antiemetics

鎮吐薬、制吐薬

WordNet

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

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/19 10:06:46」(JST)

wiki ja

[Wiki ja表示]

制吐薬（せいとやく、英：antiemetics）は、化学受容器引き金帯、大脳皮質、前庭器、嘔吐中枢のいずれかあるいはその複数に作用して悪心や嘔吐を抑制する薬物の総称。化学受容器引き金帯に拮抗するメトクロプラミド、求心性迷走神経と化学受容器引き金帯に作用するグラニセトロンなどがある。制吐薬はつわりにも使用される、しかし、胎児への影響の情報が限られている為、医師は非常時の場合を除き制吐薬の処方を好まない。

制吐薬の種類

制吐薬は以下を含む、

• セロトニン5HT3受容体拮抗薬は中枢神経の嘔吐中枢や消化管にあるセロトニン受容体を遮断する。このように、これらの薬剤は術後や細胞毒性薬剤による嘔吐や嘔気に使われる。しかし、これらの薬剤は便秘、下痢、口渇、疲労を生じさせる。
  • en:Dolasetron
  • グラニセトロン
  • オンダンセトロン
  • en:Tropisetron
  • en:Palonosetron
  • ミルタザピン

• ドーパミン拮抗薬は脳に作用し、腫瘍性疾患の治療や放射線障害、オピオイド、細胞毒性薬剤、一般的な麻酔薬による嘔吐や嘔気に使われる。副作用は痙攣や激越がある。
  • ドンペリドン（ナウゼリン®)
  • オランザピン(ジプレキサ®)（適応外）
  • en:Droperidol、ハロペリドール、クロルプロマジン、en:Prochlorperazine
  • en:Alizapride
  • en:Prochlorperazine
  • メトクロプラミド(プリンペラン®)

• NK1受容体拮抗薬
  • en:Aprepitant
  • en:Casopitant

• 抗ヒスタミン薬は多くの状態に効果がある。乗り物酔い、つわり、オピオイドの嘔気など。
  • en:Cyclizine
  • ジフェンヒドラミン
  • en:Dimenhydrinate
  • ドキシラミン
  • メクリジン
  • プロメタジン
  • en:Hydroxyzine

• その他
  • ショウガはセロトニン5HT3受容体拮抗作用のある、ジンゲロール・ショウガオール、en:Galanolactoneを含む。
  • ペパーミント
  • ムッシモール

脚注

参考文献

• 伊藤勝昭ほか編集　『新獣医薬理学 第二版』 近代出版　2004年　ISBN 4874021018

wiki en

[Wiki en表示]

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.

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.
  • 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 and is also a potent histamine H1 receptor antagonist, K_i=1.6 nM.
• 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.
  • 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.
  • Cannabis, also known as medical marijuana in the United States, is a Schedule I drug.
  • Dronabinol (Marinol) is a Schedule III drug in the U.S.
  • 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.
• Benzodiazepines
  • Midazolam is given at the onset of anesthesia has been shown in recent trials to be as effective as ondansetron.
  • Lorazepam (Ativan) is said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran.
• 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.
• Other
  • Trimethobenzamide is thought to work on the CTZ
  • Ginger contains 5-HT₃ antagonists gingerols, shogaols, and galanolactone. Preliminary clinical data suggests ginger may be effective for treatment of nausea and/or vomiting in a number of settings.
  • 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.
  • Peppermint is claimed to help nausea or stomach pain when added into a tea or peppermint candies.
  • Muscimol is purported to have antiemetic activity.
  • Ajwain is purported to be antiemetic. It is a popular spice in India, Ethiopia and Eritrea.

References

See also

• Emetic — substances that induce nausea and vomiting
• Hyperemesis gravidarum
• Chemotherapy
• Cancer and nausea

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 制吐剤の特性 characteristics of antiemetic drugs
• 2. 悪心および嘔吐を伴う成人に対するアプローチ approach to the adult with nausea and vomiting
• 3. 小児における、アデノイド切除同時施行例を含む扁桃摘出に対する麻酔 anesthesia for tonsillectomy with or without adenoidectomy in children
• 4. Prevention and treatment of chemotherapy-induced nausea and vomiting in adults
• 5. 先進国の小児における急性ウイルス性胃腸炎：マネージメントおよび予防 acute viral gastroenteritis in children in resource rich countries management and prevention

English Journal

• Update on Medication-Overuse Headache and Its Treatment.

