1. Chapter 25 Emetics and Antiemetics

2. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 2 Emetics Agents that induce vomiting  Used in overdoses Example  Ipecac syrup Inappropriate use  Clients with bulimia

3. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 3 Antiemetics Five categories of antiemetics 1. Anticholinergics 2. Antihistamines 3. Neuroleptic agents 4. Prokinetic agents 5. Serotonin blockers

4. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 4 Anticholinergics and Antihistamines Anticholinergics  Bind to and block acetylcholine receptors  Prevent nausea stimuli from being transmitted Antihistamines  Block H 2 receptors  Prevent cholinergic stimulation

5. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 5 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

6. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 6 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

7. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 7 Anticholinergics and Antihistamines Anticholinergics  Scopolamine (Trans Scop) Antihistamines  Promethazine (Phenergan)  Meclizine (Antivert)

8. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 8 Emetics and Antiemetics Neuroleptic agents  Chlorpromazine (Thorazine) Prokinetic agents  Metoclopramide (Reglan) Serotonin blockers  Ondansetron (Zofran)

9. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 9 Side Effects and Adverse Effects General  Dizziness  Drowsiness  Dry mouth  Headache

10. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 25 - 10 Nursing Process Assessment  Thorough history and physical Plan  Use proper route Implementation  Safely administer medication Evaluation  Are the nausea and vomiting gone?