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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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nausea and vomiting
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 vomiting1
Nausea and Vomiting
  • Causes are varied

- motion sickness

- morning sickness

- intense pain

- chemical toxins

- emotional stress

nausea and vomiting2
Nausea and Vomiting
  • Usually harmless but can signal a serious condition

- increased intracranial pressure

- concussions

- encephalitis

- meningitis

- intestinal blockage

- appendicitis

- migraine headaches

- brain tumors

concerns
Concerns
  • Risk for aspiration
  • Risk for dehydration or electrolyte imbalances
  • Children, the elderly, and those with chronic illnesses are more at risk of complications
emetics
Emetics
  • Agents that induce vomiting
    • Used in overdoses
  • Example
    • Ipecac syrup
  • Inappropriate use
    • Clients with bulimia
antiemetics
Antiemetics

Five categories of antiemetics

  • Anticholinergics
  • Antihistamines
  • Neuroleptic agents
  • Prokinetic agents
  • Serotonin blockers
anticholinergics and antihistamines
Anticholinergics and Antihistamines
  • Anticholinergics
    • Bind to and block acetylcholine receptors
      • Prevent nausea stimuli from being transmitted
      • Scopolamine patch – motion sickness prevention
anticholinergics and antihistamines1
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
side effects of antihistamines and anticholinergics
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
neuroleptic and prokinetic agents
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
serotonin blockers
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
serotonin blockers1
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
nursing considerations
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
nursing considerations1
Nursing Considerations
  • Prevention is better than cure – anticipate when possible
  • Assess patient for reason behind nausea/vomiting
  • Prevent aspiration