Nausea and Vomiting Flashcards
What can stimulate the vomiting center?
smells, sights, memories
stimulus from inner ear
chemicals in blood
GI tract
Roughly how many conditions present with nausea?
75
What are some common causes of nausea?
stomach flu (VGE)
motion sickness
drug-related
pregnancy
post-op
food poisoning
migraine
head injury
otitis media
IBS
peptic ulcer
chronic kidney
appendicitis
What are the odds of experiencing nausea and vomiting from amoxicilin?
2%
What are the common agents that cause drug-induced nausea? What can we do in each case?
antibiotics: power through
NSAIDs: take with food
CCB: change or dc agent
opiates: reduce dose
PlanB: pre-use of Gravol
What are the indications of Gravol?
motion sickness
post-op vomiting
drug-induced causes (we usually prefer to switch dose or drug)
radiation therapy
Menieres disease
True or false: we almost exclusively go for Pepto over Gravol for nausea
false
What are some non-drug strategies that can help with motion sickness?
focus on a distant area on horizon
fresh air can help/breathe deeply
sit in the middle of the ship or plane
dont attempt to read
front seat (higher) better than rear seat in car
driver better off than passengers
What is dimenhydrinate a salt of?
diphenhydramine
Explain how Gravol works for motion sickness.
motion sickness will cause stimulus from inner ear
-leads to cholinergic and histaminic signals being sent to CTZ
Gravol is anti-cholinergic and anti-histaminic, blocking the stimulation
What are the side effects of dimenhydrinate?
similar to 1st gen antihistamines
-slight sedation
-dry mouth
How is dimenhydrinate best used for motion sickness?
initial dose should be taken at least 1/2 hour (preferably 1-2hrs) before departure
Which age group is dimenhydrinate most common in?
more common in 2-15yrs than adults
less common in kids <2yrs
True or false: dimenhydrinate is contraindicated in pediatrics
false
its safe
Describe the use of scopolamine (Transderm V) for motion sickness.
apply 12hr before travel
works for 3 days
2nd patch in 3 days–>use other side of head
mainly anticholinergic
Which drug has more sedation and dry mouth, dimenhydrinate or scopolamine?
scopolamine
True or false: scopolamine is easily accessed in a pharmacy
false
dc in 2022
Describe meclizine.
dc in 2011
antihistamine/anticholinergic (less se than scopolamine)
OD dosing 1hr before travel
kids >12
Describe the use of P6 pressure point for motion sickness.
unknown how it works, but its FDA approved
has to be 3 fingers width past wrist
one or both wrists
no need for prior application
True or false: ginger has more proof for motion sickness than morning sickness
false
ginger has more proof for morning sickness
not helpful for motion sickness
What do people think is causing nausea and vomiting in pregnancy?
human chorionic gonadotropin
What do pregnancy tests pick up in the urine?
human chorionic gonadotropin
When do most cases of N/V in pregnancy start to cease?
week 12
-hCG levels are dropping
What percentage of women need a medicine during pregnancy for nausea and vomiting?
10%
-it is thought that throwing-up is more detrimental to her
baby’s health than med use
