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Nausea and vomiting (Aetiology (Trauma CNS: head trauma GIT: bowel…

- - - - Anti-emetics
        
        Antimuscarinics
        E.g. hyoscine hydrobromide
        MOA: antimuscarinic (inhibits vomiting centre), also antispasmodic and antisecretory in the gut
        DI: dont use with a prokinetic (opposing actions)
        
        5HT3 antagonist
        Indication: chemicals; visceral irritation (e.g. post-surgery)
        MOA: antagonises 5HT3 in gut
        E.g. ondansetron
        SEs: constipation, QTc prolongation
        
        D2 antagonists
        Indication: GI/vestibular, chemical (haloperidol)
        E.g. metaclopramide, domperidone, prochlorperazine, haloperidol
        MOA: anti-emetic and prokinetic; domperidone doesnt cross BBB
        while metaclopramide does, so central SEs
        SEs: EPS, sedation, QTc prolongation
        CI: bowel obstruction; metaclopramide in PD (crosses BBB)
        
        H1 antagonists
        Indication: GI/vestibular
        MOA: inhibit vomiting centre
        E.g. cyclizine, cinnarizine
        
        Steroid
        Indication: adjuvant
        E.g. dexamethasone
        MOA: unclear
        
        Sedative
        Indication: adjuvant
        E.g. midazolam
        MOA: unclear; antiemetic and sedative