From the Guidelines
Antiemetics are medications used to prevent or treat nausea and vomiting, and they work through different mechanisms, such as blocking serotonin receptors, histamine receptors, or substance P receptors. For mild nausea, ondansetron (Zofran) 4-8mg orally every 8 hours is often the first-line choice due to its efficacy and minimal side effects 1. For more severe cases, a combination approach may be needed, such as adding promethazine 12.5-25mg orally or IV every 6 hours, or metoclopramide 10mg orally or IV every 6 hours. For chemotherapy-induced nausea, aprepitant (125mg on day 1, then 80mg on days 2-3) is particularly effective 1. The choice of antiemetic medication depends on the underlying cause of nausea and vomiting, as well as individual patient factors, such as medical history and concurrent medications. Some key points to consider when selecting an antiemetic medication include:
- The emetogenic potential of the chemotherapy regimen or other underlying cause of nausea and vomiting
- The patient's medical history and concurrent medications
- The potential side effects of the antiemetic medication
- The patient's individual response to previous antiemetic medications It is also important to note that antiemetic medications can be administered through various routes, including oral, intravenous, and transdermal, and that the choice of route may depend on the individual patient's needs and preferences 1. Overall, the goal of antiemetic therapy is to prevent or alleviate nausea and vomiting, and to improve the patient's quality of life. Some of the antiemetic medications that are commonly used include:
- 5-HT3 antagonists, such as ondansetron and granisetron
- Corticosteroids, such as dexamethasone
- NK1 receptor antagonists, such as aprepitant
- Dopamine antagonists, such as metoclopramide
- Antihistamines, such as promethazine
- Anticholinergics, such as scopolamine.
From the FDA Drug Label
Aprepitant capsules, in combination with other antiemetic agents, are indicated in patients 12 years of age and older for the prevention of: • acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (HEC) including high-dose cisplatin • nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy (MEC).
Antiemetics are medications used to prevent or treat nausea and vomiting. In the context of the provided drug labels, antiemetic agents refer to medications like aprepitant, which are used in combination with other agents to prevent nausea and vomiting associated with chemotherapy or postoperative nausea and vomiting.
- Key points about antiemetics include:
From the Research
Definition and Mechanism of Antiemetics
- Antiemetics, also known as anti-emetic medications, are drugs used to prevent or treat nausea and vomiting [(3,4,5,6,7)].
- These medications work by blocking the action of serotonin, a natural substance that can cause nausea and vomiting, at specific receptors in the body [(3,4,5,6,7)].
Types of Antiemetics
- 5-HT3 receptor antagonists, such as ondansetron, are a class of antiemetics that are commonly used to prevent and treat nausea and vomiting caused by chemotherapy, radiation therapy, and surgery [(3,4,5,6,7)].
- Other types of antiemetics include antidopaminergics, antihistamines, and anticholinergics, which work by blocking different receptors or pathways involved in nausea and vomiting [(4,7)].
Efficacy and Safety of Antiemetics
- Ondansetron, a selective 5-HT3 receptor antagonist, has been shown to be effective in preventing and treating nausea and vomiting caused by chemotherapy, radiation therapy, and surgery [(3,5,6)].
- Antiemetics, including ondansetron, are generally well-tolerated, but can cause side effects such as headache, constipation, and diarrhea [(3,4,5,6)].
- The choice of antiemetic medication depends on the individual patient's needs and medical history, as well as the specific cause of nausea and vomiting [(4,7)].