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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.
- 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.
- 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.
- 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.
- Antihistamines (H1 histamine receptor antagonists), effective in many conditions, including motion sickness and severe morning sickness in pregnancy.
- 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.
- Cannabinoids are second-line therapy, used in patients with cytotoxic nausea & vomiting unresponsive to other agents. Drowsiness and dizziness are frequent side-effects.
Drugs for sorting
- non-pharmaceutical therapies with some evidence of efficacy include acupuncture and hypnosis. 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.
- Cholinergic blocking drugs
- Hyperemesis gravidarum
- Hypnotic drugs
- Tranquilizing drugs
Major Drug Groups
|Gastrointestinal tract (A)|
|Blood and blood forming organs (B)|
|Cardiovascular system (C)|
|Reproductive system (G)|
|Endocrine system (H)|
|Infections and Infestations (J, P)|
|Malignant and Immune disease (L)|
|Muscles, Bones, and Joints (M)|
|Brain and Nervous system (N)|
|Respiratory system (R)|
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