12 Questions
What is the primary mechanism that triggers vomiting in the medulla oblongata?
Stimulation of the chemoreceptor trigger zone
What is the usual dose of IPECAC for a patient over 10 years or an adult?
30 ml p.o.
What is the primary consideration when administering anti-emetics to a patient?
Determining the underlying cause of nausea/emesis
What is a potential complication of administering IPECAC to a patient who is not awake?
Aspiration and death
What is a common side effect of most anti-emetics?
Drowsiness
What type of medication is SCOPOLAMINE?
An anti-emetic
What is the first step in managing a patient who is experiencing nausea or emesis?
Determine the underlying cause of nausea or emesis
Why is it contraindicated to administer IPECAC to a patient who is not awake?
It may lead to aspiration and lung damage
What is a potential complication of administering anti-emetics to a patient?
Drowsiness and decreased cognitive function
Why may a patient who is vomiting require an alternative route of administration for anti-emetic medication?
Because the patient may not be able to ingest or digest the medication
What is the primary purpose of administering SCOPOLAMINE (Transderm – Scop)?
To prevent vomiting
What is an essential consideration when managing a pregnant patient who is experiencing nausea or emesis?
Referring the patient to an OB doctor or OB-GYN nurse practitioner
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)
This quiz covers the use of emetics such as IPECAC to induce vomiting in case of poison ingestion, as well as anti-emetics like Scopolamine to prevent vomiting in medical treatment.
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