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Nausea and Vomiting

GENERAL PRINCIPLES

• Nausea and vomiting may result from side effects of medications, systemic illnesses, central nervous system (CNS) disorders, and primary GI disorders.

• Vbmiting that occurs during or immediately after a meal can result from acute pyloric stenosis (e.g., pyloric channel ulcer) or from functional disorders, while vomiting within 30-60 minutes after a meal may suggest gastric or duodenal pathology.

Delayed vomiting of undigested food from a previous meal can suggest gastric outlet obstruction or gastroparesis.

• Symptoms of gastroparesis may be indistinguishable from functional dyspepsia and chronic functional nausea and vomiting with normal gastric emptying.35

DIAGNOSIS

• Bowel obstruction and pregnancy should be ruled out.

• Medication lists should be carefully scrutinized for potential offenders, and systemic illnesses (acute and chronic) should be evaluated as etiologies or contributing factors.

• Endoscopy and/or imaging should be considered in the setting of nonresolving or “red flag” symptoms, such as hematemesis or weight loss.

TREATMENT

• Correction of fluid and electrolyte imbalances is an important supportive measure.

• Oral intake should be limited to clear liquids, if tolerated. Many patients with self-limited illnesses require no further therapy.

• NG decompression may be required for patients with bowel obstruction or protracted nausea and vomiting of any etiology.

• Enteral feeding through jejunal tubes or, rarely, total parenteral nutrition (TPN) may be necessary to supplement nutrient intake.

Medications

Empiric pharmacotherapy (Table 18-2) is often initiated while investigation is in progress or when the etiology is thought to be self-limited.

TABLE 18-2

COMMONLY USED ANTIEMETICS

Medication Dosage Receptor Target Comments
Diphenhydramine 25-50 mg PO q6h

10-50 mg IV q6h

Histamine

(Hi)

May cause sedation

Dimenhydrinate 50-100 mg PO q4h Histamine

(H1)

May cause sedation
Meclizine 25-50 mg PO q4h Histamine

(H1)

Often used for motion-sickness; may cause sedation
Promethazine 12.5-25 mg PO, IM or PR q4-6h Histamine

(H1)

Drowsiness, dystonic reactions; risk of extrapyramidal symptoms
Scopolamine 1.5 mg q72h transdermal Muscarinic (M1) May cause dry mouth, drowsiness
Prochlorperazine 5-10 mg PO qid

2.5-10 mg IV q4h.

Max

dose 40 mg/d

Dopamine

(D2)

Prolongs QT
Haloperidola 0.5-2 mg PO or IV q6-8h Dopamine

(D2)

Prolongs QT; risk of extrapyramidal symptoms including acute dystonia
Metoclopramide 10 mg PO or IV q6h Dopamine (D2) Serotonin (5-HT3) Risk of extrapyramidal symptoms; not recommended for long-term use
Ondansetron 4-8 mg PO or IV q8h Serotonin

(5-HT3)

Prolongs QT
Olanzapinea 5-10 mg daily Dopamine (D2) Serotonin (5-HT2) Used for chemotherapy-induced nausea; prolongs QT, may cause sedation
Aprepitant 125 mg PO prior to chemotherapy, 80 mg PO on days 2 and 3 Neurokinin-

1 (NK1)

Used for chemotherapy-induced nausea; many drug-drug interactions
Lorazepama 0.5-2 mg PO q6h GABA-A Does not prolong QT
Dexamethasonea 4-8 mg IV once Mechanism unclear Used for chemotherapy-induced nausea; may cause insomnia, mood changes

aConsidered off-label use.

• Phenothiazines and related agents: Prochlorperazine and promethazine are often used as first-line agents in nausea. Drowsiness is a common side effect, and acute dystonic reactions or other extrapyramidal effects may occur.

• Dopamine antagonists: Metoclopramide is a prokinetic agent with central antiemetic effects.

Drowsiness and extrapyramidal reactions may occur, and a warning has been issued by the US Food and Drug Administration (FDA) regarding the risk of permanent tardive dyskinesia with high-dose and/or long-term use.36 Tachyphylaxis may limit long-term efficacy. Domperidone is an alternate agent that does not cross the blood-brain barrier and therefore has no CNS side effects; however, it is not uniformly available.

• Antihistaminic agents: Diphenhydramine, dimenhydrinate, and meclizine are most useful for nausea and vomiting related to motion sickness but may also be useful for other causes.

• Serotonin 5-hydroxytryptamine-3 (5-HT3) receptor antagonists: Ondansetron is effective in chemotherapy-associated emesis. It can also be used in emesis that is refractory to other medications, especially the sublingual formulation.

• Neurokinin-1 (NK-1) receptor antagonist: Aprepitant is an alternative agent intended for chemotherapy-induced nausea and vomiting.

• Lorazepam, haloperidol, and olanzapine are other medications with antiemetic effect.

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Source: Ancha S., Auberle C., Cash D., Harsh M., Hickman J., Kounga C.. The Washington Manual of Medical Therapeutics, 37th edition, LWW, 2022. —1250p.. 1250
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