Which antiemetic do you use? Which one would you like to use?

[BEorP]

I did a search but didn't seem to find anything addressing this specifically. I'm just curious which antiemetics are used most commonly and if you are happy with what your service uses or if there is something you would prefer.

It seems like we're a bit behind the rest of the world with our continued use of dimenhydrinate in Ontario...

[BAYAMedic]

Good question!

I currently carry Zofran and it does moderatly well with nausea, but as soon as they have tossed their cookies it seems to be shooting a BB gun at a battleship. I have been far more impressed with Phenergan as a anti emetic. And as a new medic but in conversation with the old guys, Inapsine seems to have taken the cake, before that annoying, overreactive, blackbox from the FDA.

Fireman1037

[Kiwiology]

Ondansetron works awesome and am very happy with it; it totally owns metaclopramide which is crap

[chbare]

I did a search but didn't seem to find anything addressing this specifically. I'm just curious which antiemetics are used most commonly and if you are happy with what your service uses or if there is something you would prefer.

It seems like we're a bit behind the rest of the world with our continued use of dimenhydrinate in Ontario...

Anecdotally, I've found dimenhydrinate to be a great antiemetic.

[craig]

we have both metaclopramide and ondansetron

depending on what I require it for it is horses for courses on which I use

at times I give both as they both have different actions in their use

ondansetron seems to be the less with adverse reactions

[craig]

Ondanseron acts on the 5-HT3 receptors and works to block the Serotonin, whereas the Metaclopramide inhibits the action of Dopamine.

in a basic nutshell..............

hence thats why at times I use both....anti nausea and anti vomiting actions of the two drugs

Edited April 5, 2012 by craig

[ERDoc]

Lately, I've been using whatever we are able to stock and that changes by the day. Otherwise it depends on what I am using it for. For your general n/v or for someone I don't want to make sleepy, I like Zofran. It works well and has minimal side effects. For someone with a migraine I like droperidol, phenergan, reglan, zofran in that order.

[Kiwiology]

Poor Consultant ERDoctologist and their drugs shortages

I had a Consultant Physician tell me we still primarily prescribe maloxon (metaclopramide) because it is cheap

Damn public healthcare and our shoe string budget; next we will be closing surgical wounds with the laces off a pair of House Surgeon's trainers! *

* Because a House Surgeon is the lowest form of life on earth (yes, even below bottom feeding suction eel or the hyphae growing on the underside of my bottom crack) they are made to do lots of to-ing and fro-ing at very unsociable hours and often wear sneakers

Edited April 5, 2012 by Kiwiology

[Just Plain Ruff]

I have found that putting a dose of phenergan (12.5mg to 25mg) in a miniinfuser run it over 10-20 minutes works wonders for the nauseated patient. That of course is in the ER.

You get the patient a good solid slow dose of the medication and it seems to build up and it works over time. I have found that with the dose going in over the 10 to 20 minutes it gives the body enough time to adjust to the medication.

If you are wanting immediate nausea relief then Zofran works really well. But it tends to wear off if the patient is in an acute nausea episode.

For Hyperemesis, like my wife suffered from during her pregnancy, nothing really truly works well.

ERDoc, what have you heard in regards to Zofran Drips? I had a OB doc tell me and the Mrs that if my wife's nausea didn't settle down with the next dose of zofran that she was going to give her that she was going to move on to the Zofran Drip. I've never heard of that. Any clues? *** Oh and NO She AINT PREGNANT again***

Edited April 5, 2012 by Captain Kickass

[ERDoc]

I can't say I've ever heard of a Zofran drip, but the OB guys do things a lot different than the rest of the medical world. I don't see why you can't do it, I just have never seen/heard it.