ANTIEMETICS (antivomitiva, antiemetica) — the pharmaceuticals applied to prevention and elimination of nausea and vomiting. There are P. of page of the central and peripheral action.
To it is central operating Items of page carry drugs which antiemetic activity is caused by hl. obr. the oppressing influence on neurons emetic, the center and (or) chemoceptors of a starting (trigger) zone of a myelencephalon. Include the drugs rendering antiemetic in group P. of page of peripheral action - effect, napr, by blockade of sensitive nerve terminations of a mucous membrane of a stomach, braking of momentum transfer from a vagus nerve on a stomach, relaxation of unstriated muscles of a stomach and a gullet etc.
Properties P. - villages of the central action have many neuroleptics (see) — aminazine - (see), Metherazinum (see), Triphtazinum (cm), etaperazin (see), a haloperidol (see), etc., thiethylperazine, Metoclopramidum, and also some antihistaminic substances (see) — isopromethazine (see), Dimedrol (see), Dedalonum, etc. Besides, pages of the central action carry Scopolaminum to P. (see) and the tablets «Aeronum» containing 0,0001 g of Scopolaminum of camphorate and 0,0004 g of Hyoscyaminum camphorate.
The antiemetic effect of neuroleptics is caused by hl. obr. their blocking influence on a starting zone of a myelencephalon. Drugs of this group are effective at the vomiting of various origin (caused by medicinal substances, caused by a radial illness, diseases mi went. - kish. path, etc.) » however at the vomiting connected with sea and aeroembolism they are ineffective. At vomiting of pregnant women neuroleptics use with care in connection with a possibility of their adverse influence on a fruit.
Thiethylperazine (Torecanum) on a chemical structure is close to a neuroleptic to Metherazinum. However unlike classical neuroleptics it has no the expressed sedative, kataleptogenny and other properties typical for this group of substances. At the same time thiethylperazine surpasses aminazine and Metherazinum in antiemetic activity. Its antiemetic effect is caused by the oppressing influence not only on a starting zone, but also on the emetic center. In this regard thiethylperazine is effective practically at vomiting of any origin, including vomiting at sea and aeroembolism.
Metoclopramidum (synonym: the raglan, Praminum, cerucal) has antiemetic effect due to oppression of a starting zone of a myelencephalon and as P. the page is used according to the same indications, as neuroleptics.
Antihistamines (isopromethazine, Dimedrol, Dedalonum) depressing influence the emetic center and a starting zone of a myelencephalon. They are effective generally at the vomiting caused sea and aeroembolism, Menyer's syndrome, action of a number of pharmaceuticals and also at vomiting in the postoperative period.
Antiemetic action of Scopolaminum and the tablets «Aeronum» is caused by hl. obr. oppression of the emetic center. Besides, these drugs have the activity expressed to m-holinoblokiruyushchey and in this regard reduce a tone and a peristaltics of a stomach, i.e. partially work at the expense of peripheral mechanisms. Scopolaminum and the tablets «Aeronum» apply generally at sea and aeroembolism, and also at Menyer's syndrome.
To P. of page of peripheral action carry the drugs belonging to different classes pharmacological of active means, napr, atropine (see) and other m-holinoblokatory, spasmolysants of myotropic action — a papaverine (see), etc., mestnoanesteziruyushchy means — anaesthesin (see), novocaine (see). From reflex the operating means as P. villages use menthol (see) and the drugs supporting him (mint tablets, tincture of a peppermint, etc.). The item of page of this group on efficiency are inferior to tsentralnodeystvuyushchy drugs and hl are used. obr. at sea and aeroembolism, vomiting of pregnant women, nausea and vomiting, it is caused - • ache labyrinthites and diseases went. - kish. path. According to the same indications use also the combined drugs containing various P. of page of peripheral action, napr, Bellasthesinum (contains 0,3 g of anaesthesin and 0,015 g of extract of a belladonna), etc.
As P. villages sometimes use also drugs from other groups of pharmaceuticals which mechanism of antiemetic action is not installed. So, at vomiting of pregnant women in some cases the antiemetic effect can be reached by use of polyneuramins 1 , In 6 , In 12 , hydrochloric to - you, etc.
At P.'s appointment the page should be meant that they, as a rule, act as symptomatic means. In this regard for the termination of nausea and vomiting along with P. the village needs to use methods of causal or pathogenetic treatment.
Items of page are contraindicated at appendicitis, the restrained hernias, impassability of intestines and other surgical diseases of the abdominal organs demanding the emergency operative measure.
Bibliography: Clinical pharmacology, under the editorship of V. V. Zakusov, page 319, M., 1978; Mashkovsky M. D. Pharmaceuticals, p.1, page 198, M., 1977; Laurence D. R. a. Bennett P. N. Clinical pharmacology, Edinburgh — N. Y., 1980.
P. P. Denisenko.