dimenhyDRINATE [Gravol]

Question 1

Classification

Gravol

Answer 1

• antiemetic
• antihistamine
• anticholinergic
• antivertigo

Question 2

INDICATIONs

Gravol

Answer 2

PCP
- prevention // control of nausea 2nd - motion sickness
- relief of moderate to severe nausea & vomiting

ACP
- prevention // control of nausea 2nd - narcotic administration

Question 3

CONTRAINDICATIONs

Gravol

Answer 3

hypersensitivity

AND to diphenhydramine // caffeine derivatives

Question 4

Dosage - Adult

Gravol

Answer 4

PCP
- 25 to 50mg IV/IM
- 12.5mg - elderly/frail

repeat x 1 - 4-6hrs

Question 5

Dosage - Pediatrics

Gravol

Answer 5

PCP
1.25mg/kg IV/IM
MAX single dose 25mg

repeat x 1 @ 4-6hrs - MAX daily = 5mg/kg/day

*PCP - not authorized for <12y/o

Question 6

Routes of Administration

Gravol

Answer 6

IM - given as a direct injection
IV - diluted w/ NaCl @25mg/min

Question 7

Pharmacokinetics

Gravol

Answer 7

onset - 20-30mins (IM); almost immediate (IV)
duration - 3-6hrs (IM/IV)

Question 8

Pharmacodynamics

Gravol

Answer 8

• Inhibits cholinergic vestibular (labyrinth) and reticular stimulation from motion

sensory organs for the detection of rotational and linear acceleration

Question 9

ADVERSE EFFECTs (CNS)

Gravol

Answer 9

• drowsiness
• dizziness
• excitement
• lethargy
• nausea

most effects are dose related

Question 10

ADVERSE EFFECTs (CVS, RESP, GI, GU)

Gravol

Answer 10

CVS
- Hypotension
- Palpitations
- Bradycardia/tachycardia

RESP
- Thickening of bronchial secretions
- Dry throat

GI - Dry mouth

GU - Dysuria

most effects are dose related

Question 11

Supplied

Gravol

Answer 11

50mg/1mL ampule

Question 12

OVERDOSE

Gravol

Answer 12

symptoms of OD are similar to those of atropine toxicity
* flushing
* dilated pupils
* hallucinations
* confusion
* ataxia
* seizures
* loss of consciousness

treatment is primarily supportive

Question 13

Warnings // Precautions

Gravol

Answer 13

• older adults are more susceptible to side effects

@RISK pts w/
- Increased intraocular pressure // glaucoma
- Prostatic hyperplasia/hypertrophy // urinary obstruction
- CVD (ischemic heart disease // hypertension)
- Asthma // COPD

• pregnant - (risk/benefits against oxytocic effects)

oxytocic effects - can cause uterine contractions

Question 14

Drug Interactions

Gravol

Answer 14

• may potentiate effects of ETOH // benzodiazepines // other CNS depressants
• synergistic effects w/ anticholinergic rx - TCA // MAOI // other antihistamines

TCA - tricyclic antidepressant // MAOI - monoamine oxidase inhib