Athavale Akshay, Athavale Tegan, Roberts Darren M
Drug Health Services and Clinical Pharmacology and Toxicology, Royal Prince Alfred Hospital, Sydney.
MyHealth Medical Centre, Macquarie Park, Sydney.
Aust Prescr. 2020 Apr;43(2):49-56. doi: 10.18773/austprescr.2020.011. Epub 2020 Apr 1.
Nausea and vomiting are common symptoms with many possible causes, including the adverse effects of drugs. If a drug is indicated, the cause guides the choice of antiemetic drug The main antiemetic classes include antagonists of the serotonin, dopamine, histamine, muscarinic and neurokinin systems, corticosteroids and benzodiazepines. Some antiemetics appear more effective for specific indications Serotonin and neurokinin antagonists, such as ondansetron and aprepitant, are highly effective in treating chemotherapy-induced nausea and vomiting. Metoclopramide and antihistamines are first-line options for nausea and vomiting in pregnancy Serotonin antagonists and some dopamine antagonists, such as metoclopramide, can prolong the QT interval on the ECG. Dopamine antagonists can cause extrapyramidal adverse effects, particularly in children
恶心和呕吐是常见症状，可能由多种原因引起，包括药物的不良反应。如果确定是药物所致，病因可指导止吐药的选择。主要的止吐药类别包括5-羟色胺、多巴胺、组胺、毒蕈碱和神经激肽系统的拮抗剂、皮质类固醇和苯二氮䓬类药物。某些止吐药对特定适应证似乎更有效。5-羟色胺和神经激肽拮抗剂，如昂丹司琼和阿瑞匹坦，在治疗化疗引起的恶心和呕吐方面非常有效。甲氧氯普胺和抗组胺药是治疗妊娠恶心和呕吐的一线选择。5-羟色胺拮抗剂和某些多巴胺拮抗剂，如甲氧氯普胺，可延长心电图上的QT间期。多巴胺拮抗剂可引起锥体外系不良反应，尤其是在儿童中。
