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Antiemetic drugs, Drugs for chemotherapy and radiation therapy induced…
Antiemetic drugs
vomiting(emesis) occurs due to stimulation of vomiting centre(VC) in lateral medullary reticular formation.
It receives input from GI mucosa, chemoreceptor trigger zone(CTZ) and vestibular apparatus.
Irritation of GI mucosa by drugs or irritants leads to release of serotonin that stimulates VC via 5HT3 receptors.
CTZ is rich in dopamine(D2) and serotonin(5HT3) and neurokinin(NK1) receptor.
Motion sickness occurs due to stimulation of vestibular apparatus and cerebellum.
These structures result in stimulation of VC by activating M1 and H1 receptors.
By stimulation of H1 receptors, histamine plays a permissive role in all types of vomiting.
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Dronabinol
Dronabinol(a cannabinoid) possesses anti-emetic properties and acts by stimulating CB1 receptors.
It can also stimulate appetite(used for AIDS with anorexia).
Central sympathomimetic(tachycardia, palpitation) effects, paranoid reactions
and thinking abnormalities may appear as adverse effects.
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Antihistamines
Antihistamines like promethazine, diphenhydramine, cyclizine or meclizine
can also be used for prophylaxis.
Cinnarizine(antihistaminic with anticholinergic and antiserotonergic properties) is used for treatment of vertigo
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