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07-SEPTEMBER-2008 03:17:44 - Antiemetic 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. Contents 1 Types of Anti-emetics 2 References 3 See also Types of Anti-emetics Antiemetics 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 Reglan 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 Gravol Meclizine Promethazine Pentazine, Phenergan, Promacot Hydroxyzine Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents. Cannabis Marijuana. Most patients prefer smoked or vaporized cannabis over pharmaceutical versions because they do not contain all 66 cannabinoids that are in cannabis, many of which have medicinal applications. Medical marijuana is also much less expensive than related pharmaceuticals. CBD is a main cannabinoid not in Marinol or Cesamet. Dronabinol Marinol. Ninety percent of sales are for cancer and AIDS patients. The other 10% of its sales thought to be for pain, Multiple Sclerosis and also for Alzheimer's disease. Nabilone Cesamet. Put back on the market in late 2006. In the US, it is A Schedule II substance unlike Marinol which is Schedule III and cannabis which is Schedule I. Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe but not in the U.S. Benzodiazepines Midazolam given at the onset of anesthesia 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. Lorazepam said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran. 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. NK1 receptor antagonist Aprepitant Commercially available NK1 Receptor antagonist Casopitant Investigational NK1 receptor antagonist Other Trimethobenzamide; thought to work on the CTZ Ginger Emetrol also claimed to be an effective antiemetic. Propofol given intravenously. It has been used in an acute care setting in hospital as a rescue therapy for emesis. Peppermint claimed to help nausea or stomach pain when added into a tea or peppermint candies. Muscimol purported as such 1 Ajwain purported to be antiemetic. Also known as Bishop's weed, it is a popular spice in India, Ethiopia and Eritrea. Non-pharmaceutical therapies with some evidence of efficacy include acupuncture and hypnosis. All drugs have potential side effects. It is important to try to reduce the baseline risk of nausea and vomiting, particularly with respect to surgery. References ^ Chemical Data Sheet See also Emetic Hyperemesis gravidarum Chemotherapy v d e Major drug groups Gastrointestinal tract/metabolism A stomach acid Antacids, H2 antagonists, Proton pump inhibitors Antiemetics Laxatives Antidiarrhoeals/Antipropulsives Anti-obesity drugs Anti-diabetics Vitamins Dietary minerals Blood and blood forming organs B Antithrombotics Anticoagulants, Antiplatelets, Thrombolytics Antihemorrhagics Cardiovascular system C cardiac therapy/antianginals Cardiac glycosides, Antiarrhythmics, Cardiac stimulant Antihypertensives Diuretics Vasodilators Beta blockers renin-angiotensin system ACE inhibitors, Angiotensin II receptor antagonists, Renin inhibitors Antihyperlipidemics Skin D Emollients Cicatrizant Antipruritics Reproductive system G Hormonal contraception Fertility agents SERMs Sex hormones Endocrine system H Corticosteroids Sex hormones Thyroid hormones Antithyroid agent Infections and infestations J, P Antibiotics Antivirals Vaccines Antifungals Antiparasitic Antiprotozoals, Anthelmintics Malignant and immune disease L Anticancer agents Immunostimulators Immunosuppressants Muscles, bones, and joints M Anabolic steroids Anti-inflammatories NSAID Antirheumatics Corticosteroids Muscle relaxants Brain and nervous system N Anesthetics General, Local Analgesics Anticonvulsants Mood stabilizers Psycholeptic Anxiolytics, Antipsychotics, Hypnotics/Sedatives Psychoanaleptic Antidepressants, Stimulants/Psychostimulants Respiratory system R Bronchodilators Decongestants H1 antagonists Other ATC V Antidotes Contrast media Radiopharmaceuticals Dressing v d e Antiemetics and antinauseants A04 Serotonin 5-HT3 antagonists Azasetron Dolasetron Ondansetron Granisetron Palonosetron Ramosetron Tropisetron Dopamine antagonists Alizapride Domperidone Metoclopramide Metopimazine Prochlorperazine Antihistamines Cyclizine Meclizine Promethazine NK1 receptor antagonists Aprepitant Casopitant Fosaprepitant Cannabinoids Dronabinol Nabilone Benzodiazepines Lorazepam Midazolam Anticholinergics Scopolamine Corticosteroids Dexamethasone Other Cerium oxalate Chlorobutanol Propofol Trimethobenzamide Retrieved from http://en..org/wiki/Antiemetic Categories: Antiemetics Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Türkçe Català Dansk Deutsch Español Français Hrvatski Bahasa Indonesia Nederlands Norsk bokmål Norsk nynorsk Polski Română Svenska This page was last modified on 19 August 2008, at 01:00
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