Slandom 8 Savi medicine room nausea and vomiting (3 blisters x 10 tablets)

Should prescribe ondansetron for patients under 45 years old because these people are more likely to have extra -towering reactions when using high doses of Metoclopramid and when treated with strong vomiting chemicals. This drug is still used for the elderly.

Do not prescribe ondansetron for cases of treatment with chemicals that can cause low vomiting (such as Bleomycin, Busulfan, Cyclophosphamide dose of less than 1000mg, Etoposid, 5-Fluouracil, Vinblastin, Vincristin).

Dược lực học

Ondansetron là chất đối kháng thụ thể 5HT3 có chọn lọc cao. Cơ chế tác dụng chính xác của thuốc trong việc kiểm soát nôn chưa được biết rõ. Chemotherapy and radiation can cause 5HT release in the small intestine and cause vomiting by activating vagus nerves through the receptor 5HT3.

Ondansetron has the effect of inhibiting this reflex start. Hoạt hóa dây thần kinh phế vị cũng có thể gây phóng thích 5HT trong vùng postrema ở trên sàn não thất IV và gây nôn qua cơ chế trung tâm. Như vậy, tác dụng của ondansetron trong điều trị buồn nôn và nôn do hóa trị liệu hoặc xạ trị có thể do đối kháng các thụ thể 5HT3 trên dây thần kinh ở cả ngoại vi và hệ thần kinh trung ương.

The anti -nausea and vomiting mechanisms after surgery are not well known, but may also follow the anti -vomiting and nausea mechanisms due to cytotoxicity.

The drug is not a dopamine receptor inhibitor, so there is no extrasic side effect.

Pharmacokinetics

absorption

The drug is well absorbed through the gastrointestinal tract and is used by oral bioavailability about 56% - 71%. The drug begins to work after taking about 30 minutes.

Distribution

The volume of distribution in adults is 2.2 - 2.5 liters/kg, in children is 1.7 - 3.7 liters/kg; 70% - 75% of the drug in plasma is linked to protein.

Metabolism

The drug is metabolized mainly in the liver under the effect of isenzyme cytochrom paso which is mainly CYP3A4, in addition to CYP1A2 and CYP2D6. The main reaction is hydroxylation and then glucuronid or sulfate and methylation can be removed.

Elimination

The drug is mainly eliminated (44% - 60%) in the form of metabolism through urine, about 25% in feces; About 5% excreted in constant form. Plasma clearance is 0.35 ± 0.16 liters/hour/kg in adults and may be higher in children. The body clearance decreases in severe liver failure (from 2 to 3 times) and in severe renal failure (2 times).

Ondansetron's sale time is about 2-7 hours in children under 15 years old, 3-6 hours in normal people and increases in liver failure and elderly people (up to 12 hours when there is a mild or medium liver failure and lasts up to about 20 hours in severe liver failure).

When a serious side effect occurs, it is necessary to immediately notify the treating doctor.

Caution when using

Serotonin syndrome (including: agitation, confusion, tachycardia, muscle convulsions or stiffness, fever, loss of consciousness or coma) occur when serotonin is accumulated at a high level in the body. This usually happens when combined with serotonin anti -serotonin drugs, but can also occur when using single drugs. Early diagnosis of serotonin syndrome is important because this can lead to death if not treated. If using Ondansetron simultaneously and selective Serotonin reabsorption inhibitors or serotonin and norepinephrin reabsorption inhibitors, patients need to be monitored carefully.

Should use Ondansetron for preventive purposes, not for treatment purposes, because this drug is only used to prevent vomiting and nausea rather than vomiting.

should only use ondansetron for the first 24 - 48 hours when treated with chemicals. Research shows that the drug does not increase the effectiveness in case of vomiting and nausea that appear late.

The clearance of ondansetron decreases and the sale time of an increased drug in patients with liver dysfunction; Severe cases (type C) should be reduced in these patients.

Hypersensitivity reaction has been reported in patients with hypersensitivity to other selective SHT receptor antagonists.

Patients using Ondansetron are at risk of extending the QT range, so avoid using Ondansetron for patients with congenital QT syndrome. Electrolyte monitoring in patients with abnormalities in electrolytes (e.g., hematuria or hypotension), congestive heart failure, slow heart rate or patients who are taking other drugs can lead to prolonged QT or coordination with treatments along with anthracyclin drugs. It is necessary to treat hematuria and blood magnesium before treatment with ondansetron.

Ondansetron may extend the transportation time in the large intestine, so the patient shows signs of acute bowel obstruction should be monitored during the use of the drug. Caution must be used in the case of suspected intestinal obstruction due to drugs that can hide the progression of the disease.

The use of ondansetron for patients with tonsillectomy surgery to prevent vomiting, nausea can hide bleeding. Therefore, it is necessary to supervise the patient closely.

Pediatric patients use Ondansetron while being treated with liver toxic chemotherapy should be closely monitored.

Due to the presence of lactose in preparations, patients with rare genetic diseases are galactose intolerance, Lapp Lactase enzyme deficiency or Glucose-Galactose should not be used.

The effect of the drug on the ability to drive and operate machinery

Ondansetron may have adverse side effects such as dizziness, fatigue ... should be cautious when driving, operating the machine or the jobs that need alertness.

Use drugs for women during pregnancy and lactation

Pregnant case:

There is no drug information whether or not the placenta is. Only use during pregnancy when the effect is superior to the risk of risk (in case of severe morning sickness or other drugs that do not work).

breastfeeding case:

Animal research shows that Ondansetron is excreted in milk. Therefore, it is necessary to avoid being used for breastfeeding mothers.

Drug interaction

Ondansetron does not cause induction or inhibit the cytocrom paso enzyme system, but are metabolized by many liver enzymes, including CYP3A4, CYP2D6, and CYP1A2. Therefore, these induction or inhibitors of this enzyme system (such as cyproteron, deferasirox, peginterferon alfa-2b, barbiturat, carbamazepin, rifampin conductor, phenytoin, phenylbutazon, or cimetidine, allopurinol, disulfilam, alfuzosin, artemether, artemether Ciprofloxacin, ...) can change the waste coefficient and the sale time of Ondansetron, but it is not necessary to adjust the dose.

Be cautious when taking ondansetron with drugs that extend the QT and/or cause electrolyte abnormalities. Ondansetron extends the QT interval, when used with drugs that extend the QT range may increase the risk of toxicity. Simultaneous use of Ondansetron with heart toxic drugs (anthracyclin or trastuzumab), antibiotics (such as erythromycin), antifungal (such as ketoconazole), antivacer drugs (such as amiodaron) and beta blockers (such as Atenolol or Timolol) can increase the risk of arrhythmia. Avoid using ondansetron along with the following drugs: Apomorphin, Artemether, Droneedaron, Lumefantrin, Nilotinib, Pimozid, Quetiapin, Quinin, Tetrebenazin, Thioridazin, Toremifen, Vandetanib, Vemurafenib, ZIPRASIDON.

Ondansetron is simultaneously used with selective Serotonin reabsorption inhibitors or serotonin and norepinephrine reabsorption inhibitors that can cause serotonin syndrome.

Unused non -use apomorphin with Ondansetron due to severe and conscious cases of hypotension.

Ondansetron can reduce tramadol pain effect.