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Anti-emetics
Question | Answer |
---|---|
Maropitant -drug name | Cerenia |
Maropitant - action | Blocks substance P at NK1 receptor on Nucleus Tractus Solitarius (final common pathway!) |
Maropitant - effectiveness | Peripheral and central stimuli High oral dose due to first pass metabolism in liver Effective in dogs, also used in cats |
Maropitant - use | acute gastroenteritis cytotoxic-induced vomiting Motion sickness (higher dose) |
Metoclopramide - action | Antagonises D2 dopaminergic receptors and 5HT3 serotonergic receptors at CRTZ and peripheral receptors |
Metoclopramide - effects | Not great for nausea Peripheral pro-cholingeric effect Less good in cats bc D2 in CRTZ more important in dog |
Metoclopramide - use | Cancer chemo (Cerenia better) Gastroesophageal reflux (motility) Delayed gastric emptying |
Phenothiazines - action | Antagonizes alpha 1 and 2 adrenergic receptors, D2 dopaminergic recepters, H1 and H2 histaminergic receptors, muscarinic cholinergic receptors |
Phenothiazines- location | Every except the nucleus tractus solitarius |
Phenothiazines- use and consideration | Any peripheral or central cause of vomiting Rare, bc not liscensed in animals |
Antihistamines- names | Diphenhydrinate (Dramamine) Diphenhydramine (Benadryl) |
Antihistamines - use | Motion-sickness in dogs but not cats Not liscensed for animals |
Antihistamines- action | H1 and H2 receptors in the CRTZ |
5HT3 Antagonists -names | Dolasetron (anzemel) Ondanstron (Zofran) |
5HT3 Antagonists - locations | CRTZ (cats) Peripheral receptors (dogs) |
5HT3 Antagonists- use | Effective anti-nausea (use off-liscense) Cytotoxic drug-induced emesis Persistant vomiting (ie pancreatitis) |
Anticholinergics- names | Atropine Butylscopolamine (hyoscine) Propantheline Isopropamide |
Anticholinergics - action | Antagonizes M1 receptors in CRTZ and vestibular (good for motion sickness) Antagonizes M2 receptors in peripheral -> potential for delayed gastric emptying, ileus |