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Der Internist

, Volume 50, Issue 7, pp 887–894 | Cite as

Neue antiemetische Strategien – nicht nur in der Onkologie

  • K. JordanEmail author
  • F. Müller
  • H.J. Schmoll
Arzneimitteltherapie

Zusammenfassung

Übelkeit und Erbrechen zählen zu den häufigsten Symptomen im klinischen Alltag. Die korrekte Diagnose ihrer Ursachen setzt die Kenntnis pathophysiologischer Hintergründe des Erbrechens und häufig eine interdisziplinäre Herangehensweise voraus. Das breite Spektrum emetogener Ursachen (labyrinthär, infektiös, mechanisch, medikamentös, hormonell) erfordert neben kausalen Therapieansätzen meist auch eine medikamentöse symptomorientierte Beschwerdelinderung. Dafür stehen mehrere, im Wirkmechanismus und antiemetischen Potenzial unterschiedliche Substanzklassen zur Verfügung. Die Festlegung der antiemetischen Therapiestrategie erfolgt jeweils individuell und berücksichtigt neben der Ursache des Erbrechens den rezeptorspezifischen Wirkmechanismus der Substanz mit den sich daraus ergebenden Nebenwirkungen. Obwohl in den letzten Jahren neuere Substanzklassen wie 5-HT3-Rezeptor- und Neurokinin-1-Rezeptorantagonisten zunehmend an Bedeutung gewonnen haben, sind herkömmliche und langjährig erfolgreich angewandte Antiemetika weiterhin unverzichtbar.

Schlüsselwörter

Antiemetika Erbrechen Übelkeit 5-HT3-Antagonisten Neurokinin-1-Antagonisten 

New antiemetic strategies – not only in oncology

Abstract

Nausea and vomiting are common symptoms in daily clinical practice. For appropriate diagnostics the knowledge of the pathopysiologic origin of nausea and vomiting is indispensable. Furthermore the diagnostic pathway usually has to be approached by an interdisciplinary team. Due to the broad spectrum of emetogenic causes several symptom-based treatment strategies are nowadays available. These include several kinds of antiemetics with different mechanisms of action and with an varying antiemetic potential. The antiemetic strategy is based on individual patient factors as well as on the receptor specific mechanism of action of the antiemetic drug and also the expected side effects. A number of modern antiemetic agents are available for the management of nausea and vomiting, including 5-HT3-receptor antagonists and NK1 receptor antagonists. However, other conventional antiemetic drugs are still in use and should not be underestimated.

Keywords

Antiemetics Emesis Nausea 5-HT3-antagonist Neurokinin-1-antagonist 

Notes

Interessenkonflikt

Die korrespondierende Autorin weist auf folgende Beziehungen hin:

MSD, Glaxo-Smith-Kline, Riemser.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Klinik für Innere Medizin IVUniversitätsklinikum HalleHalleDeutschland

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