Emergency department use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children

Question 1

What is the most common cause of physician visits and hospitalizations in infants and young children?

Answer 1

Acute gastroenteritis

Question 2

What is ondansetron?

Answer 2

Highly potent and selective serotonin 5-HT3 receptor antagonist

Question 3

When is the peak plasma concentration of odansetron achieved?

Answer 3

Peak [plasma] after 1-2h only

Question 4

What are the side effects of ondansetron?

Answer 4

Diarrhea (mild, self-limiting)

Question 5

What is single dose oral ondansetron therapy effective for in this population?

Answer 5

1. Reducing frequency of emesis

2. Reducing IV fluid administration

Question 6

Who should oral ondansetron be considered in?

Answer 6

Infants and children 6m-12yo who present to ED with emesis related to suspected acute gastroenteritis and who have either:

1. mild to moderate dehydration
2. failed oral rehydration therapy

Question 7

Which children with gastroenteritis is ondansetron not recommended?

Answer 7

Children who’s primary symptom is diarrhea

Question 8

What is the dosing?

Answer 8

8-15kg: 2mg
15-30kg: 4mg
>30kg: 6-8mg

Question 9

How long after administration of oral ondansetron should oral rehydration therapy be started?

Answer 9

15-30min