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Mechanism of Antihistamines

H1 Histamine Receptor Antagonists

Uses of Antihistamines

N/V Associated with motion sickness


Other vestibular disorders

Side Effects of Anti-Histamines

Drowsiness


Antimuscarinic Side Effects

3 Antihistamines

Cinnarizine


Cyclizine


Promethazine

Can Cure Puking

Antimuscarinic Mechanism

Muscarine Receptor Antagonists


Block muscarine receptor-mediated impulses from labyrinth & visceral afferents

Example of Antimuscarine

Hyoscine Hydrobromide

Hi Bro

Uses of Antimuscarine Drug

Motion Sickness

Advantages of Antimuscarine Example

Can be given in patch or tablet form

Side Effects of Antimuscarine

Dry mouth


Constipation


Transient Bradycardia

Dopamine Antagonists - Where do they act?

CTZ

Uses of Dopamine Antagonists?

CTZ-Triggered Vomiting (not stomach-induced)

Class of Dopamine Antagonists that were used for mental patients?

Pheonthiazines - Used as neuroleptics/antipsychotics (Used in Schizophrenia etc.)

Examples of Phenothiazines

Chlorpromazine


Prochlorperazine


Trifluoperazine


Perphenazine



'Azine'

Other Dopamine Antagonists

Domperidone


Metoclopramide (given in pregnancy)

Champagne


Met Jurgen

5HT3 Antagonist Mechanisms

Block 5HT3 Receptors in CNS & GI Tract

5HT3 Antagonist Uses

Preventing Cytotoxic-induced N/V


Post-operative N/V


Short-Term Use


Cancer Patients

5HT3 Antagonist Examples

Dolasetron


Granisetron


Ondansetron


Palonosetron

'Setron'

Neurokinin-1 Receptor Antagonsist Mechanism

5HT3 Antagonist

What are Neurokinin-1 Receptor Antagonists Used With?

Adjunct to Dexamethasone

Examples of Neurokinin-1 Receptor Antagonists

Aprepitant


Fosaprepitant

'Prepitant'

Synthetic Cannabinoids Uses

N/V by Chemo & unresponsive to other anti-emetics


Example of Cannabinoid

Nabilone

'nab'

Side Effects of Cannabinoids

Dizzy & Drowsy

Cannabis effects

Steroid Example

Dexamethasone

Uses of Dexamethasone

Palliative


Shrinks malignancies etc. to relieve pressure


Cancer Chemo-induced N/V


Adjunct to other anti-emetics

Neuroleptic examples

Haloperidol


Levomepromazine

Master Chief + Toby + Doll

Advantages of Neuroleptics

Can be used in syringe drivers


Can be used at home

Uses of Neuroleptics

Palliative Patients