Final: GI - Antiemetics

Question 1

Ondansetron (Zofran)

Answer 1

Most effective agents in n/v related to chemo/radiation/anesthesia

Adverse effects: Diarrhea, headache, dizziness, prolonged QT

Contraindications: Prolonged QT syndrome, risk of serotonin syndrome when used with SSRIs, SNRIs, TCA, MAOIs

Education: Baseline EKG, report adverse reactions

Can be used in conjunction with glucocorticoids/dexamethasone

Question 2

Scopolamine

Answer 2

Anticholinergic/Muscarinic, most effective for motion sickness

Adverse effects: Dry mouth, blurred vision, drowsiness

Question 3

Dimenhydrinate (Dramamine)

Answer 3

Anticholinergic/Antihistamine

Action: Blocks nerve pathways that connect the inner ear and vomiting center

Adverse effects: Dry mouth, blurred vision, drowsiness, sedation

Question 4

Metoclopramide (Reglan)

Answer 4

Gastroparesis, make the food go by

Action: Increases peristalsis and gastric emptying. Dopamine receptor antagonist

Adverse effects: CNS depression, EPS, diarrhea, hypotension

Nursing administration: Give prior to symptoms of n/v, often on maintenance dose, fall precautions and protect airway

Question 5

Prochlorperazine (Compazine)

Answer 5

Dopamine antagonist

Caution: Asthma, narrow angle glaucoma, urinary retention, BPH

Adverse effects: CNS depression, EPS, diarrhea, hypotension

Nursing intervention: Give prior to symptoms of n/v, often maintenance dose

Question 6

Promethazine (Phenergan)

Answer 6

Dopamine antagonist, phenothiazine, adjunct with benzodiazepines

Adverse effects: EPS, hypotension, sedation, anticholinergic effects

Education: ECG before therapy