Antiemetic Agents & Mechanisms
This 5-HT3 antagonist is “gold-standard” for PONV prophylaxis and commonly causes headache as its most frequent side effect.
What is ondansetron?
This alcohol-based antiseptic acts rapidly, evaporates quickly, and is commonly combined with chlorhexidine for surgical skin prep.
What is isopropyl alcohol?
H1 receptors mediate allergic-type responses, whereas H2 receptors mediate this gastric function.
What is increased gastric acid secretion?
Ondansetron, granisetron, and palonosetron all belong to this antiemetic drug class.
What are 5-HT3 antagonists?
Penicillins, cephalosporins, carbapenems, and monobactams all belong to this major antimicrobial class.
What are β-lactam antibiotics?
Dexamethasone’s antiemetic effect is thought to involve inhibition of this class of inflammatory mediators.
What are prostaglandins?
Chlorhexidine’s antiseptic action is primarily due to disruption of this component of bacterial cell membranes.
What are phospholipids / the lipid membrane?
This H2 blocker has notable CYP450 inhibition and can increase concentrations of numerous drugs.
What is cimetidine?
Droperidol, haloperidol, and metoclopramide all exert antiemetic effects through antagonism of this receptor family.
What are dopamine (D2) receptor antagonists?
Gentamicin, tobramycin, amikacin, and streptomycin all fall under this class known for nephrotoxicity and ototoxicity.
What are aminoglycosides?
This neurokinin-1 (NK-1) antagonist both interacts with CYP3A4 and is used for PONV and chemotherapy-induced emesis.
What is aprepitant?
Iodine-based agents are effective but must be avoided or used cautiously in patients with this glandular disorder.
What is thyroid disease? (esp. hyperthyroidism)
Ranitidine and famotidine reduce gastric acidity by blocking this intracellular messenger pathway in parietal cells.
What is the cAMP pathway?
Promethazine and diphenhydramine reduce PONV through their action as antagonists at this receptor subtype.
What are H1 histamine receptors?
Ciprofloxacin, levofloxacin, and moxifloxacin belong to this antibiotic class associated with tendon rupture.
What are fluoroquinolones?
This butyrophenone antipsychotic is also used as a rescue antiemetic; like droperidol, it works mainly by dopamine (D2) antagonism.
What is haloperidol?
This type of antiseptic is preferred for pre-op patient bathing according to CDC guidelines.
What is chlorhexidine (CHG)?
Scopolamine’s antiemetic effect occurs primarily via blockade of this receptor type.
What are muscarinic receptors?
Aprepitant and fosaprepitant prevent nausea by blocking this neuropeptide receptor in the brainstem.
What is the NK-1 (substance P) receptor?
Erythromycin, clarithromycin, and azithromycin belong to this antibiotic class characterized by inhibition of the 50S ribosomal subunit.
What are macrolides?
This selective dopamine antagonist antiemetic primarily blocks D2 and D3 receptors and is a newer option for PONV.
What is amisulpride?
Alcohols act most rapidly but lose activity in the presence of this environmental factor, making drying time essential before incision.
What is moisture?
Promethazine and diphenhydramine share this receptor profile, explaining both their antiemetic and sedating effects.
What is H1 antagonism?
Scopolamine belongs to this class of antiemetics, producing effects through central and peripheral blockade of this receptor.
What are anticholinergics, and what is the muscarinic receptor?
Vancomycin and telavancin are members of this class, which inhibits cell wall synthesis at a site distinct from β-lactams.
What are glycopeptide antibiotics?