Pharmacology of Antiemetics: Update and Current Considerations in Anesthesia Practice

Alan D Kaye; Elyse M Cornett; John Chalabi; Natale Z Naim; Matthew B Novitch; Justin B Creel; Preya Jhita; Thomas N Trang; Jacquelyn R Paetzold; Nicholas Darensburg; Burton D Beakley; Richard D Urman

doi:10.1016/j.anclin.2017.01.003

Pharmacology of Antiemetics: Update and Current Considerations in Anesthesia Practice

Anesthesiol Clin. 2017 Jun;35(2):e41-e54. doi: 10.1016/j.anclin.2017.01.003.

Authors

Affiliations

¹ Department of Anesthesiology and Pharmacology, Anesthesiology Services, University Medical Center Hospital, LSU School of Medicine T6M5, 1542 Tulane Avenue, Room 656, New Orleans, LA 70112, USA. Electronic address: alankaye44@hotmail.com.
² Department of Anesthesiology, LSU School of Medicine, 1501 Kings Highway, P.O. Box 33932, Shreveport, LA 71130-3932, USA.
³ Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, UCLA School of Medicine, 757 Westwood Plaza #3325, Los Angeles, CA 90024, USA.
⁴ Medical College of Wisconsin, Wausau, WI, USA.
⁵ Department of Anesthesiology and Pharmacology, Anesthesiology Services, University Medical Center Hospital, LSU School of Medicine T6M5, 1542 Tulane Avenue, Room 656, New Orleans, LA 70112, USA.
⁶ Department of Anesthesiology, Tulane School of Medicine, 1430 Tulane Ave, New Orleans, LA, 70112, USA.
⁷ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.

PMID: 28526160
DOI: 10.1016/j.anclin.2017.01.003

Abstract

Postoperative nausea and vomiting (PONV) is associated with delayed recovery and dissatisfaction after surgical procedures. A key component to management is identifying risk factors and high-risk populations. Advances in pharmacologic therapeutics have resulted in agents targeting different pathways associated with the mediation of nausea and vomiting. This review focuses on these agents and the clinical aspects of their use in patients postoperatively. Combination therapies are reviewed, and studies demonstrate that when 2 or more antiemetic agents acting on different receptors are used, an overall improved efficacy is demonstrated when compared with a single agent alone in patients.

Keywords: Anesthesia; Anticholinergics; Antiemetics; Dopamine receptor; Neurokinin-1 receptor; P6 acupuncture point; Postoperative nausea and vomiting; Serotonin receptor.

Publication types

Review

MeSH terms

Anesthesia*
Anesthetics / adverse effects*
Antiemetics / pharmacology*
Drug Therapy, Combination
Humans
Postoperative Nausea and Vomiting / prevention & control*
Risk Factors
Sex Factors

Substances

Anesthetics
Antiemetics