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Antiemetics can be used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer.
They may be used for gastroenteritis.
5 classes antidopaminergic drugs, antiserotoninergic, antihistamines, anticholinergics and neurokinins.
Antidopaminergic antiemetics are associated with be a threefold increased risk of stroke shortly after the initiation of treatment: domperidone, metopimazine, and metoclopramide.
5-hydroxytryptamine 3 receptor antagonists odansetron, granisetron dolasetron,and palonesetron.
Palonesetron is a second generation 5-HT3RA and has a significantly longer half-life than the first generation compounds.
Aprepitant, fosaprepitant, fosapretant, rolapitant, netipitant, fosnetupitant are neurokinin-1 receptor antgonists
Antiemetic
5-HT3 receptor antagonists block serotonin receptors in the central nervous system and gastrointestinal tract.
5-HT3 receptor antagonists can be used to treat post-operative and cytotoxic induced drug nausea and vomiting.
5-HT3 receptor antagonists can cause constipation or diarrhea, dry mouth, and fatigue.
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, sublingual, 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.
Dopamine antagonists act on the brainstem and are used to treat nausea and vomiting associated with cancer, radiation sickness, opioids, cytotoxic drugs and general anaesthetics.
Side effects of dopamine antagonists include muscle spasms and restlessness.
Olanzapine (Zyprexa)
Haloperidol
Alizapride
Prochlorperazine (Compazine)
Chlorpromazine
Metoclopramide
NK1 receptor antagonists
Aprepitant (Emend)
Antihistamines-H1 histamine receptor antagonists are effective in motion sickness, morning sickness in pregnancy, and to combat opioid nausea.
H1 receptors are present in brain central areas include area postrema and vomiting center in the vestibular nucleus.
Antihistamines have anticholinergic properties that block muscarinic receptors at the same sites.
Agents include:
Cyclizine
Diphenhydramine
Dimenhydrinate
Doxylamine
Mirtazapine an antidepressant that also has antiemetic effects it is also a potent histamine H1 receptor antagonist.
Meclizine
Promethazine can be administered via a rectal suppository, intravenous injection, oral tablet or oral suspension for adults and children over 2 years of age.
Hydroxyzine
Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents.
Dronabinol
Nabilone
Sativex an oral spray contains THC and CBD.
Benzodiazepines
Midazolam
Lorazepam
Anticholinergics
Hyoscine
Atropine
Diphenhydramine
Steroids
Dexamethasone
Trimethobenzamide is thought to work on the CTZ
Ginger contains 5-HT3 antagonists
Emetrol
Propofol
Peppermint
Muscimol