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ANTIEMETIC

DRUGS
Presented by Satvik Chopra

Roll no. 109


INTRODUCTION TO
ANTIEMETIC DRUGS

Drugs used to prevent or treat nausea and vomiting.

Common Causes of Nausea/Vomiting: Postoperative,


chemotherapy-induced, motion sickness, gastrointestinal
disorders.
Classification
DRUGS

Hyoscine, Dicyclomine

Anticholinergics MECHANISM
Blocks muscarinic receptors in the vomiting
center and vestibular system.

USES:
Motion sickness, postoperative nausea.
DRUGS
Chlorpromazine, Trifluoperazine,
Prochlorperazine

Neuroleptics (D2 MECHANISM

Blockers) Dopamine receptor antagonism in the


chemoreceptor trigger zone (CTZ).

USES:
Chemotherapy-induced nausea, radiation
sickness.
DRUGS
Promethazine, Diphenhydramine,
Dimenhydrinate, Doxylamine, Meclizine

H1 MECHANISM

Antihistaminics Block histamine H1 receptors, preventing


stimulation of the vomiting center

USES:
Motion sickness, vertigo
DRUGS
Metoclopramide, Domperidone, Cisapride,
Mosapride, Itopride

Prokinetic Drugs MECHANISM


Enhances gastric motility and increases lower
esophageal sphincter tone.

USES:
Gastroparesis, GERD, chemotherapy-induced
nausea.
DRUGS
Ondansetron, Granisetron, Palonosetron,
Ramosetron

5-HT3 MECHANISM

Antagonists Block serotonin receptors in the GI tract and


CTZ.

USES:
Postoperative nausea, chemotherapy-induced
nausea.
DRUGS
Aprepitant, Fosaprepitant

NK1 Receptor MECHANISM

Antagonists Inhibit substance P neuropeptide in the vomiting


center.

USES:
Delayed chemotherapy-induced nausea.
DRUGS
Dexamethasone, Benzodiazepines, Dronabinol,
Nabilone

Adjuvant MECHANISM

Antiemetics Varied mechanisms including corticosteroid


action and GABA enhancement.

USES:
Chemotherapy-induced nausea, anticipatory
nausea.
Side
Anticholinergics Neuroleptics (D2
Effects
H1
Blockers) Antihistaminics
Side Effects:
Dry mouth Side Effects: Side Effects:
Blurred vision Extrapyramidal Drowsiness
Urinary symptoms (tremors, Dry mouth
retention rigidity) Dizziness
Constipation Sedation Blurred vision
Drowsiness Hypotension Urinary retention
Anticholinergic effects
Hyperprolactinemia
(long-term use)
Side
Prokinetic Drugs 5-HT3 Antagonists NK1 Receptor Antagonists

Side Effects:
Effects
Side Effects: Side Effects:
Extrapyramidal symptoms Headache Fatigue
(especially metoclopramide) Constipation Hiccups
Diarrhea Dizziness Dizziness
Restlessness Prolonged QT interval Diarrhea
Fatigue Fatigue Elevated liver enzymes
Tardive dyskinesia (long-term use) (rare)
Side
Anticholinergics Adjuvant Antiemetics

Effects
Neuroleptics (D2 H1
Blockers) Antihistaminic
Side Effects: Side Effects:
s
Dry mouth Dexamethasone:
Side Effects:
Blurred vision Insomnia,
Extrapyramidal Side Effects:
Urinary hyperglycemia, fluid
symptoms Drowsiness
retention retention
(tremors, Dry mouth
Constipation Benzodiazepines:
rigidity) Dizziness
Drowsiness Sedation,
Sedation Blurred vision
dependence, memory
Hypotension Urinary
impairment
Anticholinergic retention
Dronabinol/Nabilone:
effects
Euphoria,
Hyperprolactine
hallucinations,
mia (long-term
Summary
Antiemetic drugs play a crucial role in
managing various causes of nausea and
vomiting, with each class targeting
different mechanisms in the vomiting
reflex
Thank you
A presentation by Satvik Chopra (Roll no.
109)

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