嘔吐是一種復(fù)雜的反射活動(dòng),各種止吐藥可通過影響嘔吐反射的不同環(huán)節(jié)而發(fā)揮止吐作用。這些機(jī)制包括抑制化學(xué)感受器、大腦皮質(zhì)、耳前庭器官或直接作用于嘔吐中樞。因此,在選擇用藥時(shí)應(yīng)根據(jù)具體情況加以考慮。
通常情況下,預(yù)防性使用止吐藥物的效果優(yōu)于治療性使用,尤其是在處理暈動(dòng)癥、放射病或化療引起的嘔吐時(shí)更為明顯。對(duì)于妊娠嘔吐,則需謹(jǐn)慎選用止吐藥,一般僅推薦苯海拉明和茶苯海拉明等藥物,在劇烈嘔吐時(shí)才可考慮使用吩噻嗪類。
常用的止吐藥物包括:
催吐藥主要用于促使急性中毒患者將胃中的毒物嘔吐出來。其催吐作用主要通過興奮中樞催吐化學(xué)感受器或刺激消化道反射性地興奮嘔吐中樞來實(shí)現(xiàn),如使用阿撲嗎啡。然而,目前更常采用洗胃法替代催吐藥物的使用。
| 中文名稱 | 英文名稱 | CAS號(hào) | 化學(xué)式 |
|---|---|---|---|
| 馬羅皮坦檸檬酸鹽水合物 | maropitant citrate monohydrate | 359875-09-5 | C6H8O7*C32H40N2O*H2O |
| 阿瑞吡坦 | aprepitant | 170729-80-3 | C23H21F7N4O3 |
| 萘二磺酸乙乳膽銨 | Aclatonium Napadisilate | 55077-30-0 | C10H6O6S2*2C10H20NO4 |
| 莫沙必利 | mosapride | 112885-41-3 | C21H25ClFN3O3 |
| 美托哌丙嗪 | metopimazine | 14008-44-7 | C22H27N3O3S2 |
| 硫酸銅 | Sulfuric acid copper(2+) salt (1:1), hydrate (8CI,9CI) | 7758-99-8 | CuH4O5S |
| 鹽酸阿扎司瓊 | Azasetron hydrochloride | 123040-16-4 | C17H20ClN3O3*ClH |
| 鹽酸阿扎司瓊 | azasetron | 123040-69-7 | C17H20ClN3O3 |
| 鹽酸地芬尼多 | diphenidol hydrochloride | 3254-89-5 | C21H27NO*ClH |
| 鹽酸去水嗎啡 | apomorphine hydrochloride | 314-19-2 | C17H17NO2*ClH |
| 鹽酸依托必利 | itopride hydrochloride | 122892-31-3 | C20H26N2O4*ClH |
| 鹽酸三甲氧苯酰胺 | trimethobenzamide hydrochloride | 554-92-7 | C21H28N2O5*ClH |
| 枸櫞酸莫沙比利 | Mosapride citrate dihydrate | 636582-62-2 | C27H37ClFN3O12 |
| 枸櫞酸莫沙必利含結(jié)晶水 | 4-Amino-5-chloro-2-ethoxy-N-[[4-[(4-fluorophenyl)methyl]-2-morpholinyl]methyl]benzamide 2-Hydroxy-1,2,3-propanetricarboxylate Hydrate | 636582-62-2 | C27H35ClFN3O11 |
| 替加色羅 | tegaserod | 145158-71-0 | C16H23N5O |
| 曲美芐胺 | Trimethobenzamide | 138-56-7 | C21H28N2O5 |
| 地芬尼多 | difenidol | 972-02-1 | C21H27NO |
| 吐根堿 | cephaeline | 483-17-0 | C28H38N2O4 |
| 匹哌馬嗪 | pipamazine | 84-04-8 | C21H24ClN3OS |
| 克立波必利 | clebopride | 55905-53-8 | C20H24ClN3O2 |
| 伊托必利 | itopride | 122898-67-3 | C20H26N2O4 |
| 乙?guī)€匹拉嗪 | thiethylperazine | 1420-55-9 | C22H29N3S2 |
| 三氯叔丁醇 | 1,1,1-trichloro-2-methyl-2-propanol | 57-15-8 | C4H7Cl3O |
