Antiemetics and Emetics. Emetic center of the brain is stimulated Goal is to empty the GI tract of...
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Transcript of Antiemetics and Emetics. Emetic center of the brain is stimulated Goal is to empty the GI tract of...
Antiemetics and Emetics
Emetic center of the brain is stimulated
Goal is to empty the GI tract of irritants and toxins
Symptoms not a disease
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Nausea and Vomiting
Causes are varied - motion sickness - morning sickness - intense pain - chemical toxins - emotional stress
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Nausea and Vomiting
Usually harmless but can signal a serious condition
- increased intracranial pressure - concussions - encephalitis - meningitis - intestinal blockage - appendicitis - migraine headaches - brain tumors
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Nausea and Vomiting
Risk for aspirationRisk for dehydration or electrolyte imbalances
Children, the elderly, and those with chronic illnesses are more at risk of complications
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Concerns
Agents that induce vomiting◦Used in overdoses
Example◦Ipecac syrup
Inappropriate use◦Clients with bulimia
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Emetics
Five categories of antiemetics1.Anticholinergics 2.Antihistamines 3.Neuroleptic agents4.Prokinetic agents5.Serotonin blockers
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Antiemetics
Anticholinergics◦Bind to and block acetylcholine receptors Prevent nausea stimuli from
being transmitted Scopolamine patch – motion
sickness prevention
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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
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Anticholinergics and Antihistamines
Dry mouthUrinary retentionBlurred vision, dizzinessUse with caution in patients with benign prostatic hypertrophy and narrow-angle glaucoma
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Side Effects of Antihistamines and Anticholinergics
Neuroleptic agents◦Bind to the dopamine receptors and block action Limit dopamine activity
Prokinetic agents◦Block dopamine◦Stimulate acetylcholine to increase gastric emptying
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Neuroleptic and Prokinetic Agents
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
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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
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Serotonin Blockers
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
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Nursing Considerations
Prevention is better than cure – anticipate when possible
Assess patient for reason behind nausea/vomiting
Prevent aspiration
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Nursing Considerations