Antiemetics



Antiemetics







TERMS



  • □ meclizine (Antivert)


  • □ metoclopropamide (Reglan)


  • □ ondansetron (Zofran)


  • □ prochlorperazine (Compazine)



QUICK LOOK AT THE CHAPTER AHEAD

The antiemetics are drugs that are used in the treatment and prevention of nausea and vomiting. They come from a variety of drug classifications. In general, these drugs work on the cerebral cortex, chemoreceptor trigger zone (CTZ), vomiting center, or the inner ear to deal with nausea and vomiting.









Table 65-1 Antiemetics



























Prototype Drug

Related Drugs

Drug Classification


prochlorperazine (Compazine)

chlorpromazine (Thorazine)


perphenazine (Trilafon)


promethazine (Phenergan)


thiethylperazine (Torecan)

Phenothiazines


metoclopropamide (Reglan)

There are no related drugs

Prokinetic agent


meclizine (Antivert)

buclizine (Bucladin-S Softab)


cyclizine (Marezine)


dimenhydrinate (Dramamine)


hydroxyzine (Vistaril)

Antihistamines


ondansetron (Zofran)

dolasetron (Anzemet)


granisetron (Kytril)


palonosetron (Aloxi)

5-HT3 receptor antagonists


There is no prototype drug for this classification

dronabinol (Marinol)


trimethobenzamide (Tigan)

Miscellaneous agents



ANTIEMETICS CLIENT TEACHING


For All Antiemetics



  • Do not drink alcohol.


  • Do not breast-feed.


  • Do not get pregnant.


  • No activities requiring concentration until drug effects are known.


  • Take drug before nausea and vomiting start.


Phenothiazines



  • Prochlorperazine (Compazine) may turn urine reddish-brown.



image Prochlorperazine (Compazine) may turn urine reddish-brown.


5-HT Receptor Antagonists



  • Headache is common side effect and will require pain medication.



image Headache is common side effect and will require pain medication.



ACTION


Phenothiazines



  • Work directly on the CTZ to prevent or treat nausea and vomiting


Prokinetic Drug



  • Desensitizes nerves in the CTZ to substances that cause vomiting


Antihistamines



  • Interfere with the action of acetylcholine in the brain


5-HT3 Receptor Antagonists



  • Block serotonin receptors in the CTZ and the periphery


Miscellaneous Drugs


Dronabinol (Marinol)



  • It is not known how this drug works, but it is believed to act on a “control mechanism” found in the medulla oblongata.


Trimethobenzamide (Tigan)



  • Acts directly on the CTZ


USE


Phenothoazines



  • Severe nausea and vomiting


  • Nausea and vomiting occurring with anesthesia


  • Intractable hiccups


Prokinetic Drug



  • Prevention of nausea and vomiting associated with cancer chemotherapy



Antihistamines



  • Nausea and vomiting associated with motion sickness


  • Prevention and treatment of nausea and vomiting associated with anesthesia in obstetrics and general surgery


5-HT3 Receptor Antagonists



  • Nausea and vomiting associated with cancer chemotherapy


Miscellaneous Drugs


Dronabinol (Marinol)



  • Nausea and vomiting associated with cancer chemotherapy in adults


Trimethobenzamide (Tigan)



  • Nausea and vomiting


ADVERSE EFFECTS AND SIDE EFFECTS


Phenothizines



  • Pregnancy category C, except for thiethylperazine (Torecan), which is category X


  • CNS: Extrapyramidal reactions, drowsiness, dizziness


  • CV: Low blood pressure


  • Derm: Photosensitivity


  • EENT: Blurred vision


  • Endocrine: Amenorrhea, galactorrhea


  • GI: Jaundice


  • Hematologic: Agranulocytosis, leukopenia


Prokinetic Drug



  • Pregnancy category B


  • CNS: Extrapyramidal reactions, fatigue, restlessness, sedation


  • Derm: Rash



  • Endocrine: Impotence, amenorrhea, galactorrhea, gynecomastia


  • GI: Diarrhea, dry mouth


  • Hematologic: Methemoglobinemia


  • Other: Periorbital edema


Antihistamines



  • Pregnancy category B, except hydroxyzine (Vistaril) and buclizine (Bucladin-S Softab), which are category C


  • CNS: Drowsiness, fatigue


  • EENT: Blurred vision


  • GI: Dry mouth


5-HT Receptor Antagonists



  • Pregnancy category B


  • CNS: Sedation, headache


  • GI: Diarrhea


  • Other: Hypersensitivity


Miscellaneous Drugs


Dronabinol (Marinol)

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Oct 21, 2016 | Posted by in NURSING | Comments Off on Antiemetics

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