HT3 receptor antagonists

5-HT3 receptor antagonists are expensive compared with other antiemetics but are often effective for otherwise unresponsive nausea and vomiting. They block vagal afferent pathways and 5-HT receptors in the area postrema. Ondansetron, tropisetron, and granisetron are much more active at the 5-HT 3 receptors than at other

5-HT receptors. Their efficacy is similar (Morrow ,.§LqL 1995). They are effective in nausea and vomiting induced by cancer chemotherapy and radiotherapy. For postoperative nausea and vomiting, ondansetron 8 mg is more effective than either metoclopramide 10 mg or droperidol 1.25 mg, all given intravenously. A combination of ondansetron and droperidol can be effective in vomiting after neurosurgery or removal of acoustic neuroma which is difficult to control. The 5-HT 3 receptor antagonists have few side-effects; the most common is headache.

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