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Anti-Emetics (MOA
D2-receptor antagonist
Prokinetic action in GIT
→ ↑…
Anti-Emetics
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5HT3-receptor antagonist
Ondansetron
Granisetron
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Avoid if ↑QTc Levels ↓d by:
- Rifampicin
- CBZ, phenytoin
Avoid with drugs that ↑ QTc
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H1-receptor antagonist
Cyclizine
Cinnarizine
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Indications:
- Opioids (but not ACS)
- Vestibular
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Anti-muscarinic
Hyoscine
hydrobromide
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Indications:
- Prophylaxis vs. motion sickness
- Hypersalivation
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Vomiting
Causes of N/V
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GI:
GORD, gastro, pancreatitis, obstruction
Neoplasia:
oesophageal, gastric, duodenal
Vestibular: e.g.
labyrinthitis, sea-sickness
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Vagal: e.g.
pancreatitis, MI, torsion
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regulated by Vomiting Centre and CTZ, both located in the medulla
CTZ
Outside BBB = accessible to drugs
Also receives input from vestibular system re. motion
Expresses: D2 and 5-HT3 receptors
CTZ projects to Vomiting Centre
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Vomiting Centre
Controls visceral and somatic functions involved in vomiting.
Receives input from CTZ
Also receives muscarinic and histaminergic input (H1)
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