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Antiemetics and Emetics

Antiemetics and Emetics. Nausea and Vomiting. Emetic center of the brain is stimulated Goal is to empty the GI tract of irritants and toxins Symptoms not a disease. Nausea and Vomiting. Causes are varied - motion sickness - morning sickness - intense pain - chemical toxins

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Antiemetics and Emetics

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  1. Antiemetics and Emetics

  2. Nausea and Vomiting • Emetic center of the brain is stimulated • Goal is to empty the GI tract of irritants and toxins • Symptoms not a disease

  3. Nausea and Vomiting • Causes are varied - motion sickness - morning sickness - intense pain - chemical toxins - emotional stress

  4. Nausea and Vomiting • Usually harmless but can signal a serious condition - increased intracranial pressure - concussions - encephalitis - meningitis - intestinal blockage - appendicitis - migraine headaches - brain tumors

  5. Concerns • Risk for aspiration • Risk for dehydration or electrolyte imbalances • Children, the elderly, and those with chronic illnesses are more at risk of complications

  6. Emetics • Agents that induce vomiting • Used in overdoses • Example • Ipecac syrup • Inappropriate use • Clients with bulimia

  7. Antiemetics Five categories of antiemetics • Anticholinergics • Antihistamines • Neuroleptic agents • Prokinetic agents • Serotonin blockers

  8. Anticholinergics and Antihistamines • Anticholinergics • Bind to and block acetylcholine receptors • Prevent nausea stimuli from being transmitted • Scopolamine patch – motion sickness prevention

  9. Anticholinergics and Antihistamines • Antihistamines • Block histamine (H2) receptors • Prevent cholinergic stimulation • Antivert for motion sickness, vertigo • Promethazine (Phenergan) for nausea/emesis • Use caution with IV route

  10. Side Effects of Antihistamines and Anticholinergics • Dry mouth • Urinary retention • Blurred vision, dizziness • Use with caution in patients with benign prostatic hypertrophy and narrow-angle glaucoma

  11. Neuroleptic and Prokinetic Agents • Neuroleptic agents • Bind to the dopamine receptors and block action • Limit dopamine activity • Prokinetic agents • Block dopamine • Stimulate acetylcholine to increase gastric emptying

  12. Serotonin Blockers • Zofran • Block serotonin receptors in the gastrointestinal tract • Block serotonin receptors in the central nervous system (emetic center) • Used often when antineoplastic agents are being given

  13. Serotonin Blockers • Prevents transmission of afferent visceral and chemoreceptor triggers • Most common agents for patients on chemotherapy • Also used for patients with migraines, gastroenteritis, and postoperatively

  14. Nursing Considerations • Evaluate effectiveness of therapy • If inducing vomiting, main goal is determination of toxic agent to determine if vomiting is appropriate and other treatment needs • Ensure an adequate airway

  15. Nursing Considerations • Prevention is better than cure – anticipate when possible • Assess patient for reason behind nausea/vomiting • Prevent aspiration

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