Antiemetic Agents Cheat Sheet

 

(Antiemetic agents are used to treat the Nausea, vomiting, motion, sickness, and vertigo.)

Drugs used in managing nausea and vomiting are called anti-Emetics . All of them work by reducing the hyperactivity of the vomiting reflex in one of two ways: locally, to decrease the local response to stimuli that are being sent to the medulla to induce vomiting, or centrally, to block the chemoreceptor trigger zone (CTZ) or suppress the vomiting center directly.

The locally acting antiemetics may be antacids, local anesthetics, adsorbents, protective drugs that coat the GI mucosa, or drugs that prevent distention and stretch stimulation of the GI tract. These agents are often reserved for use in mild nausea.

 

Centrally acting antiemetics can be classified into several groups: phenothiazines, nonphenothiazines, anticholinergics/ antihistamines, serotonin (5-HT3) receptor blockers, substance P/neurokinin 1 receptor antagonist, and a miscellaneous group.

antiemetic-drugs

Adverse Reactions

Antiemetics may cause asthenia, fatigue, dizziness, headache, insomnia, abdominal pain, anorexia, constipation, diarrhea, epigastric discomfort, gastritis, heartburn, nausea, vomiting, neutropenia, hiccups, tinnitus, dehydration, and fever.

 

1: Meclizine (Antivert)

INDICATIONS:

  • Vertigo
  • Motion sickness

ADVERSE REACTIONS

  • CNS: drowsiness, auditory and visual hallucinations, excitation, nervousness, restlessness
  • CV: hypotension, palpitations, tachycardia
  • EENT: blurred vision, diplopia, dry nose and throat, tinnitus
  • GI: anorexia, constipation, diarrhea, dry mouth, nausea, vomiting
  • GU: urinary frequency, urine retention
  • Skin: rash, urticaria

 

2: Metoclopramide (Reglan)

INDICATIONS

  • To prevent or reduce nausea and vomiting from emetogenic cancer chemotherapy
  • To prevent or reduce postoperative nausea and vomiting
  • To facilitate small-bowel intubation, to aid in radiologic examinations
  • Delayed gastric emptying secondary to diabetic gastroparesis

 

ADVERSE REACTIONS

  • CNS: anxiety, drowsiness, dystonic reactions, fatigue, lassitude, restlessness, neuroleptic malignant
  • syndrome, seizures, suicide ideation, akathisia, confusion, depression, dizziness
  • CV: bradycardia, supraventricular tachycardia
  • GI: bowel disorders, diarrhea, nausea
  • Hematologic: agranulocytosis, neutropenia
  • Gastroesophageal reflux disease

 

3: Dolasetron (Anzemet)

INDICATIONS

  • To prevent nausea and vomiting from emetogenic chemotherapy
  • To prevent postoperative nausea and vomiting
  • To prevent nausea and vomiting from radiation therapy

 

ADVERSE REACTIONS

  • CNS: dizziness, fatigue, headache, malaise, sedation, extrapyramidal syndrome, fever, pain
  • CV: arrhythmias, chest pain
  • GI: constipation, diarrhea, abdominal pain, decreased appetite
  • GU: gynecologic disorders, urine retention
  • Respiratory: hypoxia
  • Skin: pruritus, rash

4: Prochlorperazine (Compazine)

INDICATIONS

  • To control preoperative nausea
  • Severe nausea and vomiting

 

ADVERSE REACTIONS

  • CNS: extrapyramidal reactions
  • CV: orthostatic hypotension, ECG changes, tachycardia
  • EENT: blurred vision, ocular changes
  • GI: constipation, dry mouth, increased appetite
  • GU: urine retention, dark urine
  • Hematologic: agranulocytosis, transient leukopenia
  • Skin: mild photosensitivity reactions

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