Which medications in the drug class Antiemetics are used in the treatment of Nephrolithiasis?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Antiemetics

Patients with acute renal colic frequently experience intense nausea and/or vomiting. Effective pain control often is accompanied by resolution of nausea and vomiting, but some patients may require antiemetics in addition to analgesics. Various antiemetic medications are used, including phenothiazines and butyrophenones.

Metoclopramide (Reglan)

Metoclopramide is the only antiemetic that has been studied specifically in treatment of renal colic. In 2 small double-blinded studies, it provided relief of nausea and pain relief equal to that of narcotic analgesics. Metoclopramide's antiemetic effect is due to blockade of dopaminergic receptors in chemoreceptor trigger zone in CNS. Metoclopramide does not possess antipsychotic or tranquilizing activity and is less sedating than other central dopamine antagonists. Onset of action is 1-3 min after intravenous (IV) injection and 10-15 min after IM injection.

Ondansetron (Zofran)

A selective blocking agent of the serotonin 5-HT3 receptor type initially used for chemo-related nausea & vomiting. Comes in an intravenous (IV), oral pill, dissolving tablet and oral solution. Can prolong QT interval therefore should be avoided in patients with known QT prolongation. Use also has small risk of inducing serotonin syndrome though most reports have been associated with concomitant use of serotonergic drugs.

Prochlorperazine (Compazine, Compro)

Prochlorperazine may relieve nausea and vomiting by blocking postsynaptic mesolimbic dopamine receptors through its anticholinergic effects and depressing the reticular activating system. 

Promethazine (Phenadoz, Phenergan)

Promethazine is a phenothiazine derivative that possesses antihistaminic, sedative, antimotion sickness, antiemetic, and anticholinergic effects.


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