Antiemetics, parenteral

Hydroxyzine Hydroxyzine also is indicated for sedation (oral only) analgesia, adjunctive therapy (parenteral only) antiemetic (parenteral only) as adjunctive therapy in allergic conditions with strong emotional overlay, such as asthma, chronic urticaria, and pruritus (parenteral only). 

Antiemetic (parenteral only) - In controlling nausea and vomiting (excluding nausea and vomiting of pregnancy). As pre- and postoperative and pre- and postpartum adjunctive medication to control emesis. 

Promoting an Optimal Response to Therapy If the patient is unable to retain the oral form of the drug, the nurse may give it parenterally or as a rectal suppository (if the prescribed drag is available in these forms). If only the oral form has been ordered and the patient is unable to retain the drag, the nurse contacts the primary health care provider regarding an order for a parenteral or suppository form of this or another antiemetic drag. 

Domperidone [133], one of the most potent D2-dopamine blockers and antagonists of apomorphine-induced emesis with limited brain-blood barrier permeability, did not establish a position as an antiemetic, especially against cisplatin [134], Recently, the use of domperidone as a parenteral antiemetic has been discontinued because of serious cardiovascular toxicity. 

Parenterals are administered to the body by injection. They must be sterile, nonpyro-genie, and particulate-free. Examples of compoimded parenterals include high-dose analgesics for patient controlled analgesia (morphine sulfate 50 mg/mL), antiemetic injections, fentanyl and bupivacaine injections for ambulatory pump reservoirs, oncology combinations, and others (Table 10). 

Antiemetic/Analgesia, adjunctive therapy (parenteral only) -... 

The tranquillizers like benzodiazepines (diazepam 5-10 mg oral, or lorazepam 2 to 4 mg IM, IV are now preferred for preanaesthetic medication because they produce tranquillity, have better muscle relaxant property and smoothen induction. Other tranquillizer compounds include phenothiazines which possess sedative, antiemetic and antihistaminic properties. They can be given orally as well as parenterally. 

Diphenhydramine Competitive antagonism at Hi receptors Reduces or prevents histamine effects on smooth muscle, immune cells also blocks muscarinic and adrenoceptors highly sedative IgE immediate allergies, especially hay fever, urticaria some use as a sedative, antiemetic, and antimotion sickness drug Oral and parenteral t duration 4-6 h Toxicity Sedation when used in hay fever, muscarinic blockade symptoms, orthostatic hypotension Interactions Additive sedation with other sedatives, including alcohol some inhibition of CYP2D6, may prolong action of some 13 blockers... 

PROPAFENONE I. ANTIARRHYTHMICS - disopyra-mide, procainamide 2. ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES - terfenadine, hydroxyzine, mizolastine 8. ANTI-M ALARIALS - artemether with lumefantrine, chloroquine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS - pentamidine isetionate 10. ANTIPSYCHOTICS-atypicals, phenothiazines, pimozide II. BETA-BLOCKERS - sotalol 12. BRONCHODILATORS -parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs prolong the Q-T interval. Also, amitriptyline, clomipramine and desipramine levels may be t by propafenone. