drugs have potential [[side effects]] and it is important to try to reduce the baseline risk of [[nausea]] and [[vomiting]], particularly with respect to surgery. |
* non-pharmaceutical therapies with some evidence of efficacy include [[acupuncture]]{{cn}} and [[hypnosis]]{{cn}}. All drugs have potential [[side effects]] and it is important to try to reduce the baseline risk of [[nausea]] and [[vomiting]], particularly with respect to surgery. |
||
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An anti-emetic is a drug that is effective against vomiting and nausea. Anti-emetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics and chemotherapy directed against cancer.
Anti-emetics include:
- 5-HT3 receptor antagonists - these block serotonin receptors in the central nervous system and gastrointestinal tract. As such, they can be used to treat post-operative and cytotoxic drug nausea & vomiting.
- Dolasetron
- Granisetron
- Ondansetron
- Tropisetron
- Palonosetron (Aloxi, a new 5HT3 antagonist)
- Dopamine antagonists act in the brain and are used to treat nausea and vomiting associated with neoplastic disease, radiation sickness, opioids, cytotoxic drugs and general anaesthetics.
- Domperidone
- Droperidol, Haloperidol, Chlorpromazine, Promethazine, Prochlorperazine. Some of these drugs are limited in their usefullness by their extra-pyramidal and sedative side-effects.
- Metoclopramide also acts on the GI tract as a pro-kinetic, and is thus useful in gastrointestinal disease; however, it is poor in cytotoxic or post-op vomiting.
- Alizapride
- Antihistamines (H1 histamine receptor antagonists), effective in many conditions, including motion sickness and severe morning sickness in pregnancy.
- Cyclizine
- Diphenhydramine
- Dimenhydrinate
- Meclizine
- Promethazine (Pentazine, Phenergan, Promacot)
- Hydroxyzine
- Anticholinergics
- Hyoscine (also known as Scopolamine)
- Steroids
- Dexamethasone given in low dose at the onset of a general anaesthetic for surgery is an effective anti-emetic. The specific mechanism of action is not fully understood.
- Benzodiazepines
- Midazolam given at the onset of anaesthesia has been shown in recent trials to be as effective as ondansetron, a 5HT3 antagonist in the prevention of post-operative nausea and vomiting. Further studies need to be undertaken.
- Cannabinoids are second-line therapy, used in patients with cytotoxic nausea & vomiting unresponsive to other agents. Drowsiness and dizziness are frequent side-effects.
- Cannabis
- Marinol
- Other
Drugs for sorting
- non-pharmaceutical therapies with some evidence of efficacy include acupuncture[citation needed] and hypnosis[citation needed]. All drugs have potential side effects and it is important to try to reduce the baseline risk of nausea and vomiting, particularly with respect to surgery.
See also
- Cholinergic blocking drugs
- Emetic
- Hyperemesis gravidarum
- Hypnotic drugs
- Sedatives
- Tranquilizing drugs
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