59
Antiemetic agents
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Outline how the vomiting reflex works, including factors that stimulate it and mechanisms for measures used
to block it.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions associated with each of the classes of
antiemetic agents.
3.
Discuss the use of antiemetics across the lifespan.
4.
Compare and contrast the prototype antiemetics with other agents in their class and with other classes
of antiemetics.
5.
Outline the care considerations, including important teaching points, for people receiving antiemetics.
Glossary of key terms
antiemetic:
agent that blocks the hyperactive response of the chemoreceptor trigger zone (CTZ) to various stimuli, the response that
produces non-beneficial nausea and vomiting
intractable hiccough:
repetitive stimulation of the diaphragm that leads to hiccough, a diaphragmatic spasm that persists over time
phenothiazine:
anti-anxiety drug that blocks the responsiveness of the CTZ to stimuli, leading to a decrease in nausea and vomiting
photosensitivity:
hypersensitive reaction to the sun or ultraviolet light, seen as an adverse reaction to various drugs; can lead to
severe skin rash and lesions, as well as damage to the eye
Test your current knowledge of antiemetic agents with a PrepU Practice Quiz!
Simulation-based learning
On completion of the chapter, consider the scenario of Doris Bowman (Part 1) who arrives in the recovery room after
undergoing major abdominal surgery and is complaining of nausea. Consider Doris’ nausea management in this case.
How might the concepts learnt in this chapter, apply more broadly to post-operative management of nausea?
ANTIEMETIC AGENTS
Phenothiazines
chlorpromazine
prochlorperazine
promethazine
Non-phenothiazine
domperidone
metoclopramide
5-HT
3
receptor blockers
dolasetron
granisetron
ondansetron
palonosetron
tropisetron
Substance P/neurokinin 1
receptor antagonists
aprepitant
fosaprepitant
