Treatment: Nausea and Vomiting

Treatment is aimed at correcting the specific cause. The effectiveness of antiemetic medications depends on etiology of symptoms, pt responsiveness, and side effects. Antihistamines such as meclizine and dimenhydrinate are effective for nausea due to inner ear dysfunction. Anticholinergics such as scopolamine are effective for nausea associated with motion sickness. Haloperidol and phenothiazine derivatives such as prochlorperazine are often effective in controlling mild nausea and vomiting, but sedation, hypotension, and parkinsonian symptoms are common side effects. Selective dopamine antagonists such as metoclopramide may be superior to the phenothiazines in treating severe nausea and vomiting and are particularly useful in treatment of gastroparesis. IV metoclopramide may be effective as prophylaxis against nausea when given before chemotherapy. Ondansetron and granisetron, serotonin receptor blockers, and glucocorticoids are used for treating nausea and vomiting associated with cancer chemotherapy. Aprepitant, a neurokinin receptor blocker, is effective at controlling nausea from highly emetic drugs like cisplatin. Erythromycin is effective in some pts with gastroparesis.