Pages

  • Home
  • Write for Us
  • Hire Us
  • Ask Us
  • Contact Us

Monday, October 3, 2011

Vomiting - Treatment of vomiting, classification and adverse effects of antiemetic drugs

Treatment of vomiting:

Treatment of vomiting varies with its cause, which can be found out by looking at the patient’s clinical presentation.

Reversible causes of vomiting such as hypercalcemia, constipation should be treated accordingly.
If vomiting is caused by a particular drug then that drug should be stopped if possible.

Antiemetic drugs can be given once the probable cause is found out. This is because the receptors that lead to vomiting vary with the cause, eg dopamine receptors in the chemoreceptor trigger zone are stimulated by metabolic and drug causes of nausea and vomiting, whereas gastric irritation stimulates histamine receptors in the vomiting centre via the vagus nerve. So based on the receptors activated, the antiemetic drugs are prescribed.




Classification of Antiemetic agents:

Before prescribing any of the antiemetic agents it is important to find out the cause of vomiting and the type of receptors involved. Combination of antiemetic agents with different mechanism of actions are often used especially in patients with vomiting due to drugs.


Antiemetic agents
Used to prevent nausea & vomiting due to:
1. Seretonin 5 HT3 antagonists
·         Onadensetron
·         Granisetron
·         Dolasetron
·         Palonosetron
Chemotherapy  
Operation
Radiation

2. Corticosteroids
·         Dexamethasone
·         Methylprednisolone

Chemotherapy
3. Neurokinin receptor antagonists
·         Aprepitant
·         Fosaprepitant

Chemotherapy
4. Phenothiazines
·         Prochlorperazine
·         Promethazine
·         Thiethyperazine

Chemotherapy
Operation
Hyperemesis gravidarum
5. Butyrophenones
·         Droperidol
·         Heloperidol

Chemotherapy
6. Substituted Benzamines
·         Metoclopramide
·         Trimethobenzamide

Chemotherapy
7. H1 AntiHistamines & Anticholinergic drugs
·         Diphenhydramine
·         Dimenhydrinate
·         Meclizine
·         Hyoscine

Chemotherapy
Operation
Motion sickness
8. Benzodiazepines
·         Lorazepam
·         Diazepam

Anticipatory vomiting
Anxiety
9. Cannabinoids
·         Dronabinol
·         Nabilone

Chemotherapy

Table: Anti-emetic drugs

Note: Need ORS packet? Clik here to know how to make one or
Click the link to buy Adventure Medical Oral Rehydration Salts (ORS) from Amazon.







Adverse / Side effects of antiemetics:

1. Drowsiness

2. Anti-muscarinic effects (atropine like side effects):

·         Dry mouth
·         Blurred vision
·         Constipation
·         Urinary retention

3. Gynaecomastia, Galactorrhoea (D2 receptor antagonist)

4. CNS disturbances like Somnolence

5. Sedation (Droperidol, Diphenhydramine)

6. Cardiac arrhythmias (Droperidol)


Reference: The following books were used in the making of the above article:






If you enjoyed this article and found it useful then please subscribe to my feeds via RSS or E-mail, and kindly take 5 minutes to share this article with everyone by clicking the share this button below. Thank you!

No comments:

Post a Comment

Your comments are valuable to us. Please tell us what you think.

Related Posts Plugin for WordPress, Blogger...