• Giamberardino MA1, Mitsikostas DD, Martelletti P.
• Current treatment options in neurology.Curr Treat Options Neurol.2015 Aug;17(8):368. doi: 10.1007/s11940-015-0368-z.
• OPINION STATEMENT: Medication-overuse headache-i.e., a too-frequent consumption of acute headache medications leading to increased headache frequency and reduced effectiveness of acute and preventive treatments-is a serious medical condition whose pathophysiology still remains incompletely known, wh
• PMID 26139553

• Remifentanil versus fentanyl in total intravenous anesthesia for lumbar spine surgery: a retrospective cohort study.

• Thomas B1.
• Journal of clinical anesthesia.J Clin Anesth.2015 Aug;27(5):391-5. doi: 10.1016/j.jclinane.2015.03.024. Epub 2015 Apr 23.
• STUDY OBJECTIVE: The aim of this study was to compare the speed of anesthetic recovery and the perioperative analgesic requirements in patients who received total intravenous anesthesia (TIVA) with either remifentanil-propofol or fentanyl-propofol for lumbar spine surgery.DESIGN: Retrospective cohor
• PMID 25912730

• Comparison of antiemetics for nausea and vomiting of pregnancy in an emergency department setting.

• Mayhall EA1, Gray R1, Lopes V1, Matteson KA2.
• The American journal of emergency medicine.Am J Emerg Med.2015 Jul;33(7):882-6. doi: 10.1016/j.ajem.2015.03.032. Epub 2015 Mar 18.
• OBJECTIVE: To compare time from medication administration to disposition from the Emergency Department (ED) between women treated for nausea and vomiting of pregnancy with different antiemetic agents.DESIGN: We performed a retrospective cohort study of women 13 weeks gestation or less treated in our
• PMID 25921968

Japanese Journal

• 積極的ながん治療期のオキシコドン導入における予防的制吐薬の使用状況調査と評価

• 橋詰 淳哉,龍 恵美,宗像 千恵,能勢 誠一,角川 貴美代,宮永 圭,岸川 礼子,石井 浩二,中村 忠博,北原 隆志,佐々木 均,室 高広
• 日本緩和医療薬学雑誌 = Japanese journal of pharmaceutical palliative care and sciences 11(4), 119-125, 2018-12
• NAID 40021764536

• 臨床経験 当院におけるApfel scoreを用いたPONV(術後悪心・嘔吐)術前リスク評価の有効性

• 両角 幸平,田川 京子,高橋 英督,鈴木 健雄
• 麻酔 = The Japanese journal of anesthesiology : 日本麻酔科学会準機関誌 67(4), 370-375, 2018-04
• NAID 40021529552

• 化学療法誘発性悪心・嘔吐発現患者に対するパロノセトロン使用の有用性の検討

• 杉山 昌秀,篠原 佳祐,宮田 智陽,関口 展貴
• 日本農村医学会雑誌 67(2), 139, 2018
• 第2世代の5-ヒドロキシトリプタミン3受容体拮抗薬5-hydroxytryptamine 3 receptor antagonist; 5-HT3RA）であるパロノセトロンは，従来の5-HT3RA薬と比較し高い受容体親和性と長い半減期をもち，化学療法誘発性悪心・嘔吐ChemotherapyInducedNauseaandVomiting; CINV）に対する予防的投与で優れた有効性が示されている。 …
• NAID 130007465353

Related Links

• Antiemetic Guidelines - MASCC

Download the Guidelines: For translation information please contact Anne Young at ayoung@mascc.org English - Updated January 2013 MASCC Guidelines-English ( PDF 430KB) MASCC Guidelines-English (PPT 504KB)

• Antiemetics: American Society of Clinical Oncology Focused ...

The clinical practice guidelines and other guidance published herein are provided by the American Society of Clinical Oncology, Inc. ("ASCO") to assist practitioners in clinical decision making. The information therein should not be ...

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リンク元	「antiemetic agent」
関連記事	「antiemetic」

「antiemetic agent」

　　[★]

• 制吐薬、鎮吐薬

関

antiemetic、antiemetic drug、antiemetics

「antiemetic」

　　[★]

• adj.

• 制吐の

• n.

• 制吐薬、制吐剤、鎮吐薬

関

antiemesis、antiemetic agent、antiemetic drug、antiemetics

関

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