12. Drugs causing emesis
a. Drugs acting on CTZ.
• apomorphine
• emetine (when given parenterally and only at
large doses)
• L-DOPA
• estrogens (morning sickness of pregnancy)
• ergot alkaloids
• cardiac glycosides
• opiates
• cancer chemotherapeutic agents
13. b. Drugs acting locally on the G-I tract.
• Activate enterochromaffin cells
• secrete serotonin
• acts on the 5-HT3 receptors
• at the nerve endings of the vagal sensory fibers.
• The afferent fibers transmit excitation to the N.
tractus solitarius,
• which in turn activates the VC.
• These drugs are traditionally called "local
irritants".
• Ipecac, zinc salts, copper sulfate,
14. Cancer chemotherapeutic agents and
radiation therapy
• produce free radicals
enterochromaffin cells
serotonin.
• also stimulate CTZ receptors
23. • Identification and elimination of the
underlying cause if possible
• Control of the symptoms if it is not
possible to eliminate the underlying
cause
• Correction of electrolyte, fluid or
nutritional deficiencies
