Classification of drugs

Dopamine antagonist—block D2 receptors in the chemoreceptor trigger zone (CTZ). Examples are metoclopramide and domperidone—both have additional effect on enhancing gastric emptying. Side effects include extrapyramidal reactions and occasionally oculogyric crisis.

Phenothiazines—examples are prochlorperazine and cyclizine—particular benefit in opioid-induced nausea. Side effects include anticholinergic effects and drowsiness.

Benzodiazepine—lorazepam commonest used. Advantages are long t" and additional anxiolytic effect. Side effects include drowsiness.

5HT3 antagonists—block 5HT3 receptors in the CTZ. Examples include ondansetron, granisetron and tropesitron. Side effects include headaches, bowel disturbance and rashes.

Cannabinoids—nabilone is the major drug. Side effects include depersonalisation experiences.

Steroids—examples are dexamethasone and predniso(lo)ne. Side effects include fungal infection predisposition, hypertension, irritability and sleeplessness, gastric erosions and, with chronic use, diabetes and osteoporosis.

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