Wilde M I, Markham A
Adis International Limited, Auckland, New Zealand.
Drugs. 1996 Nov;52(5):773-94. doi: 10.2165/00003495-199652050-00010.
The use of ondansetron, a selective serotonin 5-HT3 receptor antagonist, is well established in patients with nausea and vomiting associated with cancer chemotherapy, radiotherapy or anaesthesia and surgery. The wide distribution of 5-HT3 receptors in the body and the role of these receptors in disease have provided the rationale for investigation of ondansetron in novel applications. Preliminary data have shown ondansetron to have clinical benefit in patients with nausea and vomiting associated with drug overdosage or poisoning, anti-infective or antidepressant therapies, uraemia or neurological trauma, and in patients with pruritus. Patients with gastrointestinal motility disorders (e.g. carcinoid syndrome, irritable bowel syndrome, diarrhoea associated with cryptosporidiosis or diabetes, and chronic refractory diarrhoea) have also shown some improvement when treated with ondansetron, as have patients with certain pain or CNS-related disorders [e.g. alcohol (ethanol) dependence, opiate withdrawal, vertigo, cerebellar tremor and Parkinson's disease treatment-related psychosis]. In contrast to conventional antiemetics, ondansetron is generally well tolerated with a lower incidence of sedation and only isolated case reports of extrapyramidal reactions. Furthermore, unlike dopamine receptor-blocking neuroleptics, ondansetron does not appear to worsen the symptoms of Parkinson's disease. Thus, in addition to its established indications, preliminary results suggest that ondansetron may be beneficial in a number of novel applications. This drug may represent a treatment alternative in patients with refractory disease, or an effective treatment of conditions for which current therapies are either poorly tolerated or not available. Further investigation of ondansetron in a range of potential new applications appears to be warranted.
5-羟色胺3（5-HT3）受体选择性拮抗剂昂丹司琼，已被广泛用于治疗与癌症化疗、放疗或麻醉及手术相关的恶心和呕吐。5-HT3受体在体内广泛分布，且这些受体在疾病中发挥的作用为昂丹司琼在新应用方面的研究提供了理论依据。初步数据显示，昂丹司琼对与药物过量或中毒、抗感染或抗抑郁治疗、尿毒症或神经创伤相关的恶心和呕吐患者以及瘙痒患者有临床益处。胃肠道动力障碍患者（如类癌综合征、肠易激综合征、隐孢子虫病或糖尿病相关腹泻以及慢性难治性腹泻）在接受昂丹司琼治疗后也有一定改善，某些疼痛或中枢神经系统相关疾病患者（如酒精（乙醇）依赖、阿片戒断、眩晕、小脑震颤以及帕金森病治疗相关精神病）同样如此。与传统止吐药不同，昂丹司琼一般耐受性良好，镇静发生率较低，仅有锥体外系反应的个别病例报告。此外，与多巴胺受体阻断型抗精神病药不同，昂丹司琼似乎不会加重帕金森病的症状。因此，除了其已确定的适应证外，初步结果表明昂丹司琼可能在许多新应用中有益。对于难治性疾病患者，这种药物可能是一种治疗选择，或者是对当前治疗耐受性差或无法获得的疾病的有效治疗方法。对昂丹司琼在一系列潜在新应用中的进一步研究似乎是有必要的。
