4 - Nausea / Vomiting Flashcards Preview

PDAT1 > 4 - Nausea / Vomiting > Flashcards

Flashcards in 4 - Nausea / Vomiting Deck (39)
Loading flashcards...
1

Emetrol

Phosphorylated Carbohydrate Solution

Dose / Indication

Fructose, dextrose, orthophosphoric acid

ANTIEMETIC

upset stomach / food indiscretions / emotional upset

Adults:

15-30ml q15min

(1-2 Tablespoons), until nausea subsides

Max 5 doses in 1 hour, no longer than 1 hour

2

Emetrol

Consultation

Fructose, dextrose, orthophosphoric acid

Do not Dilute solution or Drink Fluids prior to use

Wait 15 minutes prior to last dose

 

DNT for more than 1 hour (5 doses)

 

not for children or newborns

3

Emetrol

Adverse Effects

Phosphorylated Carbohydrates

Abdominal Cramping

 

Diarrhea

 

15-30ml q15

4

Emetrol

CI's & Precautions

Phosphorylated Carbohydrates

DNU in newborns / children unless DR

DNU w/ Diabetics high SUGAR content

DNU w/ Hereditary fructose intolerance (HFI)

 

<5 doses in 1 hour

15-30ml q15min

5

Bonine / Meclizine

Indication 

Motion Sickness Medication

chewable / 25mg tablets

Treats & prevents adults w/

Nausea / Dizziness / Vomiting

(associated w/ motion sickness)

 

1-2t QD, 1 hr before activity

6

Meclizine / Cyclizine

Bonine

Dose

1-2 Tablets (25-50mg) QD 

1 Hour before

engaging  in activity that causes motion sickness

Can be CHEWED OR SWALLOWED

7

Bonine / Meclizine

Consultation

Drowsiness

Avoid Alcohol / alertness needed in activities

Clear View

PMH: Asthma / Glaucoma / BPH

8

BONINE / Meclizine / Cyclizine​

Adverse Effects

Drowsiness

Dry Mouth

9

BONINE / Meclizine / Cyclizine

CI's + PC's

Paradoxical Stimulatory in children

DNU in children <12 y/o

DNU in pt w/ PMH of BPH/asthma/urination issue/glaucoma

CNS Depression - Alcohol / depressants

PCAT - B

10

DRAMAMINE

dimenhydrinite / meclizine / ginger

Indication

Motion Sickness Medication

Relief of Nausea / Dizziness / Vomiting (MS symptoms)

50Tab / Chewable / Kids 25mg

 

1-2t (50-100mg) q46 or 30min b4

max 8tab in 24 hrs

11

Meclizine Vs Other MS medications

Meclizine may be LESS SEDATING

12

DRAMAMINE

dimenhydrinite / meclizine / ginger

DOSE

1-2tabs (50-100mg) Q46

or

30 minutes b4 activity

Max 8 Tabs (400mg) in 24 hours

 

less drowsy formulation only for adults, 2 tabs max

13

DRAMAMINE

dimenhydrinite / meclizine / ginger

Consultation

 Same As Bonine/meclizine 

Drowsiness

Avoid Alcohol / alertness needed in activities

Clear View

PMH: Asthma / Glaucoma / BPH

14

DRAMAMINE

dimenhydrinite / meclizine / ginger

AE's

Same as Bonine / meclizine

Drowsiness

Dry Mouth

ANTICHOLINERGIC

15

DRAMAMINE

dimenhydrinite / meclizine / ginger

CI's + PC's

Similar to Bonine

Paradoxical Stimulatory in children

DNU for children <2 y/o

(vs 12 y/o with meclizine)

CNS depression - alcohol + CNS depressants

PMH of asthma / glaucoma / BPH

PC - B

16

Symptoms of NV

Nausea

feeling of needing to vomit

Retching

involuntary diaphragm/ab contractions

Vomiting

Rapid/forceful expulsion of GI tract contents

17

Types of N/V

Motion Sickness

NVP (pregnancy)

Overeating / eating disagreable foods

Food Poisoning / Viral Gastroenteritis

Medication Use

Episodic / Situational NV

18

Complications of NV

Dehydration

Electrolyte / A-B Imbalance

Esophageal Tears

Aspiration / Malnutrition

Diaphragmatic HERNIATION

Mallory-Weiss Syndrome

19

Exclusions for Self-Treatment (EX-S-T)

N/V

Head Injury

Urine Ketones / High BG

Food poisoning >24 hours

ab pain in mid or right lower quadrent

BLOOD in vomitus

Yellow skin/eye

Dark Urine

STIFF NECK

20

EX-ST

NV for CHILDREN

Severe DEHYDRATION

caregiver unable/willing to manage at home

21

Motion Sickness Facts

Better to PREVENT vs treating

rare in kids <2 y/o, more common in WOMEN

Overstimulation of Labrinth apparatus

fluid in canal moves -> postural adjustment / 2 axis

-> unusual motion patterns

 

22

Motion Sickness Treatment

Antihistamines: Meclizine / Cyclizine / Dimenhydrinate

Bonine / Dramamine

Meclizine may be less sedating

 

23

Motion Sickness Prevention

Avoid Reading during Travel

Avoid excess Food / Alcohol before&during travel

Focus on the line of vision fairly straight ahead

avoid Strong odors

Drive vehicle

24

N/V in PREGNANCY

50-80% in EARLY pregnancy

subsides by 20th week in 80% of women

MultiFactoral

Accupressure

GINGER

25

NVP Treatment

Diclegis  (Pyridoxine + Doxylamine) Extended Release

RX ONLY

 

Pyridoxine 10-25mg TID +/- Doxylamine 10mg TID

This is OTC

Doxylamine / dimenhydrinate effective

but not a lot known about fetal outcomes​

26

Preventing NVP

Fresh Air

Dry crackers 10-15 min b4 getting out of bed (slowly)

4-5 small meals, do not overeat

Avoid Fluids or Soups at meals

When nauseated, sip co2 beverages / fruit juice

avoid greasy / spicy / fatty / acidic foods

Eat Dry / Bland / High-protein foods / Chilled

27

Overeating & Treatment

Gut Distention + Decreased GI emptying

--> Stimulation of mechanoreceptors

Emetrol - 15-30ml q15

(phosphorlated carb solution)

(HYPERosmolar)

acts on GI to decrease smooth muscle contraction

delay gastric emptying time

28

Acute Viral Gastroenteritis

Inflammation of stomach / SI

Presents w/ Acute Vomiting + Diarrhea

Self-limiting - Gone after 24 Hours

can be serious with children due to dehydration

 

29

S/S of DEHYDRATION

in children

Sunken Eyes / Fontanelle

Dry eyes, Decreased skin tugor

Dark /little Urine

Absence of tears

Weight LOSS (small abdominal size)

Lethargy / sleepiness / decreased alertness / Irritability

difficulty waking child / lightheaded

30

Treatment for Dehydration

ORS (oral rehydration therapy)

Glucose Based ORS (gatorade)

more ISOMOLAR, more effective at rehydrating vs water

 

Fluid absorption may be COMPRIMISED in pts with:

continuous vomiting > more difficult than diarrhea