Table 2.
Mechanisms and Locations of Action of Common Antiemetic Therapies
| Etiology | Pathophysiology | Therapy |
|---|---|---|
| Brain metastases, meningeal irritation | Increased intracranial pressure | Steroids |
| Movement | Vestibular stimulation | Anti-acetylcholine (scopolamine) |
| Anxiety | Cortical | Anxiolytics (benzodiazepines) |
| Medications (chemotherapy, opioids) | CTZ, vestibular stimulation | Antidopaminergics (haloperidol, metoclopramide), antihistamines (diphenhydramine, meclizine), serotonin antagonists (ondansetron), anti-acetylcholine |
| Motility (opioids, ileus, other medications) | Gastrointestinal | Prokinetic agents (metoclopramide), stimulant laxatives (sennosides) |
| Mechanical obstruction | Constipation, tumor, stricture | Manage constipation, surgery when appropriate, steroids, inhibit secretions with octreotide |
| Metabolic (hypercalcemia, hyponatremia, hepatic or renal failure) | CTZ | Antidopaminergics, antihistamines, fluids, steroids |