Safety and efficacy of commonly used antiemetics

Abstract

Introduction: Clinicians use antiemetic drugs in a multitude of scenarios. Despite the differences in subspecialty and etiology of the nausea, practitioners of all subspecialties use the same drugs in similar ways to provide relief for their patients.

Areas covered: Multiple classes of antiemetics are used frequently but no single treatment course works for all types of patients. The complex etiology of nausea often requires a multimodal approach that targets the same symptom through different sites of action. Antiemetics have unique side effects and safety profiles which are covered in this review. Antihistamines, phenothiazines, corticosteroids, benzamindes, anticholinergic, neurokinin-1 antagonists, 5-HT₃ receptor antagonist and cannabinoids are discussed. These drugs were evaluated based on an in-depth literature review including a review of the original research that led to many of the drugs initial FDA approval, via internet and PubMed searches.

Expert opinion: The key to providing relief for patients suffering from nausea and vomiting is to consider multiple drugs to approach the nausea in a systematic way. Anesthesiologists identify patients who are at high risk of nausea and vomiting based on physical characteristics and surgical procedures. Oncologists treat nausea based on the prescribed chemotherapeutics regimen and known risk of emesis while palliative care physicians and others balance the etiology of the nausea while optimizing patients other co morbid conditions.

Keywords:

• 5-HT₃ serotonin receptor antagonists
• anticholinergics
• antihistamines
• benzamides
• butyrophenones
• corticosteroids
• efficacy
• neurokinin-1 antagonists
• phenothiazines
• QT interval corrected electrocardiogram effects
• safety

Declaration of interest

A Kovac is on the Speaker’s Bureau for Baxter, Merck and Helsinn, and has received research grant support from Acacia Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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