Nausea and labyrinth

Question 1

When are antiemetics used?

Answer 1

only prescribed when cause of vomitig is known, because otherwise they might delay diagnosis (mainly in children)

Question 2

treatment of motion sickness

Answer 2

• hyoscine hydrobromide
• cinnarizine
• cyclizine
• promethazine (sedative)

Question 3

treatment of GI and biliary disease

Answer 3

Metoclopramine

Question 4

treatment of underlying conditions

Answer 4

Antihistmines e.g cinnarizine, cyclizine, promethazine

Question 5

treatment for chemotherapy

Answer 5

• dopamine antagonist e.g prochlorperazine (buccal), ondansertron, dexamethasone, aprepitant, nabilone

Question 6

treatment in palliative care

Answer 6

• antipsychotics e.g haloperidol and levomepromazine

Question 7

Treatment for post-op

Answer 7

5HT3-receptor antagonists (ondasetron),
dexamethasone
haloperidol

Question 8

treatment for post-op N&V caused by opiods and GA

Answer 8

cyclizine

Question 9

Treatment for nausea and labyrinth in pregnancy

Answer 9

Common in 1st trimester, resolves within 16-20 weeks
1. self care advice - rest, oral hydration and dietary changes
2. available support - self-help information and support groups
3. antiemetics - chlorpromazine, cyclizine, metoclopramide, prochlorperazine, promethazine and ondansetron
With antiemetics offer thiamine supplements to reduce risk of Wernicke’s encephalopathy

Question 10

How to give Metopramide?

Answer 10

• only prescribed for short term (up to 5 days)
• usual dose is 10mg, repeated up to 3 times daily - max dose 500mcq/kg

Question 11

how to give domperidone?

Answer 11

• not for children <12 or weighting <35kg
• lowest effective dose for shortest possible duration (max duration 1 week)
  patient adviced on signs of arrythmia - seek medical attention if developed