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Antiemetics Prokinetic drugs

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Antiemetics Prokinetic drugs

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    1. Antiemetics & Prokinetic drugs Objectives: Mechanism of vomiting. Receptors involved in the process of emesis. Antiemetic drugs, mechanism, uses & S/E. Management of motion sickness, vertigo, Menier’s disease & vomiting in pregnancy. Prokinetic drugs, mechanism, uses, S/E.

    2. Vomiting center Physiology of vomiting

    4. Receptors involved in the emesis process

    5. Antiemetic Drugs

    9. Other antiemetics: Glucocorticoids (dexamethasone & methylprednisolone) Nabilone (a synthetic cannabinoid). Glucocorticoids & nabilone are used in cytotoxic drugs-induced vomiting.

    10. Drugs used in treatment of motion sickness: Antimuscarinic: hyoscine. Antihistaminic H1-blockers (having antimuscarinic action): cinnarizine, Cyclizine, dimenhydrinate & promethazine.

    11. Vomiting during pregnancy: Reassurance. Rarely it needs drug therapy e.g. cyclizine or promethazine (preferred). Pyridoxine & multivitamins plus i.v fluids in severe vomiting as that with hyperemesis gravidarum

    12. Vertigo Labyrinthine disorders & Menier's syndrome Cyclizine or prochlorperazine in acute attack. Betahistine (histamine analogue). Cinnarizine (antihistaminic, calcium channel blocker & antimuscarinic) These drugs are used in hope to improve the blood circulation in the inner ear.

    13. Prokinetic Drugs (Metoclopramide & domperidone) The Prokinetic drugs produce the following effects: Hasten esophageal clearance. Increase tone of the gastro-esophageal sphincter. Accelerate gastric emptying. Antiemetic effects by dopamine (D2) blockade.

    15. Uses: GERD, nonulcer dyspepsia, vomiting, diabetic gastropathy, emergency evacuation of stomach before surgery, and hiccup

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