title: Comparative Pharmacology and Guide to the Use of the Serotonin 5-HT3Receptor Antagonists for Postoperative Nausea and Vomiting.
abstract: Since the introduction of the serotonin 5-hydroxy tryptamine 3 (5-HT3) receptor antagonists in the early 1990s, the incidence of postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) has decreased, yet continues to be a problem for the surgical patient. The clinical application of the 5-HT3receptor antagonists has helped define the approach and role of these antiemetics in the prevention and treatment of PONV and PDNV. Pharmacological and clinical differences exist among these medications resulting in corresponding differences in effectiveness, safety, optimal dosage, time of administration, and use as combination and rescue antiemetic therapy. The clinical application of the 5-HT3receptor antagonist antiemetics has improved the prevention and treatment of PONV and PDNV. The most recent consensus guidelines for PONV published in 2014 outline the use of these antiemetics. The 5-HT3receptor antagonists play an important role to help prevent PONV and PDNV in perioperative care pathways such as Enhanced Recovery After Surgery (ERAS). Comparisons and guidelines for use of the 5-HT3receptor antagonists in relation to the risk for PONV and PDNV are reviewed.
authors.affiliation: Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Mailstop 1034, Kansas City, KS, 66160, USA. akovac@kumc.edu.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Kovac
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D006801:Humans; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy*; D044406:Receptors, Serotonin, 5-HT3 / Q000378:metabolism*; D012701:Serotonin / Q000378:metabolism*; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use*
chemical_list: D000932:Antiemetics; D044406:Receptors, Serotonin, 5-HT3; D058831:Serotonin 5-HT3 Receptor Antagonists; D012701:Serotonin