鎮吐薬
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/10 01:04:15」(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]
Contents
- 1 Types of antiemetics
- 2 References
- 3 See also
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, Ki=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, PMID 16364290 Epub 2005 Dec 20
- ^ 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
See also
- Emetic
- Hyperemesis gravidarum
- Chemotherapy
- Cancer and nausea
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Antiemetics (A04)
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5-HT3 Serotonin ion
channel antagonists |
- Alosetron
- Azasetron
- Bemesetron
- Cilansetron
- Clozapine
- Dazopride
- Dolasetron
- Granisetron
- Lerisetron
- Metoclopramide
- Mianserin
- Mirtazapine
- Olanzapine
- Ondansetron
- Palonosetron
- Quetiapine
- Ramosetron
- Ricasetron
- Tropisetron
- Zatosetron
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5-HT Serotonin G-protein
receptor antagonists |
- Clozapine
- Cyproheptadine
- Hydroxyzine
- Olanzapine
- Risperidone
- Ziprasidone
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CB1 Agonists
(Cannabinoids) |
- Dronabinol
- Nabilone
- Nonabine
- Tetrahydrocannabinol
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| D2/D3 Antagonists |
- Alizapride
- Bromopride
- Chlorpromazine
- Clebopride
- Domperidone
- Haloperidol
- Hydroxyzine
- Itopride
- Metoclopramide
- Metopimazine
- Prochlorperazine
- Thiethylperazine
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H1 antagonists
(Antihistamines) |
- Cyclizine
- Dimenhydrinate
- Diphenhydramine
- Hydroxyzine
- Meclozine
- Promethazine
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mACh antagonists
(Anticholinergics) |
- Atropine
- Diphenhydramine
- Hydroxyzine (very mild)
- Hyoscyamine
- Scopolamine
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| NK1 Antagonists |
- Aprepitant
- Casopitant
- Ezlopitant
- Fosaprepitant
- Maropitant
- Vestipitant
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| Others |
- Cerium oxalate
- Dexamethasone
- Lorazepam
- Midazolam
- Propofol
- Trimethobenzamide
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Inflammatory bowel disease
- Gluten sensitivity
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- anabolic steroids
- antacids
- diarrhoea and infection
- bile and liver
- functional gastrointestinal disorders
- laxatives
- peptic ulcer and reflux
- vomiting
- other
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English Journal
- Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial.
- Abas MN1, Tan PC, Azmi N, Omar SZ.
- Obstetrics and gynecology.Obstet Gynecol.2014 Jun;123(6):1272-9. doi: 10.1097/AOG.0000000000000242.
- OBJECTIVE: To compare ondansetron with metoclopramide in the treatment of hyperemesis gravidarum.METHODS: We enrolled 160 women with hyperemesis gravidarum in a double-blind randomized trial. Participants were randomized to intravenous 4 mg ondansetron or 10 mg metoclopramide every 8 hours for 24 ho
- PMID 24807340
- Cannabinoid-induced reduction in antral pacemaker frequency: a telemetric study in the ferret.
- Percie du Sert N1, Ho WS, Rudd JA, Andrews PL.
- Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.Neurogastroenterol Motil.2010 Nov;22(11):1257-66, e324. doi: 10.1111/j.1365-2982.2010.01581.x. Epub 2010 Aug 22.
- BACKGROUND: The gastric myoelectric activity (GMA) is the electrical pacesetter potential, which drives gastric motility. Cannabinoids have broad-spectrum antiemetic and antinauseant activity. Paradoxically, they inhibit intestinal peristalsis and reduce gastric motility but their effect on GMA rema
- PMID 20731777
- Granisetron, an antiemetic drug, and its cobalt complex.
- Ravikumar K1, Sridhar B.
- Acta crystallographica. Section C, Crystal structure communications.Acta Crystallogr C.2010 Feb;66(Pt 2):m35-9. doi: 10.1107/S0108270109055449. Epub 2010 Jan 15.
- The crystal structures of granisetron [systematic name: 1-methyl-N-(9-methyl-9-azabicyclo[3.3.1]nonan-7-yl)indazole-3-carboxamide], C(18)H(24)N(4)O, (I), an antinauseant and antiemetic agent, and its Co(II) complex, diaqua[1-methyl-N-(9-methyl-9-azoniabicyclo[3.3.1]nonan-7-yl)indazole-3-carboxamide]
- PMID 20124677
Related Links
- forum Join the Word of the Day Mailing List For webmasters TheFreeDictionary Google Bing? Word / Article Starts with Ends with Text ... antinauseant /an·ti·nau·se·ant/ (-naw´ze-ant) preventing or relieving nausea, or an agent that ...
- Antinauseant definition, producing nausea. See more. Added to Favorites Dictionary Thesaurus Word Dynamo Quotes Reference Translator Spanish Log In Sign Up Premium antinauseant nauseant / / [naw-zee-uh nt, -zhee ] . 1. ...
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★リンクテーブル★
[★]
- 英
- antiemetic drug, antiemetic,antiemetic drugs, antinauseant
- 同
- 制吐薬 "鎮吐"の方が一般的らしい
- 関
- 薬理学、鎮吐薬一覧、セロトニン受容体、嘔吐
抗セロトニン薬
GOO. 1000-
嘔吐が起こるのは
①嘔吐中枢
延髄、網様体背外側部
②chemoreceptor trigger zone(CTz)
第4脳室
ジキタリスが刺激
中枢性嘔吐：嘔吐中枢とCTzを刺激
反射性嘔吐：消化管→求心路→嘔吐中枢
抗ガン剤投与時に起きる吐き気の機序
①血中に入った抗ガン剤が直接CTzを刺激
②抗癌剤により腸管細胞(enterochromaffin cell)から化学神経伝達物質が生産され、CTzを経てあるいは直接嘔吐中枢に作用する。
中枢神経終末にある5-HT3受容体を介して嘔吐が起こる