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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Antinausea, antiemetic, and related medications used for children

Antinausea, antiemetic, and related medications used for children
Drug class and drug Mechanism of action Indications Side effects
Antihistamines Minimal antiemetic activity  
Diphenhydramine Vestibular suppression, anti-ACh effect, and H1 antagonist Motion sickness. Sedation, anti-ACh effects*
Hydroxyzine
Dimenhydrinate
Meclizine
Antipsychotics Mild to moderate antiemetic activity  
Promethazine D2 antagonist at CTZ and H1 antagonist Chemotherapy-induced vomiting. Anti-ACh effects*, extrapyramidal reactions, QTc prolongation
Prochlorperazine D2 antagonist at CTZ
Chlorpromazine
Olanzapine D2 antagonist at CTZ, 5-HT6 antagonist
Substituted benzamides Moderate antiemetic activity  
Metoclopramide D2 antagonist at CTZ and 5-HT4 agonist in gut GERD; gastroparesis; chemotherapy-induced vomiting. Irritability and extrapyramidal reactions
Trimethobenzamide D2 antagonist at CTZ
Cisapride 5-HT4 agonist, ACh release in gut GERD; gastroparesis. Diarrhea, abdominal pain, headache, QT prolongation
Benzimidazole derivatives Moderate antiemetic activity  
Domperidone D2 antagonist in gut Gastroparesis; chemotherapy-induced vomiting. Headaches; not available in the United States
Motilin agonist    
Erythromycin Motilin agonist and ACh release Gastroparesis (eg, postinfectious). Nausea, diarrhea
5-HT3 receptor antagonists High antiemetic activity  
Ondansetron 5-HT3 antagonist at CTZ and decreases vagal afferents from gut

Chemotherapy- and postoperative-induced vomiting; cyclic vomiting syndrome.

Ondansetron has also been used in the treatment of acute gastroenteritis.

Ondansetron comes in PO, IM, and IV formulations. All others are IV formulations only. Palonosetron has a longer half-life (40 hours).
Headache, constipation
Granisetron
Tropisetron
Dolasetron
Palonosetron
Tachykinin receptor antagonists High antiemetic activity  
Aprepitant NK1 antagonist, acts on emetic program Chemotherapy-induced vomiting (effect is on delayed phase, >24 hours); cyclic vomiting syndrome. Fatigue, dizziness, diarrhea
Anticholinergics Minimal to mild antiemetic activity  
Scopolamine Vestibular suppression, anti-ACh Motion sickness. Sedation, anti-ACh effects*
Butyrophenones Moderate antiemetic activity  
Droperidol D2 antagonist at CTZ; anxiolytic action and sedation Chemotherapy- and postoperative-induced vomiting. Hypotension, sedation, extrapyramidal effects
Benzodiazepines Minimal antiemetic activity  
Lorazepam Enhanced central GABA-ergic signaling; induces anxiolysis, sedation, and amnesia Adjunctive therapy (sedation) for chemotherapy-induced vomiting and cyclic vomiting syndrome. Diazepam may be given rectally. Sedation, respiratory depression
Diazepam
Antimigraine-abortive triptans  
Sumatriptan 5-HT1B1D agonist; induces cerebral vasoconstriction, relaxes gastric fundus Abortive approach for migraine, abdominal migraine, cyclic vomiting syndrome. Subcutaneous, PO, nasal and rectal formulations. Transient burning sensation in chest and neck
Zolmitriptan PO, ODT, and nasal formulations.
Frovatriptan PO formulation; longer half-life (26 hours).
Rizatriptan ODT formulation.
Other – NSAIDs  
Ketorolac Cyclooxygenase inhibitor of prostaglandin synthesis Abortive approach for migraine, cyclic vomiting syndrome. Gastrointestinal bleeding
Antimigraine – prophylactic medication  
Cyproheptadine H1 antagonist and 5-HT2 antagonist Prevention of migraine, abdominal migraine, cyclic vomiting syndrome. Sedation, anti-ACh effects*, weight gain due to appetite stimulation
Pizotifen, pizotyline 5-HT2 antagonist Not available in the United States
Propranolol β1, β2 adrenergic antagonist Prevention of abdominal migraine, cyclic vomiting syndrome. Hypotension, bradycardia, fatigability; monitor pulse
Amitriptyline, nortriptyline 5-HT2 antagonist, increases synaptic norepinephrine Prevention of migraine, abdominal migraine, cyclic vomiting syndrome. Sedation, anti-ACh effects*, QTc prolongation
Corticosteroids  
Dexamethasone Unknown Adjunctive therapy for chemotherapy- and postoperative-induced vomiting. Adrenal suppression
Cannabinoids  
Dronabinol Acts on CB1R receptors on vagus Chemotherapy-induced vomiting. Disorientation, vertigo, hallucinations
Nabilone

ACh: acetylcholine; H: histamine; D: dopamine; CTZ: chemoreceptor trigger zone; 5-HT: 5-hydroxytryptamine (serotonin); GERD: gastroesophageal reflux disease; PO: orally; IM: intramuscularly; IV: intravenously; NK: neurokinin; GABA: gamma aminobutyric acid; ODT: orally dissolving tablet; NSAID: nonsteroidal antiinflammatory drug; CB1R: cannabinoid receptor 1.

* Anticholinergic effects include blurred vision, dry mouth, hypotension, palpitations, and urinary retention.

¶ Pharmacotherapy for cyclic vomiting syndrome may be preventive, supportive, or abortive, depending on the patient's characteristics. For detailed guidance, refer to UpToDate content and tables on cyclic vomiting syndrome.
Adapted from: B U K. Li, "Vomiting and pyloric stenosis." In Walker's Pediatric Gastrointestinal Disease, 5th Edition. Kleinman RE, Sanderson IR, Goulet O, Sherman PM, Mieli-Vergani G, and Shneider BL, Eds. B.C. Decker Inc. Hamilton, Ontario, 2008. Used with permission from People's Medical Publishing House—USA (PMPH-USA), Shelton, CT.
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