Anti-Emetics, Anesthetics, Blockers, Anticoags, Anemia, Shock & Geriatrics
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| Anti-Emetics/Suppression of nausea and vomiting | Serotonin Receptor Antagonists
Ondansetron, Granisetron
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| Prototype: Ondansetron (Zofran): Tx. of N/V r/t anesthesia, radiotherapy. Off label: viral gastritis (children), morning sickness
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| 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)
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| Side Effects: HA (give tylenol), dizziness, constipation, diarrhea, increase liver enzymes, abd. pain & Torsades de Pointe
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| Interactions: Apomorphine increase r/o severe hypotension
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| 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
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| 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)
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| Patient Teaching: Take as directed, notify MD if irregular heartbeat or involuntary movement of eyes, face or limbs occurs
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| Glucocorticoids
Dexamethasone, Methylprednisolone (Solu-Medrol)
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| 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
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