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Various classes of antiemetic drugs and their mechanism of action

Various classes of antiemetic drugs and their mechanism of action
Class Mechanism Examples
Neuroleptics Dopamine receptor blockade in lower brainstem (chemoreceptor trigger zone)
  • Phenothiazines:
    • Prochlorperazine
  • Chlorpromazine
  • Butyrophenones:
    • Haloperidol
  • Atypical:
    • Olanzapine
Prokinetic drugs Peripheral effects to increase peristalsis; metaclopramide also has central dopamine antagonist
  • Metoclopramide
5-HT3 receptor antagonists Block serotonin receptor (chronic use may cause constipation)
  • Palonosetron
  • Ondansetron
  • Granisetron
  • Dolasetron
Anticholinergic drugs Block acetylcholine release in lower brainstem
  • Trimethobenzamide
  • Scopolamine
  • Promethazine
Antihistamines Block histamine receptors in lower brainstem
  • Meclizine
  • Diphenhydramine
  • Dimenhydrinate
  • Hydroxyzine
Corticosteroids Multiple effects
  • Dexamethasone
Benzodiazepines Reduce anxiety; direct effect on lower brainstem
  • Lorazepam
Cannabinoids Binds to cannabinoid receptors to exert direct effect in the lower brainstem
  • Dronabinol
  • Nabilone
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