II. Mechanism
- Nausea and Vomiting is mediated via the physiologic Vomiting center in the Medulla
- Stimulation of Vomiting center via three pathways
- Vestibular fibers (e.g. Vertigo)
- Afferent visceral fibers (e.g. gastrointestinal)
- Fourth Ventricle (ChemoreceptorTrigger Zone)
III. Preparations: 5-HT3 Receptor Antagonist
- Indications
- Preferred first-line Antiemetic in U.S. in most cases
- Severe Nausea and Vomiting
- Chemotherapy-Induced (See Nausea in Cancer)
- Agents
- Adverse effects
- Asthenia
- Dizziness
- Constipation
- QT Prolongation (see Ondansetron)
- Serotonin Syndrome
- Use in pregnancy may be associated with increased risk of Congenital Heart Defect and Cleft Palate
- (2014) Presc Lett 21(1): 5
IV. Preparations: Phenothiazines
- Indications
- Migraine Headaches
- Motion Sickness or Vertigo
- Chemotherapy-Induced (See Nausea in Cancer)
- Postoperative Nausea (See Nausea After Surgery)
- Severe Nausea and Vomiting
- Agents
- Adverse effects
V. Preparations: Substituted benzamides
- Indications
- Agents
- Metoclopramide (Reglan)
- Trimethobenzamide (Tigan)
- Adverse effects
VI. Preparations: Butyrophenones
- Agents
- Droperidol (Inapsine)
- Use limited due to potential for Prolonged QT
- Generally unavailable in U.S. since 2012
- Haloperidol (Haldol)
- Droperidol (Inapsine)
- Indications
- Chemotherapy-Induced (See Nausea in Cancer)
- Postoperative Nausea (See Nausea After Surgery)
- Adverse Effects
- Sedation
- Agitation or restlessness
VII. Preparations: Antihistamines
- Agents
- Dimenhydrinate (Dramamine)
- Meclizine (Antivert)
- Scopolamine (Transdermal)
- Indications
- Adverse Effects (Anticholinergic effects)
VIII. Preparations: Adjunctive and atypical Antiemetics
-
Dexamethasone
- Chemotherapy-Induced (See Nausea in Cancer)
-
Cannabinoids (Dronabinol)
- Chemotherapy-Induced (See Nausea in Cancer)
-
Benzodiazepines (Lorazepam, Diazepam, Clonazepam)
- Chemotherapy-Induced (See Nausea in Cancer)
- Not generally recommended
IX. Preparations: Brief list of some options for Adults
-
Prochlorperazine (Compazine)
- Other Routes: 5-10 mg PO/IM/IV every 6-8 hours prn
- Rectal: 25 mg PR g12h
- Metoclopramide (Reglan)
- Dose: 10 mg PO/IM/IV every 6 hours prn or 1 hour before meals and qhs
-
Promethazine (Phenergan)
- Dose: 12.5 mg IV or 25 mg PO/IM/PR q4-6h
-
Ondansetron (Zofran)
- Dose: 4 mg (0.15mg/kg) IV (or PO) over 15 min q4h prn
X. References
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSH) | Drugs used to prevent NAUSEA or VOMITING. |
Definition (NCI_NCI-GLOSS) | A drug that prevents or reduces nausea and vomiting. |
Definition (NCI) | Drugs used to prevent nausea or vomiting. Antiemetics act by a wide range of mechanisms. Some act on the medullary control centers (the vomiting center and the chemoreceptive trigger zone) while others affect the peripheral receptors. (MeSH) |
Definition (CSP) | drugs used to prevent nausea or vomiting; act by a wide range of mechanisms; some act on the medullary control centers while others effect the peripheral receptors. |
Concepts | Pharmacologic Substance (T121) |
MSH | D000932 |
SnomedCT | 372764000, 52017007 |
English | Antiemetic Drugs, Drugs, Antiemetic, Agents, Antiemetic, Antiemetic Agents, ANTIEMETICS, [GA605] ANTIEMETICS, Anti-emetic, Anti-emetic Agent, Anti-emetic Agent [TC], Antiemetic Agent, anti-emetic agents, antiemetic drugs, antiemetic agents, antiemetics, antiemetic drug, antiemetic, antinauseant drugs, Antiemetic, Antiemetic (product), Antiemetic (substance), Antiemetic, NOS, Anti emetics, Anti-emetics, Antinauseant Drugs, Antiemetics |
French | Agents antiémétiques, Anti-émétiques, Médicaments antiémétiques, Médicaments antivomitifs, Antiémétisants, Agents antivomitifs, Anti-vomitifs, Antiémétiques, Antivomitifs |
Swedish | Antiemetika |
Czech | antiemetika |
Finnish | Antiemeetit |
Italian | Sostanze antiemetiche, Farmaci antiemetici, Antiemetici |
Russian | PROTIVORVOTNYE SREDSTVA, ПРОТИВОРВОТНЫЕ СРЕДСТВА |
Japanese | 制吐剤, 制吐薬, 鎮吐剤, 鎮吐薬 |
Polish | Leki przeciwwymiotne |
Spanish | Efecto Antiemético, Antiemético, antiemético (producto), antiemético (sustancia), antiemético, Antieméticos |
Portuguese | Efeito Antiemético, Antiemético, Antieméticos |
German | Antiemetika |