Vomiting ondansetron

Apomorphine is approved for acute off episodes in patients with advanced stages of PD. The onset of effect is within 10 to 20 minutes and the duration of effect is about 60 minutes. It requires premedication with an antiemetic because it causes nausea and vomiting. Antiemetics that block central dopamine worsen the symptoms of PD, and 5-HT3 antagonists, such as ondansetron, can aggravate PD-related hypotension. Trimethobenzamide (300 mg three times daily) should be... 

Nausea and vomiting Prevention hydroxyzine 25-1 00 mg (PO/IM) every 4-6 hours as needed diphenhydramine 25-50 mg (PO/IM) every 6 hours as needed ondansetron 4 mg IV or 16 mg PO Treatment prochlorperazine 5-10 mg (PO/IM) every 3-4 hours as needed or 25 mg per rectum twice daily ondansetron 4-8 mg IV every 8 hours as needed... 

Ondansetron Postoperative vomiting and vomiting associated with cancer chemotherapy... 

The answer is e. (Hardmanr p 930.) All the drugs listed in the question are used as antiemetics. Chlorpromazine is a general antiemetic, used orally, rectally, or by injection for the control of nausea and vomiting that is caused by conditions that are not necessarily defined. Ondansetron is indicated in the oral or intravenous route for the prevention of nausea and vomiting caused by cancer chemotherapy Diphenhydramine and dimen-hydrinate are used orally for the active and prophylactic treatment of motion sickness. Scopolamine is a transdermal preparation used in the prevention of motion sickness. The drug is incorporated into a bandage-like... 

Koivuranta M, Laara E, Ranta P, Ravaska P, Alahuhta S. (1997). Comparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women. A randomised, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand. 41(10) 1273-9. 

Ondansetron is the first 5-HT3-receptor antagonist to be used for the treatment of nausea and vomiting induced by cancer therapy. Its high receptor selectivity is reflected in clinical studies which show ondansetron to be a very effective antiemetic drug with few side-effects. 

Ondansetron is a 5HT3 antagonist, blocking serotonin receptors in the central nervous system and the gastrointestinal tract. It is useful in the management of postoperative nausea and vomiting associated with cytotoxics. 

Ondansetron is a 5HT3 antagonist indicated as an anti-emetic agent in nausea and vomiting associated with chemotherapy. The dose administered depends on the emetogenic degree of the chemotherapeutic agents used. 

Parenteral Immediately before induction of anesthesia, or postoperatively if the patient experiences nausea or vomiting shortly after surgery, administer 4 mg undiluted IV in not less than 30 seconds, preferably over 2 to 5 minutes. Alternatively, 4 mg undiluted may be administered IM as a single injection in adults. In patients who do not achieve adequate control, administration of a second IV dose of 4 mg ondansetron postoperatively does not provide additional control of nausea and vomiting. 

Postoperatively Routine prophylaxis is not recommended for patients in whom there is little expectation that nausea or vomiting will occur postoperatively. In patients where nausea or vomiting must be avoided postoperatively, IV ondansetron is recommended even where the incidence of postoperative nausea or vomiting is low. For patients who have postoperative nausea or vomiting, ondansetron may be given to prevent further episodes. 

B. Two medicines, ipecac and apomorphine, induce vomiting. Metoclopramide is a prokinetic with antiemetic properties and therefore would have the opposite of the desired effect. Morphine is an opioid with analgesic and sedating properties. Promethazine and ondansetron are also antiemetics, not emetics. 

The serotonin antagonist ondansetron (Zofran) has proved effective in the prevention of nausea and vomiting due to chemotherapy. 

Applied to the skin in a transdermal patch (transdermal therapeutic delivery system), this drug is used to prevent or reduce the occurrence of nausea and vomiting that are associated "with motion sickness. Diphenhydramine Chlorpromazine Ondansetron Dimenhydrinate Scopolamine... 

It is newer compound. Mechanism of action is similar to ondansetron but can cause elevation of liver enzyme level e.g. SCOT, SGPT etc. It is mainly used in the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy. 

R(-) Ondansetron oral Solution For chemotherapy, induced nausea and vomiting... 

Candiotti KA, Birnbach DJ, Lubarsky DA et al. The impact of pharmacogenomics on postoperative nausea and vomiting do CYP2D6 allele copy number and polymorphisms affect the success or failure of ondansetron prophylaxis Anesthesiology 2005 102 543-549. 

Ondansetron is well tolerated by patients but may be less effective if vomiting is established or if the emesis is due to opioid analgesia. A number of comparative studies with other antiemetics have appeared in the literature and ondansetron appears to be more effective than some of these drugs. However differences in efficacy from some older drugs are not always large, and advantage may lie more in a lesser side-effect profile of 5-HT3 antagonists. 

Alosetron is a 5-HT3 antagonist that has been approved for the treatment of patients with severe IBS with diarrhea (Figure 62-5). Four other 5-HT3 antagonists (ondansetron, granisetron, dolasetron, and palonosetron) have been approved for the prevention and treatment of nausea and vomiting (see Antiemetics) however, their efficacy in the treatment of IBS has not been determined. The differences between these 5-HT3 antagonists that determine their pharmacodynamic effects have not been well studied. 

Ondansetron, other 5-HT3 antagonists 5-HT3 blockade in gut and CNS with shorter duration of binding than alosetron Extremely effective in preventing chemotherapy-induced and postoperative nausea and vomiting First-line agents in cancer chemotherapy also useful for postop emesis Usually given IV but orally active in prophylaxis. 4-9 h duration of action very low toxicity but may slow colonic transit... 

---