, Volume 76, Issue 18, pp 1719–1735 | Cite as

Comparative Pharmacology and Guide to the Use of the Serotonin 5-HT3 Receptor Antagonists for Postoperative Nausea and Vomiting

  • Anthony L. KovacEmail author
Review Article


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-HT3 receptor 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-HT3 receptor 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-HT3 receptor 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-HT3 receptor antagonists in relation to the risk for PONV and PDNV are reviewed.


Ondansetron Granisetron Palonosetron Tropisetron Dolasetron 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance and Ethical Standards

Dr. Kovac has previously received grant support from GlaxoSmithKline, Roche, Aventis, Baxter Pharmaceuticals, Merck, and Helsinn Healthcare. Dr. Kovac has served as an advisory consultant for Aventis, Roche, GlaxoSmithKline, Adolor Pharma, Merck, and Helsinn Healthcare. Dr. Kovac has served as a member of the speakers’ bureau for GlaxoSmithKline, Abbott Laboratories, Roche, Baxter Pharmaceuticals, Merck, and Helsinn Healthcare.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Kansas Medical CenterKansas CityUSA

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