Podcast
Questions and Answers
What is the primary mechanism that triggers vomiting in the medulla oblongata?
What is the primary mechanism that triggers vomiting in the medulla oblongata?
- Stimulation of the vagus nerve
- Stimulation of the chemoreceptor trigger zone (correct)
- Inhibition of the sympathetic nervous system
- Inhibition of the gut-brain axis
What is the usual dose of IPECAC for a patient over 10 years or an adult?
What is the usual dose of IPECAC for a patient over 10 years or an adult?
- 90 ml p.o.
- 30 ml p.o. (correct)
- 60 ml p.o.
- 15 ml p.o.
What is the primary consideration when administering anti-emetics to a patient?
What is the primary consideration when administering anti-emetics to a patient?
- Determining the underlying cause of nausea/emesis (correct)
- .Administering the medication orally
- Monitoring the patient's respiratory rate
- Checking the patient's blood pressure
What is a potential complication of administering IPECAC to a patient who is not awake?
What is a potential complication of administering IPECAC to a patient who is not awake?
What is a common side effect of most anti-emetics?
What is a common side effect of most anti-emetics?
What type of medication is SCOPOLAMINE?
What type of medication is SCOPOLAMINE?
What is the first step in managing a patient who is experiencing nausea or emesis?
What is the first step in managing a patient who is experiencing nausea or emesis?
Why is it contraindicated to administer IPECAC to a patient who is not awake?
Why is it contraindicated to administer IPECAC to a patient who is not awake?
What is a potential complication of administering anti-emetics to a patient?
What is a potential complication of administering anti-emetics to a patient?
Why may a patient who is vomiting require an alternative route of administration for anti-emetic medication?
Why may a patient who is vomiting require an alternative route of administration for anti-emetic medication?
What is the primary purpose of administering SCOPOLAMINE (Transderm – Scop)?
What is the primary purpose of administering SCOPOLAMINE (Transderm – Scop)?
What is an essential consideration when managing a pregnant patient who is experiencing nausea or emesis?
What is an essential consideration when managing a pregnant patient who is experiencing nausea or emesis?
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Study Notes
Emetics
- Substances that induce vomiting, such as IPECAC, which is available over-the-counter (OTC) for first aid use in case of certain poison ingestions
- Dose: 30 ml PO for adults and children over 10 years old
- Contraindication: do not give to an unconscious patient, as it may lead to aspiration and death
Anti-emetics
- Drugs that prevent or stop vomiting
- Examples:
- Scopolamine (Transderm-Scop patches): prevents vomiting, especially for sea or air-sickness, by blocking chemoreceptor trigger mechanisms
- Ondansetron (ZOFRAN): antiemetic for chemotherapy-induced nausea and vomiting
- Anti-histamines:
- Benadryl (Diphenhydramine)
- Vistaril (Hydroxyzine)
- Phenothiazines:
- Prochlorperazine (COMPAZINE)
- Promethazine (PHENERGAN)
- Thiethylperazine (TORECAN)
- Often used in pre-op and post-op patients
- Available in various forms (oral, rectal, and IM injection)
Important Considerations
- Before administering anti-emetics, identify the underlying cause of nausea and emesis
- Choose the most desirable route of administration, considering the patient's condition (e.g., suppository or IM injection for patients who cannot ingest oral forms)
- Anti-emetics can cause drowsiness, so patients should avoid driving or operating machinery and refrain from alcohol use
- Monitor for fluid and electrolyte imbalances
- Pregnant patients should consult an OB doctor or OB-GYN nurse practitioner before taking anti-emetics
- Phenothiazines can cause:
- Sedation
- Orthostatic hypotension
- Extrapyramidal side effects (muscle tremors, rigidity, and involuntary movements)
Emetics
- Substances that induce vomiting, such as IPECAC, which is available over-the-counter (OTC) for first aid use in case of certain poison ingestions
- Dose: 30 ml PO for adults and children over 10 years old
- Contraindication: do not give to an unconscious patient, as it may lead to aspiration and death
Anti-emetics
- Drugs that prevent or stop vomiting
- Examples:
- Scopolamine (Transderm-Scop patches): prevents vomiting, especially for sea or air-sickness, by blocking chemoreceptor trigger mechanisms
- Ondansetron (ZOFRAN): antiemetic for chemotherapy-induced nausea and vomiting
- Anti-histamines:
- Benadryl (Diphenhydramine)
- Vistaril (Hydroxyzine)
- Phenothiazines:
- Prochlorperazine (COMPAZINE)
- Promethazine (PHENERGAN)
- Thiethylperazine (TORECAN)
- Often used in pre-op and post-op patients
- Available in various forms (oral, rectal, and IM injection)
Important Considerations
- Before administering anti-emetics, identify the underlying cause of nausea and emesis
- Choose the most desirable route of administration, considering the patient's condition (e.g., suppository or IM injection for patients who cannot ingest oral forms)
- Anti-emetics can cause drowsiness, so patients should avoid driving or operating machinery and refrain from alcohol use
- Monitor for fluid and electrolyte imbalances
- Pregnant patients should consult an OB doctor or OB-GYN nurse practitioner before taking anti-emetics
- Phenothiazines can cause:
- Sedation
- Orthostatic hypotension
- Extrapyramidal side effects (muscle tremors, rigidity, and involuntary movements)
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