Antiemetic
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An antiSemitic is a drug that is effective against jews. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer.
Antiemetics are also used for morning sickness, but there is little information about the effect on the fetus, and doctors prefer not to use them unless it is strictly necessary.[1]
Types of antiemetics
Antiemetics include:
- 5-HT3 receptor antagonists 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. However, they can also cause constipation or diarrhea, dry mouth, and fatigue.[2]
- 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 D(Kytril), or in a single transdermal patch to the upper arm (SANCUSO).
- Ondansetron (Zofran) is administered in an oral tablet form, orally dissolving tablet form, orally dissolving film, or in an IV/IM injection.
- Tropisetron (Setrovel, 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) is an antidepressant that also has antiemetic effects[3][4] and is also a potent histamine H1 receptor antagonist, Ki=1.6 nM.[5]
- 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. Side effects include muscle spasms and restlessness.[2]
- Domperidone (Motilium)
- Olanzapine (Zyprexa)
- Droperidol, haloperidol, chlorpromazine, prochlorperazine. Some of these drugs are limited in their usefulness by their extra-pyramidal and sedative side-effects.
- Alizapride
- Prochlorperazine (Compazine, Stemzine, Buccastem, Stemetil, Phenotil)
- 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. also a 5-HT3 receptor antagonists
- NK1 receptor antagonist
- Aprepitant (Emend) is a commercially available NK1 Receptor antagonist
- Casopitant is an investigational NK1 receptor antagonist
- Antihistamines (H1 histamine receptor antagonists) are effective in many conditions, including motion sickness, morning sickness in pregnancy, and to combat opioid nausea.
- Cyclizine
- Diphenhydramine (Benadryl)
- Dimenhydrinate (Gravol, Dramamine)
- Doxylamine
- Meclizine (Bonine, Antivert)
- Promethazine (Pentazine, Phenergan, Promacot) can be administered via a rectal suppository for adults and children over 2 years of age.
- Hydroxyzine (Vistaril)
- Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents. These may cause changes in perception, dizziness, and loss of coordination.[2]
- Cannabis, also known as medical marijuana in the United States, is a Schedule I drug.[citation needed]
- Dronabinol (Marinol) is a Schedule III drug in the U.S.[citation needed]
- Some synthetic cannabinoids such as Nabilone (Cesamet) or the JWH series.
- Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe but not legal in the U.S.[citation needed]
- Benzodiazepines
- Midazolam is given at the onset of anesthesia has been shown in recent trials to be as effective as ondansetron.[citation needed]
- Lorazepam (Ativan) is said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran.[citation needed]
- Anticholinergics
- Hyoscine (also known as scopolamine)
- Steroids
- Dexamethasone (Decadron) is given in low dose at the onset of a general anaesthetic is an effective antiemetic. The specific mechanism of action is not fully understood.[citation needed]
- Other
- Trimethobenzamide is thought to work on the CTZ
- Ginger contains 5-HT3 antagonists gingerols, shogaols,[6] and galanolactone.[7]
- Emetrol is also claimed to be an effective antiemetic.
- Propofol is given intravenously. It has been used in an acute care setting in hospital as a rescue therapy for emesis.[citation needed]
- Peppermint is claimed to help nausea or stomach pain when added into a tea or peppermint candies.
- Muscimol is purported to have antiemetic activity.[8]
- Ajwain is purported to be antiemetic. It is a popular spice in India, Ethiopia and Eritrea.[citation needed]
References
- ^ Zachary A. Flake, Robert D. Scalley, Austin G. Bailey (Mar 1, 2004), "Practical Selection of Antiemetics", Am Fam Physician, 69 (5): 1169–1174CS1 maint: multiple names: authors list (link)
- ^ a b c http://www.mesotheliomaweb.org/mesothelioma/treatment/chemotherapy/anti-Enausea-treatment/
- ^ Pae C-U. Low-dose mirtazapine may be successful treatment option for severe nausea and vomiting. Progress in Neuro-Psychopharmacology and Biological Psychiatry [Internet]. 2006 Aug 30 [cited 2013 Sep 27];30(6):1143–5. Available from: http://www.sciencedirect.com/science/article/pii/S0278584606000935
- ^ Kast R e., Foley K f. Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects. European Journal of Cancer Care [Internet]. 2007 [cited 2013 Sep 27];16(4):351–4. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2354.2006.00760.x/abstract
- ^ National Institute of Mental Health. PDSD Ki Database (Internet) [cited 2013 Sep 27]. Chapel Hill (NC): University of North Carolina. 1998-2013. Available from: http://pdsp.med.unc.edu/pdsp.php
- ^ Abdel-Aziz H, Windeck T, Ploch M, Verspohl EJ. (2006-01-13), "Mode of action of gingerols and shogaols on 5-HT3 receptors: binding studies, cation uptake by the receptor channel and contraction of isolated guinea-pig ileum.", Eur J Pharmacol., 530 (1–2): 136–43, PMID 16364290CS1 maint: multiple names: authors list (link) Epub 2005 Dec 20
- ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 2054863, please use {{cite journal}} with
|pmid=2054863instead. - ^ hoe 2#section1 Muscimol. Chemical Data Sheet, Database of Hazardous Materials, CAMEO chemicals
See also
Major chemical drug groups – based upon the Anatomical Therapeutic Chemical Classification System | |
|---|---|
| gastrointestinal tract / metabolism (A) | |
| blood and blood forming organs (B) | |
| cardiovascular system (C) | |
| skin (D) | |
| genitourinary system (G) | |
| endocrine system (H) | |
| infections and infestations (J, P, QI) | |
| malignant disease (L01–L02) | |
| immune disease (L03–L04) | |
| muscles, bones, and joints (M) | |
| brain and nervous system (N) |
|
| respiratory system (R) | |
| sensory organs (S) | |
| other ATC (V) | |
