Anti Emetics Doses

Question 1

Ondansetron

Answer 1

PO dose 4-8mg for PONV prophylaxis
Dose 4mg single dose IV
.1mg/kg <40kg

Question 2

Palonsteron

Answer 2

.75mg IV, .25mg chemo induced N/V

Question 3

Dolastetron (Anzemet)

Answer 3

12.5mg IV, single dose 100mg 1-2h preop is effective also. 50mg IV shown to have equal efficacy as 4mg ondansetron in preventing PONV

Question 4

Droperidol

Answer 4

.625-1.25 IV slow or IM

• 10-20mcg/kg IV shown to be effective in reducing vomiting
• 20mcg/kg IV immediately after induction superior to metaclopramide 5-10mg PO in reducing PONV
• 20mcg/kg dose causes prolonged sedation (increased PACU LOS)
• high dose (50-75mcg/kg): increased side effects of anxiety, dizziness, drowsiness, hypotension, EPS SE.

Question 5

Prochlorperazine

Answer 5

5-10mg IM/IV before induction

Question 6

Metoclopramide

Answer 6

10mg IV (range 5-20mg)
(.1-.25mg/kg q6-8 hours)
chemotherapy: 1-2mg/kg large doses
.15mg/kg IV

Question 7

Aprepitant

Answer 7

40-80mg PO preoperatively

Question 8

Dexamethasone (Decadron)

Answer 8

4-10mg IV

.2-.5mg/kg IV

Question 9

Dimenhydrinate (Dramamine)

Answer 9

50-100mg IV/IM (max dose 100mg q4h)

Question 10

Ephedrine

Answer 10

10-25mg IV recommended for N/V associated with postural hypotension in PACU

• .5mg/kg IM at the end of surgery shown to have equivalency to droperidol
• 40mcg/kg IM shown to minimize N/V with less sedation

Question 11

Midazolam

Answer 11

pedes dose 50-75mcg/kg IV

2mg IV