Antiemetic drugs
Motion sickness/hyperemesis gravidarum- Antimuscarinics (M1), e.g. scopolamine- Antihistamines (H1), e.g. diphenhydramine, meclizine, promethazine Chemotherapy-induced emesis:- Dopamine receptor antagonists, e.g. prochlorperazine, metoclopramide- Serotonin (5-HT3) receptor antagonists, e.g. ondansetron, granisetron→ Side effects: Headaches, constipation or diarrhea, QT interval prolongation (torsades de pointes), increase in liver enzymes, serotonin syndrome- Neurokinin 1 (NK1) receptor antagonists, e.g. aprepitant, fosaprepitant The vomiting reflex can be activated by hormonal or neuronal stimuli. The area postrema in the fourth ventricle has a chemoreceptor trigger zone that can respond to many neurotransmitters, drugs, or toxins. The nucleus tractus solitarius in the medulla receives information from the area postrema, GI tract via the vagus nerve, vestibular system, and the CNS. Neurons from the NTS coordinate the vomiting process.
Enoxaparin
Low-molecular-weight heparin Acts predominantly on factor Xa. - Has better bioavailability and 2-4x longer half life than unfractionated heparin. - Can be administered subcutaneously and without laboratory monitoring.
Dalteparin
Low-molecular-weight heparin Acts predominantly on factor Xa. - Has better bioavailability and 2-4x longer half life than unfractionated heparin. - Can be administered subcutaneously and without laboratory monitoring.
Tenecteplase (TNK-tPA)
Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Reteplase (rPA)
Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Streptokinase
Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Alteplase (tPA)
Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.
Prasugrel
ADP receptor inhibitor
Leflunomide
Pyrimidine synthesis inhibitor Inhibits the enzyme orotate reductase, which catalyzes the oxidation of dihydroorotic acid (an essential step in pyrimidine synthesis). Side effects:- Hepatotoxicity- Cytopenias
Hydroxychloroquine
TNF & IL-1 suppressor Indications:- Treatment and prophylaxis of malaria due to P. malariae, P. ovale, or susceptible strains of P. falciparum (not P. vivax)- Rheumatoid arthritis (basic therapy)- Systemic and discoid lupus erythematosus (without organ involvement) Side effects:- Retinopathy
