Antiemetics + PONV facts

Question 1

ANTIEMETICS

Dose, Onset, Duration:
Droperidol

Inapsine

Answer 1

0.625mg, 1-5min, 2-3hrs

Question 2

ANTIEMETICS

Dose, Onset, Duration:
Promethazine

Phenergran

Answer 2

6.25 -12.5 mg, 1-5mins, 4-6hrs

Question 3

ANTIEMETICS

Dose, Onset, Duration:
Ondansetron

Zofran

Answer 3

4mg, 10mins, 4-9hrs

Question 4

ANTIEMETICS

Dose, Onset, Duration:
Dexamethasone

Decadron

Answer 4

4mg, 10-30mins, 2-10hrs

Question 5

ANTIEMETICS

Dose, Onset, Duration:
Metoclopramide

Reglan

Answer 5

10-20mg, 10mins, 2hrs

Question 6

ANTIEMETICS

Dose, Onset, Duration:
Scopolamine

Answer 6

Patch, 2-4hrs, 72hrs!

Non-hairy area - dont touch eyes after handling –> can cause mydriasis.

Question 7

ANTIEMETICS

Dose, Onset, Duration:
Propofol

Diprivan

Answer 7

10-15mg IV followed by 10mcg/kg/min

Question 8

List some PONV risk factors.

Answer 8

Female, <40yrs, Hx of PONV or Motion Sickness, vertigo, non-smokers

Surgeries: Laparotomy, Laparoscopy, Major Breast, Strabismus, Intraocular, Middle Ear, Tonsils, Adenoids, Neuro (intracranial), Gynecologic, Testicular, Scrotum, Kidney stones

Question 9

If I have 0 PONV risk factors, what is the chance I will have PONV?

Answer 9

10%

This requires NO pre-treament drugs.

Question 10

My chance of PONV is 20%.

How many risk factors do I have?
What drug(s) will you give me?

Answer 10

I have 1 risk factor and you should give me a 5HT-blocker like zofran :)

Question 11

My patient requires 2 pre-treatment drugs for PONV; I gave zofran and decadron before her surgery.

How many risk factors do you think she has?
What are her chances of developing PONV based on this info?

Answer 11

2 risk factors = 40% chance of developing PONV

Question 12

If I have 3 PONV risk factors, what is the chance I will have PONV?
What drugs will you pre-treat your patient with?

Answer 12

> 60% chance.
Give at least 3 pre-treament drugs: 5HT blocker, steroid, propofol + TIVA??