Nausea/Vomiting Flashcards
General N/V can be caused by what two conditions?
Gastroenteritis and pancreatitis
Disorders of balance can be caused by what three conditions?
Motion sickness, dizziness, vertigo
Post-operative N/V can be caused by what?
Opioids and anesthetics
Arfal’s Risk Score is used for what?
Determining treatment for post-op N/V
Four factors that go into in Arfal’s Risk Score
Female
Smoker
History of motion sickness or previous post-op N/V
Expected use of post-op opioids
Rx therapies for general N/V (the drug classes)
Metoclopramide (prokinetic), phenothiazine, 5-HT antagonists
Therapy for disorders of balance (the drug class)
Antihistamines
Therapies for N/V with pregnancy (OTC, Rx, CAM)
Doxylamine, B6, acupressure bands, ginger, Emetrol, sea bands, 5HT-3 antagonists (ondansetron), metoclopramide, prochlorperazine
Therapy for post-op N/V with an Arfal Risk Score of 4
Scopolamine patch 2h before anesthesia
IV dexamethasone after anesthesia induction
5HT-3 antagonist after surgery
Therapy for post-op N/V with an Arfal Risk Score of 2-3
5HT-3 antagonist after surgery
Other antiemetics PRN
Therapy for post-op N/V with an Arfal Risk Score ≤1
No therapy needed
Complications of N/V
DEHYDRATION, electrolyte imbalances, esophageal tears, aspiration, malnutrition
Where are H1 antagonists used in N/V treatment?
N/V in pregnancy, disorders of balance, rescue therapy for post-op N/V when alternate treatment is needed
H1 antagonist drugs
Dimenhydrinate (Dramamine), diphenhydramine (Benadryl), meclizine, doxylamine, scopolamine, hydroxyzine
H1 antagonists that are available OTC
Dimenhydrinate, diphenhydramine, meclizine, doxylamine
H1 antagonists available Rx
Doxylamine (when in combination with B6 in one tablet), scopolamine, hydroxyzine
Which brands of doxylamine are available OTC?
Unisom, Diclegis (delayed-release with B6)
Which brand of doxylamine is available Rx?
Bonjesta (ER with B6)
Route of administration for scopolamine
Transdermal (place patch behind the ear)
How often is scopolamine dosed?
Every 72 hours
Side effects of H1 antagonists
SEDATION, dry mouth, constipation with frequent use, paradoxical effect in kids