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a drug that prevents or alleviates nausea and vomiting (同)antiemetic_drug

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/20 10:22:36」(JST)

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An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer. They may be used for severe cases of gastroenteritis, especially if the patient is dehydrated.

Antiemetics can also be used for morning sickness, but there is little information about the effect on the fetus, and doctors prefer not to use them unless it is strictly necessary.^[1]

Types of antiemetics

Antiemetics include:

5-HT₃ receptor antagonists block serotonin receptors in the central nervous system and gastrointestinal tract. As such, they can be used to treat post-operative and cytotoxic drug nausea & vomiting. However, they can also cause constipation or diarrhea, dry mouth, and fatigue.^[2]
- Dolasetron (Anzemet) can be administered in tablet form or in an injection.
- Granisetron (Kytril, Sancuso) can be administered in tablet (Kytril), oral solution (Kytril), injection D(Kytril), or in a single transdermal patch to the upper arm (SANCUSO).
- Ondansetron (Zofran) is administered in an oral tablet form, orally dissolving tablet form, orally dissolving film, or in an IV/IM injection.
- Tropisetron (Setrovel, Navoban) can be administered in oral capsules or in injection form.
- Palonosetron (Aloxi) can be administered in an injection or in oral capsules.
- Mirtazapine (Remeron) is an antidepressant that also has antiemetic effects^[3]^[4] and is also a potent histamine H1 receptor antagonist, K_i=1.6 nM.^[5]
Dopamine antagonists act in the brain and are used to treat nausea and vomiting associated with neoplastic disease, radiation sickness, opioids, cytotoxic drugs and general anaesthetics. Side effects include muscle spasms and restlessness.^[2]
- Domperidone (Motilium)
- Olanzapine (Zyprexa)
- Droperidol, haloperidol, chlorpromazine, prochlorperazine. Some of these drugs are limited in their usefulness by their extra-pyramidal and sedative side-effects.
- Alizapride
- Prochlorperazine (Compazine, Stemzine, Buccastem, Stemetil, Phenotil)
- Metoclopramide (Reglan) also acts on the GI tract as a pro-kinetic, and is thus useful in gastrointestinal disease; however, it is poor in cytotoxic or post-op vomiting. also a 5-HT₃ receptor antagonists
NK1 receptor antagonist
- Aprepitant (Emend) is a commercially available NK1 Receptor antagonist
- Casopitant is an investigational NK1 receptor antagonist
Antihistamines (H₁ histamine receptor antagonists) are effective in many conditions, including motion sickness, morning sickness in pregnancy, and to combat opioid nausea.
- Cyclizine
- Diphenhydramine (Benadryl)
- Dimenhydrinate (Gravol, Dramamine)
- Doxylamine
- Meclizine (Bonine, Antivert)
- Promethazine (Pentazine, Phenergan, Promacot) can be administered via a rectal suppository for adults and children over 2 years of age.
- Hydroxyzine (Vistaril)
Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents. These may cause changes in perception, dizziness, and loss of coordination.^[2]
- Cannabis, also known as medical marijuana in the United States, is a Schedule I drug.^{[citation needed]}
- Dronabinol (Marinol) is a Schedule III drug in the U.S.^{[citation needed]}
- Some synthetic cannabinoids such as Nabilone (Cesamet) or the JWH series.
- Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe but not legal in the U.S.^{[citation needed]}
Benzodiazepines
- Midazolam is given at the onset of anesthesia has been shown in recent trials to be as effective as ondansetron.^{[citation needed]}
- Lorazepam (Ativan) is said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran.^{[citation needed]}
Anticholinergics
- Hyoscine (also known as scopolamine)
Steroids
- Dexamethasone (Decadron) is given in low dose at the onset of a general anaesthetic is an effective antiemetic. The specific mechanism of action is not fully understood.^{[citation needed]}
Other
- Trimethobenzamide is thought to work on the CTZ
- Ginger contains 5-HT₃ antagonists gingerols, shogaols,^[6] and galanolactone.^[7] Preliminary clinical data suggests ginger may be effective for treatment of nausea and/or vomiting in a number of settings.^[8]^[9]
- Emetrol is also claimed to be an effective antiemetic.
- Propofol is given intravenously. It has been used in an acute care setting in hospital as a rescue therapy for emesis.^{[citation needed]}
- Peppermint is claimed to help nausea or stomach pain when added into a tea or peppermint candies.
- Muscimol is purported to have antiemetic activity.^[10]
- Ajwain is purported to be antiemetic. It is a popular spice in India, Ethiopia and Eritrea.^{[citation needed]}

