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anti-emetics
pharmacology of anti-emetics
| Question | Answer |
|---|---|
| cholinergic antagonists | reduce excitability of labrythine receptors and depress conduction form the vestibular apparatus to the vomiting center |
| cholinergic antagonists | used to treat motion sickness and in preoperative situations. not useful for nausea cuased by chemo |
| cholinergic antagonists | produce adverse effects that include drowsiness, dry mouth, and blurred vision |
| histamine receptor antagonists (H1) | diphenhydramine, meclizine, cyclizine, dimenhydrinate and promethazine |
| H1 antagonists | likely act by inhibiting cholinergic pathways of the vestibular apparatus |
| H1 antagonists | used to treat motions sickness, true vertigo, and the nausea of pregnancy |
| H1 antagonists | produce dry mouth and sedation |
| metoclopramide | blocks receptors with CTZ; increases the sensitivity of the GI tract to ACh (enhancing GI motitlity and gastric emptying and increases lower esophageal sphincter tone) |
| metoclopramide | high doses antagonize serotonin receptors in the vomiting center and the GI tract |
| metoclopramide | used to treat nausea due to chemo and narcotic induced vomiting |
| metoclopramide | produces sedation, diarrhea, extrapyramidal effects and elevated prolactin secretion |
| phenothiazines | chlorpromazine and prochlorperazine |
| butyrophenones | heloperidol and droperidol |
| phenothiazines and butyrophenones | block dopaminergic receptors in the CTZ and appear to inhibit peripheral transmission to the vomiting center |
| phenothiazines and butyrophenones | used to treat nausea due to chemo and radiation and to control post operative nausea |
| phenothiazines and butyrphenones | adverse effects include anticholinergic effects, extrapyramidal effects, and orthostatic hypotension |
| 5-HT3 antagonists | ondanestron (zofran) and granisetron (kytril) |
| ondansetron | more efective than metoclopramide for nausea induced by high dose cisplatin; administered IV; does not produce extrapyramidal side effects |
| granisetron | greater affinity for 5-HT3-receptors than ondansetron; longer acting and more potent; administerd by IV infusion; most common adverse effect is headache |
| cannabinoids | dronabinol and nabilone |
| cannabinoids | used to control nausea induced by chemo; administered as oral preparations or smoked; produce sedation, psychoactive effects, dry mouth, and orthostatic hypotension |
| glucocorticoids | highly effective for vomiting caused by highly emetic agents; gigh doses are given as IV bolus or orally for delayed nausea |
| benzodiazapines | lorazepam and diazepam |
| benzodiazapines | act as anxiolytic agents to reduce anticipatory emesis |
| diazepam | useful in the treatment for vertigo and controls symptoms in Meniere's disease |
| benzodiazapines | cause anterograde amnesia which lasts 4-6 hours |
Created by:
swohlers
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