Antiemetics

Question 1

Ondansetron (Zofran) - Dose/Timing

Answer 1

• 4 mg IV over 30 sec q 3-4 hr

* No dilution required

Question 2

Ondansetron (Zofran) - Indications

Answer 2

• Management of N&V associated with chemotherapy

* Prevention & treatment of post-op N&V

Question 3

Ondansetron (Zofran) - Adverse Effects

Answer 3

• Possible prolongation of QT interval

* Hepatic enzyme serum concentration may increase - use with caution with hepatic impaired patients

Question 4

Metoclopramide (Maxeran) - Dose/Timing

Answer 4

• 10 mg IV over 1-2 min

* No dilution required

Question 5

Metoclopramide (Maxeran) - Indications

Answer 5

• Prophylaxis of N&V associated with chemotherapy

* Prophylaxis of post-op vomiting

Question 6

Metoclopramide (Maxeran) - Adverse Effects

Answer 6

• Dizziness, drowsiness
• Extrapyramidal symptoms/tardive dyskinesia (use with caution with epileptic patients)
• Use with caution with patients on MAOIs or with renal impairment

Question 7

Dimenhydrinate (Gravol) - Dose/Timing

Answer 7

• 25-50 mg q4h IV
• max 400mg/24 hr
• Dilute to 5mg/ml (i.e., 50mg in 10 mL NS)

Question 8

Dimenhydrinate (Gravol) - Indications

Answer 8

• Prevention & treatment of radiation sickness, post-op vomiting, drug induced N&V

Question 9

Dimenhydrinate (Gravol) - Adverse Effects

Answer 9

• Dizziness, drowsiness
• Dose reduction in hepatic impaired patients
• Additive effect with opiates
• Precaution in patients in whom anti-cholinergic side effects would be detrimental (i.e., glaucoma)
• Precaution in patients with CV disease, asthma, seizure disorders, >60 yrs

Question 10

Droperidol - Dose/Timing

Answer 10

• 0.625-1.25 mg IV over 2-3 min

* No dilution

Question 11

Droperidol - Indications

Answer 11

• Sedation, tranquilization and prevention of N&V pre/post-op
• Neurolepsis (produce tranquility, decrease anxiety and pain)

Question 12

Droperidol - Adverse Effects

Answer 12

• Cardiac monitoring for doses >1.25 mg for 2 hr post administration (prolonged QT)
• Additive effect with opiates

Question 13

Dexamethasone - Dose/Timing

Answer 13

• 4-8 mg IV over 1-2 min
• No dilution required
• Higher doses can be given (i.e., for chemo)

Question 14

Dexamethasone - Indications

Answer 14

• Shock, cerebral edema, inflammatory disorders

* Prevention of N&V

Question 15

Dexamethasone - Adverse Effects

Answer 15

• Occur with high doses for prolonged periods and less likely to occur with short-term use