Antiemetic

An antiemetic (from ancient Greek ἀντί anti , German , against ' , and ἐμετικός emetikós , German , vomiting arousing' ) is a drug , the nausea and vomiting is to suppress.

Indications

Antiemetics are used therapeutically and prophylactically

against motion sickness and other kinetoses
against nausea and vomiting during illness, for example gastroenteritis
against nausea and vomiting during pregnancy
when given certain medications to prevent nausea and vomiting, for example in emergency medicine or in connection with chemotherapy
against postoperative nausea and vomiting caused by surgery or anesthetics (PONV)

Antiemetics are contraindicated if the nausea occurs in the form of a defense reaction of the body and therefore makes sense from a medical point of view.

An example for differentiating between indication and contraindication (in general terms, the individual clinical case is much more complex and must be taken into account):

Indication: The person has symptoms that can be treated antiemetically (mainly nausea and vomiting). She is z. B. treated for a long time with chemotherapy drugs . Infectious and parasitic diseases with involvement of the gastrointestinal tract and / or triggering gastrointestinal symptoms were excluded (see also ICD code A00-B99 - 1st chapter of ICD-10-GM-2019).

Contraindication: Infectious or parasitic diseases or various other (especially acute and inflammatory) diseases in which nausea and / or related symptoms are important from a medical point of view have been found. The body's own healing process is usually assumed if it is mild. If (highly) pathogenic germs are the trigger, anti- infectious or anti-parasitic treatment must be given.

A disease caused by acute intoxication , i.e. by acute ( central nervous ) poisoning (e.g. nausea as a result of excessive alcohol consumption) must not be treated antiemetically, since in this case the symptoms that are to be treated are an important protective mechanism of the Body, because nausea allows the body to get rid of the toxic substance (but only the poisons that are (still) in the stomach ).

Contraindications

In the case of poisoning , e.g. In the case of food poisoning or gastrointestinal infections, vomiting may (medically) be “desired” in order to eliminate the poison or poisons from the body. In such cases, the administration of antiemetics would not make sense.

Antiemetics cannot prevent nausea and vomiting if the cause of the vomiting is a (mechanical) obstruction of the gastrointestinal passage (for example in ileus or pyloric stenosis ).

effect

Depending on the substance used, antiemetics usually act on one or more receptors (for example receptors for acetylcholine , dopamine , histamine and serotonin ).