ANTIEMETIC DRUGS

CLASSIFICATIONS
1. H1antihistamines: Meclizine, Cinnarizine, Cyclizine,
Dimenhydrinate &
Diphenydramine.
2. Muscarinic Antagonist: Hyoscine (Scopolamine).
3.Selective 5-HT3 Antagonists :
Ondansetron, Granisetron,
Palonosetron & Dolasetron.
4. D2 Antagonists
a. Substituted Benzamides: Metoclopramide
Trimethobenzamide
b.Domperidone
c. Phenothiazines: Prochlorperazine, Promethazine
& Thiethylperazine.
d. Butyrophenone: Droperidol
5. Cannabinoids: Dronabinol , Nabilone
6. Glucocorticoids: Dexamethasone
Methylprednisolone
7. Benzodiazepines: Diazepam , Lorazepam
8. Neurokinin-I Antagonist: Aprepitant
 Metoclopramide
Pharmacokinetics:
Rapidly absorbed from GIT, undergoes high degree of 1st pass effect.
Excreted in urine & breast milk.

MOA:
Dual MOA, acts by increasing motility of stomach ( minimizing food stasis) & by
central inhibition of CTZ.

Adverse Effects:
 Extra pyramidal reactions: facial & sk muscle spasms
 Bowl upsets
 Drowsiness, fatigue, dizziness, restlessness, & anxiety
Therapeutic Uses of Anti-emetics:
 Motion sickness: Hyoscine, Cinerazine
 Vestibular disorders( Meniere’s disease)
Cinerazine
 Vomiting due to Uremia,Radiation,Viral
gastro enteritis. Prochlor perazine ,Metroclopramide
 Vomiting due to Cytotoxic
Anticancerdrugs. Metroclopramide, 5HT3
Antagonists– Ondensetron
 Cannabinoids– Nabilon.
 Post Operative Vomiting: Prochlor perazine ,
Prochlorperazine , Dimenhydrinate.
5HT3 Antagonists– Ondensetron

Anticipatory Vomiting due to Cytotoxic

Anticancerdrugs. Benzodiazepines:
Diazepam
 Pro Kinetic Agents(selectively stimulate gut motility)
1. Cholinergic Drugs
2. Specific Drugs:
 Metoclopramide & Domperidone
 Cisapride
 Erythromycin
 MOA:
 Actions:
Uses:
 Chronic GORD.

 Delayed Gastric emptyimg time.

 Gastropresis in DM & after Vagotomy

 Intestinal Pseudo- obstruction.