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Glossary of Antiemetic Agents

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Four ways to stimulate nausea and vomitting
stretch afferents in stomach
stimulus of the Area Postrema
Vestibular afferents
Higher cortical centers
Exception to the rule that drugs for motion sickness don't work for drug induced nausea
promethazine
Promethazine is unique because
it is effective against motion sicknes and drug-induced nausea
Drugs that work for motion sickness also work for...?
nausea induced by vertigo
Drugs for motion sickness
muscarinic antagonists of histamine anatgonists

scopolamine
dimenhydrinate
hydroxyzine

Must use 1 hours before (4 hours if transdermal)
Motion sickness drugs side effects
sedation and antimuscarinic effects
Ondansetron
5HT-3 antagonist

1st line anti N/V from operation, opiates or chemo
1st line antiemtic that can be used alone or combined for different uses
Ondansetron
Its prokinetic effects is atropine sensitive
Metoclopromide
Metoclopromide
Dopamine antag, prokinetic
May produce akathisia, dystonic reactions

Sensitive to atropine
Safe alternative to metoclopromide
Domperidone
Domperidone
Alternative to metoclopromide because it doesn' cross the BBB
Third line rescue therapy for chemp N/V
phenothiazines
Chlorpromazine
Prochlorperazine

Have high incidence of extrapyramidal side effects
Chlorpromazine
Procholorperazine
Third line anti cancers due to extra pyramidal side effects
Greatly enance effectiveness of other antiemetics
Dexamethasone

Used with Ondansetron for actue emesis from drugs
Dexamthasone
Enhances effectiveness of other cancer drugs
Lorazepam
Pretreatment to reduce stress and anticipatory emesis

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