References

^ Zachary A. Flake, Robert D. Scalley, Austin G. Bailey (Mar 1, 2004), "Practical Selection of Antiemetics", Am Fam Physician 69 (5): 1169–1174
^ ^a ^b ^c http://www.mesotheliomaweb.org/mesothelioma/treatment/chemotherapy/anti-Enausea-treatment/
^ Pae C-U. Low-dose mirtazapine may be successful treatment option for severe nausea and vomiting. Progress in Neuro-Psychopharmacology and Biological Psychiatry [Internet]. 2006 Aug 30 [cited 2013 Sep 27];30(6):1143–5. Available from: http://www.sciencedirect.com/science/article/pii/S0278584606000935
^ Kast R e., Foley K f. Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects. European Journal of Cancer Care [Internet]. 2007 [cited 2013 Sep 27];16(4):351–4. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2354.2006.00760.x/abstract
^ National Institute of Mental Health. PDSD Ki Database (Internet) [cited 2013 Sep 27]. Chapel Hill (NC): University of North Carolina. 1998-2013. Available from: http://pdsp.med.unc.edu/pdsp.php
^ Abdel-Aziz H, Windeck T, Ploch M, Verspohl EJ. (2006-01-13), "Mode of action of gingerols and shogaols on 5-HT3 receptors: binding studies, cation uptake by the receptor channel and contraction of isolated guinea-pig ileum.", Eur J Pharmacol. 530 (1-2): 136–43, doi:10.1016/j.ejphar.2005.10.049, PMID 16364290
^ Huang, Q.; Iwamoto, Y.; Aoki, S.; Tanaka, N.; Tajima, K.; Yamahara, J.; Takaishi, Y.; Yoshida, M.; Tomimatsu, T.; Tamai, Y. (1991). "Anti-5-hydroxytryptamine3 effect of galanolactone, diterpenoid isolated from ginger". Chemical & pharmaceutical bulletin 39 (2): 397–399. doi:10.1248/cpb.39.397. PMID 2054863. edit
^ Marx, WM; Teleni L; McCarthy AL; Vitetta L; McKavanagh D; Thomson D; Isenring E. (2013). "Ginger (Zingiber officinale) and chemotherapy-induced nausea and vomiting: a systematic literature review". Nutr Rev 71 (4): 245–54. doi:10.1111/nure.12016. PMID 23550785.
^ Ernst, E.; Pittler, M.H. (1 March 2000). "Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials" (PDF). British Journal of Anesthesia 84 (3): 367–371. doi:10.1093/oxfordjournals.bja.a013442. PMID 10793599. Retrieved 6 September 2006.
^ hoe 2#section1 Muscimol. Chemical Data Sheet, Database of Hazardous Materials, CAMEO chemicals

English Journal

Japanese Society of Clinical Oncology clinical practice guidelines 2010 for antiemesis in oncology: executive summary.

Takeuchi H1, Saeki T, Aiba K, Tamura K, Aogi K, Eguchi K, Okita K, Kagami Y, Tanaka R, Nakagawa K, Fujii H, Boku N, Wada M, Akechi T, Udagawa Y, Okawa Y, Onozawa Y, Sasaki H, Shima Y, Shimoyama N, Takeda M, Nishidate T, Yamamoto A, Ikeda T, Hirata K.
International journal of clinical oncology.Int J Clin Oncol.2015 Jun 17. [Epub ahead of print]
The purpose of this article is to disseminate the standard of antiemetic therapy for Japanese clinical oncologists. On the basis of the Appraisal of Guidelines for Research and Evaluation II instrument, which reflects evidence-based clinical practice guidelines, a working group of the Japanese Socie
PMID 26081252

The correlation between plasma aprepitant concentration and antiemetic effect in Japanese gastric or esophageal cancer patients.

Nishizawa K1, Shimada H, Ito M, Oshima Y, Yajima S, Kikuchi Y, Sumino Y, Kaneko H, Nishizawa K, Obayashi M.
International journal of clinical oncology.Int J Clin Oncol.2015 Jun;20(3):538-42. doi: 10.1007/s10147-014-0747-6. Epub 2014 Sep 9.
BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) are significant problems in cancer patients, but a correlation between plasma aprepitant concentration and antiemetic effect has not been reported. This study aimed to characterize the correlation between plasma aprepitant concentration and
PMID 25196862

Evaluation of the validity of chemotherapy-induced nausea and vomiting assessment in outpatients using the Japanese version of the MASCC antiemesis tool.

Matsuda Y1, Okita K2, Furuhata T3, Kutomi G3, Yamashita K4, Sato Y5, Takimoto R5, Hirata K3.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.Support Care Cancer.2015 May 24. [Epub ahead of print]
PURPOSE: The Multinational Association of Supportive Care in Cancer (MASCC) developed the MASCC antiemesis tool (MAT) as a tool for chemotherapy-induced nausea and vomiting (CINV) assessment and subsequently published its Japanese version in 2010. We evaluated the validity of CINV assessment in outp
PMID 26003425

Japanese Journal

がん薬物療法の支持療法 : 化学療法に対する制吐療法 : 現状と将来 (特集がん薬物療法の支持療法・副作用対策・リスク/コストベネフィット)

齊藤光江
腫瘍内科 14(2), 121-127, 2014-08
NAID 40020198001

外来化学療法センターにおける制吐薬の適正使用および医療経済に関する後方視的研究

阿部哲也,横山智央,黒川由衣 [他],早部紘子,宮里明芽,大里洋一,鈴木康予,大屋敷一馬
東京醫科大學雜誌 70(1), 15-25, 2012-01-30
NAID 10030195566

乳がんEC療法における制吐剤の患者による選択と制吐効果の評価

丸山陵子,関矢知恵,近藤時江,辻内史子,高橋佳奈子,島影尚弘,利川千絵,田島健三
医療薬学 38(9), 584-591, 2012
… We investigated which antiemetic treatment patients selected during epirubicin /cyclophosphamide (EC) therapy for breast cancer, and assessed the antiemetic efficacy of each treatment using the MASCC Antiemesis Tool (MAT) completed by the patients. …
NAID 130004502771