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首页> 外文期刊>Clinical drug investigation >Combination antiemetic regimens for prevention of postoperative nausea and vomiting: Focus on high-risk patients
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Combination antiemetic regimens for prevention of postoperative nausea and vomiting: Focus on high-risk patients

机译：联合止吐方案预防术后恶心和呕吐：针对高危患者

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None of the available antiemetics is entirely effective, perhaps because most of them act through the blockade of one receptor. There is a possibility that a combination of antiemetics with different sites of activity would be more effective than one drug alone for prophylaxis against postoperative nausea and vomiting (PONV). The clinical use of combined traditional antiemetics, including antihistamines (e.g. diphenhydramine), butyrophenones (e.g. droperidol) and benzamides (e.g. metoclopramide), for the prevention of PONV is limited because of the possibility of additive central nervous system toxicity, such as delayed emergence, drowsiness and extrapyramidal reactions. The efficacy of a combination of a serotonin 5-HT3 receptor antagonist (ondansetron, granisetron or tropisetron) and dexamethasone is superior to that of 5-HT3 receptor antagonists alone for the prevention of PONV, suggesting that dexamethasone enhances the antiemetic efficacy of 5-HT3 receptor antagonists. The combination of a 5-HT3 receptor antagonist with a traditional antiemetic (droperidol, metoclopramide or promethazine) acting at a different emetogenic receptor is more effective in reducing the incidence of PONV than each antiemetic alone acting at one receptor site. The risk of undesirable adverse effects does not increase with the combination of a 5-HT3 receptor antagonist and a traditional antiemetic at the doses commonly used for PONV, because of the absence of drug interactions. The combination of a 5-HT3 receptor antagonist (ondansetron) with other agents (propofol and CP-122721) reduces the incidence of PONV to a greater degree than monotherapy. However, no data are available for the combination of 5-HT3 receptor antagonists and small doses of propofol for the prevention of PONV. Further studies are needed to evaluate the efficacy and safety of combination antiemetic regimens for PONV. Knowledge regarding combinations of these antiemetic drugs may be necessary to completely prevent PONV.
机译：没有一种可用的止吐药是完全有效的，也许是因为它们中的大多数通过一种受体的阻断而起作用。有可能将具有不同活性部位的止吐药联合使用，比单独使用一种药物更有效地预防术后恶心和呕吐（PONV）。由于可能会累加中枢神经系统毒性，例如延缓出现，包括抗组胺药（例如苯海拉明），丁苯酮（例如氟哌啶）和苯甲酰胺（例如甲氧氯普胺）在内的传统止吐药在临床上的使用受到限制。嗜睡和锥体束外反应。 5-羟色胺5-HT 3 受体拮抗剂（恩丹西酮，格拉司琼或托吡司琼）与地塞米松联合使用的疗效优于单独的5-HT 3 受体拮抗剂。预防PONV，提示地塞米松可增强5-HT 3 受体拮抗剂的止吐功效。 5-HT 3 受体拮抗剂与作用于另一种催吐剂的传统止吐药（氟哌啶，甲氧氯普胺或异丙嗪）的组合比单独使用一种止吐药对降低PONV的发生更为有效。受体部位。由于没有药物相互作用，使用5-HT 3 受体拮抗剂和常规止吐药以PONV常用剂量联合使用不会增加不良不良反应的风险。 5-HT 3 受体拮抗剂（恩丹西酮）与其他药物（丙泊酚和CP-122721）的组合比单药治疗可更大程度地降低PONV的发生率。但是，尚无5-HT 3 受体拮抗剂与小剂量丙泊酚联合用于预防PONV的数据。需要进一步的研究来评估止吐药联合用药的有效性和安全性。要完全预防PONV，可能需要有关这些止吐药组合的知识。

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