Antiemetic

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Last updated 1:16 PM on 3/17/26
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13 Terms

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1st Generation Drugs: Dolasetron, Ondansetron, Granisetron

Serotonin 5-HT3 Receptor Antagonists

  • Potent antiemetic

  • Antiemetic action is restricted to emesis caused by vagal stimulation and chemotherapy

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2nd Generation Drugs: Palonosetron

Serotonin 5-HT3 Receptor Antagonists

  • For CINV, Radiation therapy and Post-op. N&V

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Aprepitant

NK-1 Receptor Antagonists

  • Selective antagonist of the binding of Substance P to the neurokinin-1 (NK1) receptor

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IV: Fosaprepitant

NK-1 Receptor Antagonists

  • Used in combination with 5HT3-receptor antagonists and corticosteroids for the prevention of acute and delayed nausea and vomiting from highly emetogenic chemotherapeutic regimens

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Dexamethasone

Corticosteroids

  • Mechanism is unclear

  • Prevention of acute and delayed CINV

  • Recommended in combination with aprepitant before highly emetogenic chemotherapy

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Domperidone

Dopamine Antagonists

  • Used in the preventive and curative treatment of nausea and vomiting and dyspepsia with motility disorder

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Metoclopramide

Dopamine Antagonists

  • Same as domperidone

  • Phenothiazine Derivatives: Promethazine, Prochlorperazine

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Tetrahydrocannabinol (THC)

Cannabinoids

  • A psychoactive constituent from marijuana

  • Used to control nausea and vomiting during chemotherapy in the 1970's

  • Antiemetic mechanism is unknown

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Nabilone

Cannabinoids

  • A synthetic cannabinoid

  • Is more active than prochlorperazine in preventing chemotherapy-induced emesis, including cisplatin-containing regimens

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Levonantradol

Cannabinoids

  • Synthetic cannabinoid

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Antihistamines

  • Block the histamine receptors in the vomiting center and thus reduce activity along these pathways

  • Includes: Buclizine, Cyclizine, Dimenhydrinate, Diphenhydramine, Meclizine

  • Reduce N&V associated with motion sickness

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Scopolamine

Anticholinergics

  • Available as transdermal patch for motion sickness

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Benzodiazepines

  • Suppress vestibular responses (GABA modulation) and reduce cerebral cortex input to vomiting center

  • Good for anticipatory nausea and vomiting before cancer chemotherapy