L5 - Nausea and Vomiting

what pharm class blocks dopamine receptors in the CTZ and GI tract.

Dopamine Receptor Antagonists

what pharm class has antiemetic properties

antihistamines

what pharm class blocks serotonin receptors in the GI tract and CTZ.

Selective 5-HT3 Receptor Antagonists

Drugs under Dopamine receptor antagonists

Domperidone, Metoclopramide, Prochlorperazine maleate

Drugs under Antihistamines

Cinnarizine, Dimenhydrinate, Promethazine HCl

Drug under Selective 5HT₃- receptor antagonist

Ondansetron

Indications to use Dopamine receptor antagonist

Relief of nausea and vomiting

Indications to use Antihistamine

Motion sickness

Indications to use Selective 5HT₃- receptor antagonist

For nausea/vomiting due to chemotherapy or radiotherapy

Domperidone side effects

Dry mouth, dizziness

Domperidone Contraindications

Hypersensitivity to domperidone, heart failure

Domperidone counselling points

Take 15 to 30 minutes before food.

Avoid taking grapefruit or grapefruit juice

Do not exceed 30mg per day (may cause irregular heartbeat, fainting)

Metoclopramide Side effects

Drowsiness

Metoclopramide Contraindications

Hypersensitivity to metoclopramide

Metoclopramide Special counselling points

Take 30 minutes before food, may affect mental alertness so do not drive or operate machinery

Prochlorperazine maleate Side effects

Constipation, dry mouth, drowsiness

Prochlorperazine maleate Contraindications

Hypersensitivity to phenothiazines

Prochlorperazine maleate Special counselling points

do not drive or operate machinery, no alcohol, may cause dizziness especially when you stand up quickly

Cinnarizine Side effects

Drowsiness (esp children and elderly), GI discomfort

Cinnarizine Contraindications

hypersensitivity to cinnarizine

Cinnarizine counselling points

do not drive or operate machinery, no alcohol

Dimenhydrinate Side effects

Drowsiness, dizziness, dry mouth, headache, epigastric distress, tachycardia

Dimenhydrinate Contraindications

Hypersensitivity to dimenhydrinate

Dimenhydrinate counselling points

do not drive or operate machinery, no alcohol

Promethazine HCl Side effects

Drowsiness, dizziness, dry eyes, nausea/ vomiting, dry mouth, urinary retention

Promethazine HCl Contraindications

Hypersensitivity promethazine, other phenothiazines, do not give children <2 years of age ( affect respiratory tract)

Promethazine HCl counselling points

Take with food, water, or milk to decrease GI discomfort. do not drive or operate machinery, no alcohol

Ondansetron Side effects

Constipation, fatigue, headache, malaise

Ondansetron Contraindications

Hypersensitivity to ondansetron, concomitant use with apomorphine

Ondansetron counselling points

If you vomit within 1 hour of taking your first tablet, take the same dose again. If you continue to vomit, consult your doctor