Emetics and Antiemetics Chapter 25 Emetics and Antiemetics

Emetics Agents that induce vomiting Example Inappropriate use Used in overdoses and certain poisionings Example Ipecac syrup Inappropriate use Clients with bulimia No adverse effects Danger of aspiration Contraindicated in unconscious, semiconscious, or convulsing patients Contraindicated in poisoning caused bye corrosive substances Acids, petroleum products Emetics Examples Apomorphine Ipecac Nursing interventions and patient education Monitor the patient for s/s of drug overdose Position patient on side before or immediately after drug is given Suction as needed VS every 5-10 minutes Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Antiemetics Agents that inhibit vomiting Five categories of antiemetics Anticholinergics Antihistamines Neuroleptic agents Prokinetic agents Serotonin blockers Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Anticholinergics and Antihistamines Bind to and block acetylcholine receptors Prevent nausea stimuli from being transmitted Scopolamine (Trans Scop) Antihistamines Block H2 receptors Prevent cholinergic stimulation Promethazine (Phenergan) Meclizine (Antivert) Anticholinergics Reduce gastric motility and decrease the amount of hydrochloric acid produced by the stomach Occasionally used for the treatment of peptic ulcer Side effects include dry mouth, blurred vision, urinary hesitancy, urinary retention, constipation, nausea, vomiting, palpitations, and headache May cause drowsiness, dizziness, and photophobia Examples: Belladona, Bentyl, Robinul, Banthine, Probanthine Nursing interventions and patient education Offer sips of water to decrease dry mouth Monitor for urinary retention and hesitancy Keep room semidark if photophobia occurs sunglasses Supervise ambulation if dizziness occurs Encourage fluids to prevent constipation Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Neuroleptic and Prokinetic Agents Neuroleptic agents Bind to the dopamine receptors and block action Limit dopamine activity Prokinetic agents Block dopamine Stimulate acetylcholine to increase gastric emptying Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Serotonin Blockers Block serotonin receptors in the gastrointestinal tract Block serotonin receptors in the central nervous system (emetic center) Used often when antineoplastic agents are being given Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Emetics and Antiemetics Neuroleptic agents Chlorpromazine (Thorazine) Prokinetic agents Metoclopramide (Reglan) Serotonin blockers Ondansetron (Zofran) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Side Effects and Adverse Effects General Dizziness Drowsiness Dry mouth Headache Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Nursing Process Assessment Plan Implementation Evaluation Thorough history and physical Plan Use proper route Implementation Safely administer medication Evaluation Are the nausea and vomiting gone? Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.