Nausea and Vomiting Drugs

pT teaching for Motion Sickness

avoid trigger

Long term use drugs for Nausea and Vomiting

Benadryl and Antihistamines

• anticholinergic effects

When using patches for Nausea, how long before triggers should they be applied?

4 hours

What are the primary nonpharmacological methods to prevent nausea for postoperative a pT?

• Supplemental Oxygen

• IV fluids for hydration

• Positions of comfort

• NG Tube to prevent abdominal distention

Psychogenic Vomiting

Metoclopramide or antianxiety drugs with counseling

What drugs is safe for Pregnant patients?

• Antihistamines

• Phenothiazines

• ginger

• Diphenhydramine (Benadryl)

Chemotherapy-Induced Nausea and Vomiting (CINV) “Cocktail”

• Ondansetron (Zofran)

• Metoclopramide (Reglan)

• Dexamethasone ( Decadron)

• Lorazepam (Ativan)

• Diphenhydramine (Benadryl)

Taken AT LEAST 30 minutes prior to treatment

Delayed Emesis pT Teaching for at home

they need to take their medication 1 Hour before meals

• Prochlorperazine (Compazine)

• Lorazepam ( Ativan)

• and Benadryl

Nausea and Vomiting Nursing Implementation

Gradual Progression of Diet

→ stop solid foods and liquids for a short time, then slowly reintroduce clear fluids and bland foods as tolerated.

→→ if they vomit again, restart the process

When are NG tubes perscribed and why?

when the Nausea and Vomiting is SEVERE and to prevent gastric ulcers from stagnant acid eating away at the lining and to provide nutritional support when oral intake is not possible.

Dopamine Antagonists

metoclopramide (Reglan)

Dopamine Antagonists Action and Use

• inhibit dopamine receptors that are part of the pathway to the vomiting center

• treat mild to moderate N&V associated with

  • anesthesia

  • surgery

  • radiation therapy

  • cancer chemotherapy

Dopamine Antagonists Serious Adverse Effects

Cardiovascular: Prolonged QT interval

• monitor ECG especially pT with preexisting conduction disorders

• ensure normal Electrolyte levels ( Potassium)

Serotonin Antagonists

end in -setron

Serotonin Antagonists Uses

Treat N&V associated with chemotherapy, radiation, and postoperative recovery.

Serotonin Antagonists Common Adverse Effects

• Headache

• Diarrhea

• Constipation

• Sedation

Serotonin Antagonists Serious Adverse Effects

Cardiovascular: Prolonged QT interval

Serotonin Antagonists Drug Interactions

Apomorphine

• may have an additive effect leading to severe hypotension and loss of consciousness.

Anticholinergic Agents Action and Uses

• Counterbalance excessive amounts of acetylcholine in the body, reducing nausea and vomiting.

• treat motion sickness and N&V associated with pregnancy

Anticholinergic Agents Common Side Effects

• Sedative effects

• anticholinergic Effects

  • blurred vision

  • constipation

  • urinary retention

  • dry mouth, throat, and nose

Corticosteroids

Dexamethasone (Decadron, Hexadrol)

Corticosteroids Action and Uses

• Actions

  • mood elevation

  • increased appetite

  • sense of well-being

• uses- in combination with other antiemetics or alone to relieve N&V

Corticosteroids Side Effects

• Hyperglycemia

• Peptic Ulcers

• Osteoporosis

• immunosuppression

Benzodiazepines

• Lorazepam (Ativan)

• Diazepam (Valium)

Benzodiazepines Actions and Uses

• Actions: sedation, antianxiety, depression of vomiting center, amnestic effect

• Uses: treat N&V and anxiety associated with chemo

Benzodiazepines Common and Serious Side Effects

Sedation and Hepatotoxicity

• be careful with pain medication, blood dyscrasias, and abuse

Cannabinoids Action and Uses

• Actions: inhibit pathways to vomiting center

• Uses: in patients with chemotherapy only

Cannabinoids Side Effects

Common side effects include dizziness, dry mouth, and increased appetite. Serious effects may involve anxiety or paranoia.

Neurokinin-1 Receptor Antagonists

Aprepitant (Emend)

Neurokinin-1 Receptor Antagonists Action and Uses

Action: block effects of substance P, a neuropeptide in the CNS, which is responsible for vomiting

Uses: Prevent acute and delayed Chemo Induced N&V

• SHORT-TERM ( 3 Days)

• Last resort type of med

Neurokinin-1 Receptor Antagonists Common Side Effects

• Tiredness

• Nausea

• Hiccups

• Constipation

• Headache

• Diarrhea

• Loss of Appetite

Neurokinin-1 Receptor Antagonists Adverse Effects

hair loss