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Centrally acting emetic
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Apomorphine is a D2-dopamine-receptor agonist that works at the level of the chemoreceptor trigger zone (CRTZ) of the brain in dogs. Emesis is regulated by both neural pathways and by humoral pathways within the brain. Most emetic and antiemetic drugs work through the humoral pathways on the CRTZ. There are species differences for both emetic and antiemetic drugs based on receptor differences in the CRTZ. Cats do not respond consistently to apomorphine and its use is controversial in this species.
Emetics are an important early treatment for some orally ingested toxins. Emetics generally remove only 40-60% of the stomach contents and are useful in the first four hours after ingestion. Apomorphine is metabolized in the liver and excreted in urine.
Apomorphine is the emetic of choice in dogs. It commonly is given parenterally (IM or IV) or topically in the conjunctival sac. When given intravenously, vomiting occurs rapidly. After intramuscular injection, vomiting should occur within five minutes. Conjunctival administration usually is effective although not as quickly or reliably as parenteral administration. If vomiting does not occur after one dose, repeated doses are unlikely to be effective and increase the likelihood of undesirable side-effects or toxicity. Apomorphine is poorly absorbed orally.
Apomorphine Maleate Side Effects
Overdose with apomorphine can cause respiratory and cardiac depression, CNS stimulation or depression and protracted vomiting. Naloxone may be used to reverse CNS and respiratory signs, but will not diminish the vomiting.
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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