Posted by yxibow on February 10, 2007, at 1:14:54
In reply to Re: antiemetics -- yxibow, posted by munificentexegete on February 9, 2007, at 21:20:37
> > > > would be IV ondansetron or granisetron, the 5HT3 blockers.
> > > >
> > >
> > > hmmm... would you have developed akathisia from those meds?
> >
> >
> > No, I would have developed a considerable medical bill and it is unlikely you find 5HT3 blockade medication outside of chemotherapy treatment, because of its extreme expense of manufacture because of its low volume use and supply and demand.
> >
>
> aren't some of the benzos like Lorazepam antiemetics too, or are they ineffective by comparison?
Lorazepam alone I think would be ineffective, but you are correct, there are citations of lorazepam being used adjunctively with medications including 5HT3 blockade agents.
5HT3 receptors are in the CTZ (chemoreceptor trigger zone) and on vagal nerve terminals in the periphery.
From the Kytril PI: "In the ferret animal model, a single granisetron injection prevented vomiting due to high-dose cisplatin or arrested vomiting within 5 to 30 seconds." (cisplatin is an emetogenic material)
Old antiemetics are still used, Reglan, Tigan, but they do carry a risk of TD over an extended period of time (especially Reglan I think.) The D2 activity and possibly at higher doses the 5HT3 activity of Reglan contributes to its effectiveness in the CTZ. Tigan while potent in the CTZ for whatever reason does not carry the D2 potency of Reglan.
Other uses of 5HT3 blockade drugs today include postoperative nausea and vomiting. As well as all the other drugs mentioned. Sometimes scopolamine transdermally is used.
Dramamine and Benadryl have some effectiveness alone as anti-emetics in postoperative nausea/vomiting and I imagine in other situations.
poster:yxibow
thread:730582
URL: http://www.dr-bob.org/babble/20070207/msgs/731539.html