ANTI EMETIC DRUGS GET DEEP UNDERSTANDING

Anti Emetic Drugs 

 Antiemetic drugs used in clinical practice include:

Chlorpromazine ,Metoclopramide,  Promethazine hydrochloride,Droperidone,Donperidone.

They are indicated for treatment of nausea and vomiting due to: Adverse effects from medications Systemic disorders: pregnancy, vestibular dysfunction, increased pressure, hepatobiliary disorders, radiation or chemotherapy, and gastrointestinal obstruction, dysmotility Infections: central nervous system infection, peritonitis.

Also used in intractable hiccoughs and vertigo.Also are indicated in post operative.

STEP 3: Contraindications of Antiemetic Drugs

Antiemetic drugs are contraindicated in patients with known hypersensitivity to these drugs. 

Prochlorperazine is contraindicated in patients with:

Narrow angle glaucoma.

Severe liver disease.

Cardiovascular disease.

STEP 4: Dose, Dosage and Course of Antiemetic Drugs:

a)Chlorpromazine 10-25 mg PO q4-6 h prn.

b)Metoclopramide 1-2mg/kg iv 15-30 min. 

c)Promethazine hydrochloride 20-25mg at bed time.

d)Droperidol 0.625-1.25mg 30 min before end of the surgery.

e)Donperidone 10-20mg 3-4 times daily

STEP 5: Side Effects and Adverse Effects of Antiemetic Drugs:

Side effects of antiemetic drugs are: Headache, Dizziness ,Constipation ,Drowsiness ,Sedation ,Dry mouth ,Hypertension ,Hypotension ,Nasal congestion, Diarrhea.

STEP 6: Interactions and Precautions of Antiemetic Drugs

Precaution should be taken in: 

a)Severe nausea and vomiting b)Obstructive diseases of gastro intestinal or genitourinary system 

To be used with caution to patients with:

 Hypertension, Sleep apnea ,Epilepsy ,

Antiemetics interact with:

Central nervous system depressants such as: Sedatives Antidepressants,Opiates,Hypnotics,Antianxiety drugs.

Also exaggerate the anticholinergic effects of antihistamine, antidepressants, phenothiazines and disopyramide.

Antiacids decrease absorption of antiemetic.

Step 7: Key Points

Antiemetic drugs are indicated in patients with nausea and vomiting due to infections, systemic disorders and effects of other medications 

 Antiemetic drugs are contraindicated in patients with known hypersensitivity and severe liver and cardiovascular diseases .

The side effects of Antiemetic drugs are headache, dizziness, constipation diarrhea and sedation.

Caution should be taken to patient with severe nausea and vomiting and genitourinary and gastrointestinal obstructive condition.

Antiemetic drugs react with different drugs central nervous depressant and increases effects of anticholinergic drugs. 

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STEP 8:References

Ministry Of Health and Social Welfare. (2013).

Standard Treatment Guidelines & National Essential Medicines List Tanzania Mainland (4th ed.).Dar es salaam, Tanzania government printers.  

Robert, L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael. (2014). Pharmacotherapy: A Pathophysiologic Approach (9th ed.). New York, McGraw-Hill Education. Sally, S.R, Jeanne C.S. (2000). 

Introductory Clinical Pharmacology (6th ed) New York, Lippincott Williams and Wilkins

School of Pharmaceutical sciences. (2011).

Tanzania Pharmaceutical Handbook (2nd ed.). Dar es Salaam, ARDHI University press. The Royal Pharmaceutical Society of Great Britain. (2007).

Martindale, The Extra Pharmacopoeia (5TH ed).

London, pharmaceutical press.

The Royal Pharmaceutical Society of Great Britain.

(2009). British National Formulary (59th ed). London, BMJ Group and RPS Publishing.