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Antiemetics

8. Miscellaneous - Benząuinamide HCL (Emetecon), diphenidol (Vontrol), trimethobenzamide (Tigan) -

suppress the impulses to the CTZ. Vontrol also prevents vertigo by inhibiting impulses to the yestibular area

-    labeled miscellaneous because they don’t act strictly as antihistamines, anticholinergics, or phenothiazides

-    SE = drowsiness, anticholinergic symptoms, CNS stimulation, EPS

Emetics

•Emetics - for when an individual has consumed certain toxic substances and must be expelled before absorption — Don’t induce vomiting if caustic substances have been ingested, -> ammonia, chlorine bleach, lye, toilet cleaners, or battery acid. Activated charcoal is given when emesis is CI

•Ipecac - stimulates the CTZ in the medulla & acts directly on the gastric mucosa - take w/ water (not milk or carbonation) - onset in 15 to 30 min. Repeat tx if needed. Toxic if absorbed -> give charcoal.

-    s/s toxicity -> hypotension, tachycardia, chest pain

-    SE: diarrhea, sedation, lethargy

•Apomorphine is a morphine derive emetic, SQ/IM, Onset 15 min

Antiemetics

RELATIYE ANTIEMETIC RECEPTOR AFFINITIES

lilii	ilililliill
	■ ■ i					1250
Haloperidol Prochlorperazine Chlorpromazine Vt>	i
	-i>				Hpopam ■ Muscai h Histam	ine inic ine
Metoclopramide j " i-—..........		i i

0    50    100    150    200    250    300    350

Antidiarrheals

•    Diarrhea = freąuent liąuid stool due to an intestinal disorder (passage of stool weighing morę than 200 g/day) ~ causes: e.g. food poisoning or intolerance (lactose,

wheat [celiac disease]) or allergy, fecal impaction, bacteria (Salmonella), virus (rotavirus), drug prescription (antibiotics), laxative abuse, malabsorption syndrome, stress/anxiety, bowel tumor, IBS, U.c.)

-    can be mild to severe - identify underlying causes first

-    can cause minor or severe dehydration & electrolyte imbalance

-    can be life threatening to the young & elderly

•    Nonpharm Rx = elear liąuids & orał Solutions (gatorade,

pedialyte), IV electrolyte Solutions.....(BRAT diet)

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