Nausea and Vomiting

Purpose | Principles | How to Care for a Patient in Pain | Nutrition
Nausea and Vomiting | Constipation | Anxiety and Depression | Dyspnea
Fatigue | End-of-Life Decision-Making | Community Resources
How to Refer PatientsCommunication | Links and References

Nausea

  • Consider regular -- or around the clock -- antiemetic therapy
  • Complement medication with:
    • Relaxation techniques
    • Deep breathing
    • Cool room temperatures
    • Elevated head
    • Frequent oral hygiene

Use For Antiemetic Can Give Typical Dose
1st Line prn
Any reason for emesis
Compazine
(prochlorperazine)
oral
rectal
IV
IM
5-10 mg prn
12.5-25 mg prn
5-10 mg prn
5-10 mg prn
  Phenergan
(promethazine)
oral
IV
12.5-25 mg po
q 6 hr prn
Weak antiemetic Tigan
(trimethobenzamide
hydrochloride)
oral
IM

rectal
200 mg tid or qid
200 mg (2 ml) tid or qid
200 mg tid or qid
Moderate nausea, appetite stimulant, gastroparesis Reglan
(metoclopramide)
oral IV 10 mg qid or every 6 hr
Anti-anxiety drugs Ativan
(lorazepam)
oral
IV
sublingual
0.5-1.0 mg every 4-6 hr
Vistaril
(hydroxyzine)
oral
IM
25-100 mg every 6 hr
2nd Line Haldol
(haloperidol)
IM 1.25-5 mg every 4-6 hr
Decadron
(dexamethasone)
oral 4-8 mg oral tid
10 mg IV one-time dose
Vertigo, motion sickness Trans-Derm Scop
(scopolamine)
transdermal 1.5 mg patch every 3 days
Antivert
(meclizine)
oral 25-50 mg every 24 hr
Prevent nausea in cancer and AIDS patients Marinol
(dronabinol)
oral 5 mg-10 mg po every 4 hr
Post-operative Zofran
(ondansetron)
oral
IV
4-8 mg po bid or tid

Note: Serotonin antagonists Zofran, Kytril (granisetron), Anzemet (dolasetron), Aloxi (palonosetron) and NK1 antagonist Emend (aprepitant) are intended for the prevention of chemotherapy-induced emesis.

 

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