Book contents
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
102 - Ondansetron
Published online by Cambridge University Press: 06 October 2020
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
Summary
THERAPEUTICS
Brands
• Zofran, Zuplenz
Generic?
• Yes
Class
• Antiemetic
Commonly Prescribed for
(FDA approved in bold)
• Prevention of nausea and vomiting (chemotherapy, radiotherapy, postoperative)
• Nausea and vomiting (pregnancy)
• Pruritus (opioid related)
• Acute gastroenteritis vomiting (children)
How the Drug Works
• Selective blocking agent of 5-HT3 receptors on both peripheral vagal nerve terminal and central chemoreceptor trigger zone (area postrema)
How Long Until It Works
• Usually works in less than 30 minutes
If It Works
• Use at lowest effective dose
If It Doesn't Work
• Increase dose, or discontinue and change to another agent
Best Augmenting Combos for Partial Response or Treatment-Resistance
• May try adding D2 antagonist, NK1 antagonist, antihistamine, benzodiazepine, or corticosteroid
Tests
• None required
ADVERSE EFFECTS (AEs)
How the Drug Causes AEs
• Blocking of 5-HT3 receptors
Notable AEs
• Headache, flushing, arrhythmia, urticaria, constipation, fever
• Transient blurred vision, elevated hepatic function tests
Life-Threatening or Dangerous AEs
• Hypersensitivity
• QTc prolongation
Weight Gain
• Unusual
Sedation
• Unusual
What to Do About AEs
• Reduce dose or discontinuation
Best Augmenting Agents to Reduce AEs
• Symptomatic management
DOSING AND USE
Usual Dosage Range
• 8–32mg
Dosage Forms
• Tablets: 4, 8, 16, 24mg
• Orally disintegrating tablet: 4, 8mg
• Film: 4, 8mg
• Injection: 2mg/mL, 4mg/5mL, 32mg/50mL
How to Dose
• For chemotherapy-induced nausea/ vomiting: 8–32mg IV or orally 15–30 minutes before chemotherapy
• Before anesthesia induction: 4mg IV undiluted over 2–5 minutes
Dosing Tips
• Should be administered 30 minutes before emetogenic cancer chemotherapy; 1–2 hours before radiotherapy; or 1 hour before induction of anesthesia
Overdose
• Sudden blindness of 2–3 minutes, hypotension, or vasovagal episode has been reported
Long-Term Use
• No long-term side effect
Habit Forming
• No
How to Stop
• No need to taper
Pharmacokinetics
• Metabolized predominantly by CYP3A4. Half-life 3–6 hours
- Type
- Chapter
- Information
- Essential NeuropharmacologyThe Prescriber's Guide, pp. 375 - 377Publisher: Cambridge University PressPrint publication year: 2015