McKenna's Pharmacology for Nursing, 2e

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Antiemetic agents

Learning objectives Upon completion of this chapter, you should be able to: 1. Outline how the vomiting reflex works, including factors that stimulate it and mechanisms for measures used to block it. 2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most common adverse reactions and important drug–drug interactions associated with each of the classes of antiemetic agents. 3. Discuss the use of antiemetics across the lifespan. 4. Compare and contrast the prototype antiemetics with other agents in their class and with other classes of antiemetics. 5. Outline the care considerations, including important teaching points, for people receiving antiemetics.

Test your current knowledge of antiemetic agents with a PrepU Practice Quiz!

Simulation-based learning On completion of the chapter, consider the scenario of Doris Bowman (Part 1) who arrives in the recovery room after undergoing major abdominal surgery and is complaining of nausea. Consider Doris’ nausea management in this case. How might the concepts learnt in this chapter, apply more broadly to post-operative management of nausea?

Glossary of key terms antiemetic: agent that blocks the hyperactive response of the chemoreceptor trigger zone (CTZ) to various stimuli, the response that produces non-beneficial nausea and vomiting intractable hiccough: repetitive stimulation of the diaphragm that leads to hiccough, a diaphragmatic spasm that persists over time phenothiazine: anti-anxiety drug that blocks the responsiveness of the CTZ to stimuli, leading to a decrease in nausea and vomiting photosensitivity: hypersensitive reaction to the sun or ultraviolet light, seen as an adverse reaction to various drugs; can lead to severe skin rash and lesions, as well as damage to the eye

ANTIEMETIC AGENTS Phenothiazines chlorpromazine prochlorperazine promethazine

Non-phenothiazine domperidone metoclopramide

5-HT 3

receptor blockers

Substance P/neurokinin 1 receptor antagonists aprepitant fosaprepitant

dolasetron granisetron ondansetron palonosetron tropisetron