Antiemetic Flashcards
dolasetron trade name
anzemet
dolasetron expected effect
prevent nausea, vomit by blocking it in small intestine
why use dolasetron
prevent postop nausea and vomit
dolasetron route admin
IV PO
dolasetron adverse effects
dysrhythmias, ventricular tachycardia/ fibrillation, QT prolongation, cariac arrest, bronchospasm
dolasetron doses
IV 12.5mg before start anesthesia
PO 100mg 2h before surgery
dolasetron nursing implications
assess: hypersensitivity, cardiac conduction, electrolyte imbalances, dysrhythmias
evaluate: therapeutic response
teach: report typical side effect problems
may cause headache so use anagesic
dimenhydrinate trade names
dramamine, driminate, gravol
dimenhydrinate classes
antiemetic, antihistamine, anticholinergic
dimenhydrinate why use
motion sickness, nausea, vomit, vertigo
dimenhydrinate expected effect
compete with histamine for H1 receptors in GI, blood, rest tract; anticholinergic, less vestibular sim, block chemoreceptor trigger
dimenhydrinate dose
PO 50-100 q4h
IM IV 50mg q4h
dimenhydrinate route admin
PO IM IV elixir
dimenhydrinate adverse effects
ANAPHYLAXIS, dry mouth, drowsy, dry mouth, hypotension, constipation
dimenhydrinate nursing implications
check BP, vitals,
signs toxicity mask symptoms of disease
avoid hazards/ alert activities
avoid alcohol depressants
meclizine trade names
antivert, bonine, dramamine less drowsy formula
meclizine class
antiemetic, antihistamine, anticholinergic
meclizine expected effect
act centrally by blocking chemo zone which acts on vomit centre
meclizine why use
vertigo, motion sickness
meclizine route admin
PO
meclizine doses
vertigo: 25-100mg
motion sickness: 25-50mg 1h before travelling
meclizine adverse effects
ANAPHYLAXIS, drowsy, urine retention, hypotension, constipation, blurred vision
meclizine nursing implications
alert: signs toxicity other products mask symptoms disease
may cause false positive allergy
avoid alcohol, depressants, no breast feeding
metoclopramide trade names
Apo-metoclop, metozolv, reglan
metoclopramide drug classes
antiemetic, cholinergic
metoclopramide expected effect
contract gastric muscle in upper GI tract by enhancing tissues response to ACh, relax pyloric & duodenal segments, increase peristalsis without stimulating secretions & block dopamine in chemo trigger zone in CNS
why use metoclopramide
prevent nausea, vomit from chemo, radiation, delayed gastric emptying, GERD
metoclopramide route admin
PO IV
metoclopramide adverse effects
sucide, neuroleptic malignant, tardive dyskinesia, penias
metoclopramide doses
nausea vomit: 1-2mg/kg IV 30 min befor chemo, q2h x 2 doses then q3h x 3 doses
GERD
PO 10-15 mg qid 30 mins before meals and bed
diabetic gastroparesis
PO 10mg 30min before meals, at bed x 2-8 wk
metoclopramide black box warning
EPS, tardive dyskinesia
metoclopramide nursing implications
neuroleptic malignant syndrome, avoid driving & hazardous activities, avoid alcohol & CNS depressants
