dimenhyDRINATE [Gravol]

Question 1

Classification

Gravol

Answer 1

• Antiemetic
• Antihistamine
• Anticholinergic
• Antivertigo

Question 2

Indications

Gravol

Answer 2

[PCP]
- prevention // control of nausea 2nd - motion sickness
- relief of moderate to severe nausea & vomiting

[ACP]
- prevention // control of nausea 2nd - narcotic administration

Question 3

Contraindications

Gravol

Answer 3

• hypersensitivity

and to diphenhydramine // caffeine derivatives

Question 4

Dosage - Adult

Gravol

Answer 4

[PCP]
- 25 to 50mg IV/IM
- 12.5mg - elderly/frail

repeat x 1 - 4-6hrs

Question 5

Dosage - Pediatrics

Answer 5

[PCP]
- 1.25mg/kg - MAX 25mg

repeat x 1 @ 4-6hrs - MAX daily = 5mg/kg/day

PCP - not authorized for <12y/o

Question 6

Routes of Administration

Gravol

Answer 6

• IM - given as a direct injection
• IV - diluted with NaCl @25mg/min

Question 7

Pharmacokinetics

Gravol

Answer 7

• IM
  onset - 20-30mins
  peak - u/k
  duration - 3-6hrs

-IV
onset - immediate
peak - u/k
duration - 3-6hrs

Question 8

Pharmacodynamics

Gravol

Answer 8

• Inhibits cholinergic vestibular (labyrinth) and reticular stimulation from motion

sensory organs for the detection of rotational and linear acceleration

Question 9

ADVERSE EFFECTs (CNS)

Gravol

Answer 9

• Drowsiness
• Ataxia (overdose)
• Disorientation (overdose)
• Excitement
• Dizziness
• Nausea
• Lethargy

most effects are dose related

Question 10

ADVERSE EFFECTs (CVS, GI, GU)

Gravol

Answer 10

CVS - Hypotension

• Palpitations
• Bradycardia/tachycardia

GI - Dry mouth

Respiratory - Thickening of bronchial secretions
- Dry throat

GU - Dysuria

most effects are dose related

Question 11

Supplied

Gravol

Answer 11

50mg/1mL ampule

Question 12

Warnings // Precautions

Gravol

Answer 12

• older adults are more susceptible to side effects

@RISK pts w/
- Increased intraocular pressure // glaucoma
- Prostatic hyperplasia/hypertrophy // urinary obstruction
- CVD (ischemic heart disease // hypertension)
- Asthma // COPD

• pregnant - (risk/benefits against oxytocic effects)

oxytocic effects - can cause uterine contractions

Question 13

Drug Interactions

Gravol

Answer 13

• may potentiate effects of ETOH // benzodiazepines // other CNS depressants
• synergistic effects w/ anticholinergic Rx - TCA // MAOI // other antihistamines

TCA - tricyclic antidepressant // MAOI - monoamine oxidase inhibitor