1. Emetics and Antiemetics
Chapter 25
Emetics and Antiemetics

2. 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
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3. Antiemetics Agents that inhibit vomiting
Five categories of antiemetics
Anticholinergics
Antihistamines
Neuroleptic agents
Prokinetic agents
Serotonin blockers
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4. 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
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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
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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
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7. Emetics and Antiemetics
Neuroleptic agents
Chlorpromazine (Thorazine)
Prokinetic agents
Metoclopramide (Reglan)
Serotonin blockers
Ondansetron (Zofran)
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8. 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.

9. 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.