Antihistamines block histamine receptors that trigger

Antihistamines
 block histamine receptors that trigger nausea and
vomiting
 S/E: dry mouth, hypotension, sedative effects, rashes,
constipation
 Prokinetic Agents
 Inhibit action of dopamine; increase gastric motility
and emptying
 S/E: CNS effects ranging from anxiety to
hallucinations, extrapyramidal side effect including
tremor and dyskinesias
 Serotonin Antagonists

 Block the action of serotonin (substance that causes
nausea and vomiting
 S/E: constipation, diarrhea, headache, fatigue,
malaise, elevated LFTs
 Anticholinergic
 Block the cholinergic pathways to vomiting center
 S/E: xerostomia, somnolence
 Butyrophenone
 Blocks the neurochemicals that trigger nausea and
vomiting
 S/E: dry mouth, hypotension, sedative effects, rashes,
constipation
 Others
 Dexamethasone
o Used in the management of both acute and
delayed caner chemo induced emesis, usually
in combination with other antiemetic’s such as,
ondansetron.
 Aprepitant
o Used for the prevention of chemo induced
post-op nausea and vomiting
 Dronabinol
o Orally active cannabinoid that is used alone or
in combination with other antiemetic’s for the
prevention of chemotherapy induced emesis
o Because of the potential for abuse, as well as
drowsiness and sedation, this drug is only used
when others are ineffective
o Nutritional Therapy
 Pt. with severe vomiting requires IV fluid therapy with
electrolyte and glucose replacement until able to tolerate oral
intake.
 Some cases a NG tube and suction are used to decompress
the stomach
 Carbonated beverages at room temp. and with the
carbonation gone and warm tea are easier tolerated
 Sipping small amounts of fluids every 15-20 min, is usually
tolerated better than drinking large amounts less frequently.
 Broth and Gatorade are high in sodium, so administer them
with caution

 Items such as baked potatoes, plain gelatin, cereal, and hard
candy are ideal.
 Tell pt. to eat food slowly and in small amounts to prevent
overdistention of the stomach.
 Liquids taken between meals rather than with also reduce
distention
o Nursing Management
 Assessment (table 42-2)
 Subjective date
o Important health info
 Past health history
 Medications
 Surgery or other treatments
o Functional health patterns
 Nutritional-metabolic amount: frequency,
character, and color of vomitus; dry
hives; anorexia; weight loss
 Activity-exercise: Weakness, fatigue
 Cognitive perceptual: abdominal
tenderness or pain
 Coping-stress tolerance: stress, fear
 Objective data
o General
 Lethargy, sunken eyeballs
o Integumentary
 Pallor, dry mucosa membrane, poor skin
turgor
o Gastrointestinal
 Amount, frequency, character, and color
of vomit
o Urinary
 Decreased output, concentrated urine
o Possible Diagnostic findings
 Altered serum electrolytes, metabolic
alkalosis, abnormal upper GI findings on
endoscopy or abdominal x-rays
 Diagnosis
 Nausea related to multiple etiologies
 Deficient fluid volume related to prolonged vomiting

 Imbalanced nutrition: less than body requirements
related to nausea and vomiting
 Planning
