This figure shows the different sites of actions of anti-emetics. The agents used to treat emesis generally exert their effect by blocking one neurotransmitter receptor and can thus be grouped into classes of dopamine D2 antagonists,
A patient receives a prophylactic dose of droperidol near the end of surgery. In the recovery room, the patient becomes nauseated and vomits. What do you recommend?
Extra info: Close A rescue anti-emetic is likely to be more efficacious if its mechanism is different than the failing agent. Therefore, ondansetron (a 5-HT3 antagonist) is likely to be more efficacious than the other anti-emetics. Domperidone, alizapride, and metoclopramide all are primarily D2 antagonists like droperidol.