| —— | 1H-Indole-3-carboxylic acid, octahydro-3-oxo-2,6-methano-2H-quinolizin-8-yl ester, (2alpha,6alpha,8alpha,9abeta)-, monomethanesulfonate | 115956-13-3 | C20H24N2O6S |
| —— | Dolasetron mesylate hydrate | 115956-13-3 | C20H26N2O7S |
| —— | (6aR)-6-methyl-5,6,6a,7-tetrahydro-4H-dibenzo[de,g]quinoline-10,11-diol;hydron;dichloride;hydrate | 314-19-2 | C34H38Cl2N2O5 |
| —— | methanesulfonic acid;[(7R)-10-oxo-8-azatricyclo[5.3.1.03,8]undecan-5-yl] 1H-indole-3-carboxylate | 115956-13-3 | C20H24N2O6S |
| —— | Tropisetron | 89565-68-4 | C17H20N2O2 |
| —— | 2-methyl-1-(9-methyl-4-oxo-2,3,4,9-tetrahydro-1H-carbazol-3-yl)imidazol-3-ium chloride dihydrate | 103639-04-9 | C18H19N3O*ClH*2H2O |
| —— | Dolasetron methanesulfonate | 878143-33-0 | C20H24N2O6S |
| —— | Aclatonium napadisilate | 55077-30-0 | C30H46N2O14S2 |
| —— | (6aR)-6-methyl-5,6,6a,7-tetrahydro-4H-dibenzo[de,g]quinoline-10,11-diol;chloride | 41372-20-7 | C17H17ClNO2- |
| —— | Granisertron hydrochloride | 107007-99-8 | C18H25ClN4O |
| —— | 1-Methyl-N-((1R,3R,5S)-9-methyl-9-azabicyclo[3.3.1]nonan-3-YL)-1H-indazole-3-carboxamide | 109889-09-0 | C18H24N4O |
| —— | Fosaprepitant Dimeglumine | 265121-04-8 | C37H56F7N6O16P |
| —— | cephaeline | 483-17-0 | C28H38N2O4 |
| —— | granisetron | 109889-09-0 | C18H24N4O |
| —— | Granisetron hydrochloride | 107007-99-8 | C18H24N4O*ClH |
| —— | [1-methyl-N-(9-methyl-9-azabicyclo[3.3.1]nonan-7-yl)indazole-3-carboxamide] | 109889-09-0 | C18H24N4O |
| —— | trans-hexahydro-8-(3-indolylcarbonyloxy)-2,6-methano-2H-quinolizin-3(4H)-one base | 115956-12-2 | C19H20N2O3 |
| —— | [(3S,7R)-10-oxo-8-azatricyclo[5.3.1.03,8]undecan-5-yl] 1H-indole-3-carboxylate | 115956-12-2 | C19H20N2O3 |
| —— | [(7S)-10-oxo-8-azatricyclo[5.3.1.03,8]undecan-5-yl] 1H-indole-3-carboxylate | 115956-12-2 | C19H20N2O3 |
| —— | [(7R)-10-oxo-8-azatricyclo[5.3.1.03,8]undecan-5-yl] 1H-indole-3-carboxylate | 115956-12-2 | C19H20N2O3 |
| —— | 1H-Indole-3-carboxylic acid, 8-methyl-8-azabicyclo[3.2.1]oct-3-yl ester,exo- | 89565-68-4 | C17H20N2O2 |
| —— | Fosaprepitant dimeglumine | 265121-04-8 | 2C7H17NO5*C23H22F7N4O6P |