The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting

Chin Chen Chu, Chung-Hsi Hsing, Ja Ping Shieh, Chih Chiang Chien, Chiu Ming Ho, Jhi Joung Wang

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Glucocorticoids, used primarily as anti-allergic and anti-inflammatory drugs, are also effective, alone or combined with other antiemetics, for preventing nausea and vomiting. Dexamethasone, one of the glucocorticoids, has been suggested as a first-line drug for preventing low-level emetogenic chemotherapy- and radiotherapy-induced nausea and vomiting, and in patients with only one or two risks for postoperative nausea and vomiting (PONV). Dexamethasone combined with 5-HT3 or tachykinin NK1 antagonists is also suggested for higher-level emetogenic chemotherapy and radiotherapy and for patients at high risk for PONV. Glucocorticoids may act via the following mechanisms: (1) anti-inflammatory effect; (2) direct central action at the solitary tract nucleus, (3) interaction with the neurotransmitter serotonin, and receptor proteins tachykinin NK1 and NK2, alpha-adrenaline, etc.; (4) maintaining the normal physiological functions of organs and systems; (5) regulation of the hypothalamic-pituitary-adrenal axis; and (6) reducing pain and the concomitant use of opioids, which in turn reduces opioid-related nausea and vomiting.

Original languageEnglish
Pages (from-to)48-54
Number of pages7
JournalEuropean Journal of Pharmacology
Volume722
Issue number1
DOIs
Publication statusPublished - Feb 5 2014

Keywords

  • CINV
  • Dexamethasone
  • Emesis
  • Glucocorticoids
  • PONV
  • RINV

ASJC Scopus subject areas

  • Pharmacology

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