The role of 5-HT3 receptor antagonists in preventing postoperative nausea and vomiting.
Postoperative nausea and vomiting (PONV) is a frequent complication of surgery. Guidelines recommend using a 5-HT3 receptor antagonist (eg, ondansetron, dolasetron, granisetron) combined with a second agent (eg, dexamethasone) for patients at moderate to high risk for PONV. Although all 5-HT3 antagonists are effective, ondansetron and granisetron have been found to be effective at substantially lower doses than those approved by the US Food and Drug Administration. Metabolism of granisetron differs from metabolism of other 5-HT, antagonists, so it is less likely to adversely interact with other medications. This article explains the clinical pharmacology of 5-HT3 antagonists and provides recommendations for nursing management of PONV.
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Thomas
T
Department of Pharmacy, Concord Hospital, NH, USA.
Board
Rhonda
R
D000328:Adult; D000465:Algorithms; D000932:Antiemetics / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D003907:Dexamethasone / Q000627:therapeutic use; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000451:nursing; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007546:Isoquinolines / Q000627:therapeutic use; D024802:Nurse's Role; D009730:Nursing Assessment; D017294:Ondansetron / Q000494:pharmacology / Q000627:therapeutic use*; D009871:Operating Room Nursing / Q000458:organization & administration; D000077924:Palonosetron; D018579:Patient Selection; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011807:Quinolizines / Q000627:therapeutic use; D011812:Quinuclidines / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000494:pharmacology / Q000627:therapeutic use*
D000932:Antiemetics; D003907:Dexamethasone; D017829:Granisetron; D007211:Indoles; D007546:Isoquinolines; D017294:Ondansetron; D000077924:Palonosetron; D011807:Quinolizines; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; C060344:dolasetron