Nausea
Nausea is the unpleasant sensation of about to vomit. This can occur alone or with vomiting. Many differentials are associated with nausea depending on patient's symptoms.
Always check patients electrolytes if they have been having severe vomiting and replete electrolytes if required. Suggestive labs could include BMP (checking electrolytes), UA (checking for ketones and specific gravity).
Treatment of nausea includes:
- Metoclopramide (Reglan) 10mg po/iv q4hr PRN
- Prochlorperazine (Compazine) 10mg po/im/iv q6hr
- Droperidol 0.625-1.25mg IV/IM q6hr PRN
- Lorazepam (Ativan) 0.5-2.0 mg po/iv q4-6hr PRN
Things to prevent nausea include:
- Ginger ale or chamomile tea to settle that stomach
- Avoiding caffeine that tends to upset stomach
- Drink lots of water and stay hydrated
- Eating small meals to allow your stomach to digest foods slowly
- Avoiding spicy, processed foods
Neuroleptic Malignant Syndrome can be caused by excessive use of Compazine or Droperidol (stop antiemetic and start Lorazepam 1-2mg IV 4-6hrs or Dantrolene 1-2.5 mg/kg IV with max dose of 10mg/kg/day).
Advise all patients that Antiemetics can cause drowsiness
Combination of anti-emetics will resolve patient's nausea if patient is unresponsive to a single medication.
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