Class/Condition | |
Anti-Emetics/Suppression of nausea and vomiting | Serotonin Receptor Antagonists
Ondansetron, Granisetron |
| Prototype: Ondansetron (Zofran): Tx. of N/V r/t anesthesia, radiotherapy. Off label: viral gastritis (children), morning sickness |
| Granisetron (PO/IV/transdermal); Dolasetron (PO/IV; in high doses IV = risk of fatal dysrhythmias); Palonosetron (PO/IV; longer half life (40 hrs) effective against delayed emesis) |
| Side Effects: HA (give tylenol), dizziness, constipation, diarrhea, increase liver enzymes, abd. pain & Torsades de Pointe |
| Interactions: Apomorphine increase r/o severe hypotension |
| Nursing Implications: Assess for N/V, abd. distension, BS b4 & during administration. Monitor ECG in patients that are hypo-kalemic, magnesemic, HF, Bradyarrhythmias or meds that prolong QT interval |
| Labs: Increased bilirubin, AST/ALT
Administration: Admin. prior to emetogenic even0t (1hr b4 anesthesia), peel backing & remove tab (PO disintegrating tabs), undiluted (2mg/ml)b4 anesthesia or post-op, over 30 seconds over 2-5 min(IV) |
| Patient Teaching: Take as directed, notify MD if irregular heartbeat or involuntary movement of eyes, face or limbs occurs |
| Glucocorticoids
Dexamethasone, Methylprednisolone (Solu-Medrol) |
| Action: Blocks Type-3 serotonin receptors in the CTZ (chemoreceptor trigger zone) and on afferent vagal neurons in the upper GI tract
Pharmacokinetics: PO/IV administration (100% absorbed PO), hepatic excretion, half life of 3.5-5.5 hr (adults); 2.9 hr |