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*[[5-HT3 antagonist|5-HT<sub>3</sub> 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. |
*[[5-HT3 antagonist|5-HT<sub>3</sub> 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. |
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| + | ** [[Dolasetron]] ('''Anzemet''') - can be administered in tablet form or in an injection. |
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| − | ** [[Dolasetron]] |
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| + | ** [[Granisetron]] ('''Kytril''', '''Sancuso''') - can be administered in tablet (Kytril), oral solution (Kytril), injection (Kytril), or in a single transdermal patch to the upper arm (SANCUSO). |
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| − | ** [[Granisetron]] |
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| + | ** [[Ondansetron]] ('''Zofran''') - administered in an oral tablet form, oral dissolving tablet form, or in an injection. |
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| − | ** [[Ondansetron]] |
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| + | ** [[Tropisetron]] ('''Navoban''') - can be administered in oral capsules or in injection form. |
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| − | ** [[Tropisetron]] |
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| − | ** [[Palonosetron]] ('''Aloxi''' |
+ | ** [[Palonosetron]] ('''Aloxi''') - can be administered in an injection or in oral capsules. |
| + | ** [[Mirtazapine]] ('''Remeron'''), an [[antidepressant]] that also has antiemetic effects.{{Citation needed|date=November 2009}} |
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| + | |||
*[[Dopamine antagonist]]s act in the brain and are used to treat nausea and vomiting associated with [[neoplastic disease]], radiation sickness, opioids, cytotoxic drugs and general anaesthetics. |
*[[Dopamine antagonist]]s act in the brain and are used to treat nausea and vomiting associated with [[neoplastic disease]], radiation sickness, opioids, cytotoxic drugs and general anaesthetics. |
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**[[Domperidone]] |
**[[Domperidone]] |
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** [[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. |
** [[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. |
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** [[Alizapride]] |
** [[Alizapride]] |
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* [[Antihistamine]]s ([[Histamine receptor|H<sub>1</sub> histamine receptor]] antagonists), effective in many conditions, including motion sickness and severe morning sickness in pregnancy. |
* [[Antihistamine]]s ([[Histamine receptor|H<sub>1</sub> histamine receptor]] antagonists), effective in many conditions, including motion sickness and severe morning sickness in pregnancy. |
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** [[Cyclizine]] |
** [[Cyclizine]] |
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** [[Promethazine]] (Pentazine, Phenergan, Promacot) |
** [[Promethazine]] (Pentazine, Phenergan, Promacot) |
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** [[Hydroxyzine]] |
** [[Hydroxyzine]] |
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*[[Anticholinergic]]s |
*[[Anticholinergic]]s |
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**[[Hyoscine]] (also known as [[Scopolamine]]) |
**[[Hyoscine]] (also known as [[Scopolamine]]) |
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*[[Steroid]]s |
*[[Steroid]]s |
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** [[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. |
** [[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. |
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| + | |||
* [[Benzodiazepines]] |
* [[Benzodiazepines]] |
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** [[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. |
** [[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. |
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{{Major Drug Groups}} |
{{Major Drug Groups}} |
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| + | {{Antiemetics}} |
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[[Category:Antiemetic drugs| ]] |
[[Category:Antiemetic drugs| ]] |
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Latest revision as of 10:39, 11 July 2013
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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 (Anzemet) - can be administered in tablet form or in an injection.
- Granisetron (Kytril, Sancuso) - can be administered in tablet (Kytril), oral solution (Kytril), injection (Kytril), or in a single transdermal patch to the upper arm (SANCUSO).
- Ondansetron (Zofran) - administered in an oral tablet form, oral dissolving tablet form, or in an injection.
- Tropisetron (Navoban) - can be administered in oral capsules or in injection form.
- Palonosetron (Aloxi) - can be administered in an injection or in oral capsules.
- Mirtazapine (Remeron), an antidepressant that also has antiemetic effects.[citation needed]
- 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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