1. Antiemetics and Emetics

2. Nausea and Vomiting Emetic center of the brain is stimulated
Goal is to empty the GI tract of irritants and toxins
Symptoms not a disease

3. Nausea and Vomiting Causes are varied - motion sickness
- morning sickness
- intense pain
- chemical toxins
- emotional stress

4. Nausea and Vomiting
Usually harmless but can signal a serious condition
- increased intracranial pressure
- concussions
- encephalitis
- meningitis
- intestinal blockage
- appendicitis
- migraine headaches
- brain tumors

5. Concerns Risk for aspiration
Risk for dehydration or electrolyte imbalances
Children, the elderly, and those with chronic illnesses are more at risk of complications

6. Emetics Agents that induce vomiting Used in overdoses Example
Ipecac syrup
Inappropriate use
Clients with bulimia

7. Antiemetics Five categories of antiemetics Anticholinergics
Antihistamines
Neuroleptic agents
Prokinetic agents
Serotonin blockers

8. Anticholinergics and Antihistamines
Bind to and block acetylcholine receptors
Prevent nausea stimuli from being transmitted
Scopolamine patch – motion sickness prevention

9. Anticholinergics and Antihistamines
Block histamine (H2) receptors
Prevent cholinergic stimulation
Antivert for motion sickness, vertigo
Promethazine (Phenergan) for nausea/emesis
Use caution with IV route

10. Side Effects of Antihistamines and Anticholinergics
Dry mouth
Urinary retention
Blurred vision, dizziness
Use with caution in patients with benign prostatic hypertrophy and narrow-angle glaucoma

11. 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

12. Serotonin Blockers Zofran
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

13. Serotonin Blockers
Prevents transmission of afferent visceral and chemoreceptor triggers
Most common agents for patients on chemotherapy
Also used for patients with migraines, gastroenteritis, and postoperatively

14. Nursing Considerations
Evaluate effectiveness of therapy
If inducing vomiting, main goal is determination of toxic agent to determine if vomiting is appropriate and other treatment needs
Ensure an adequate airway

15. Nursing Considerations
Prevention is better than cure – anticipate when possible
Assess patient for reason behind nausea/vomiting
Prevent aspiration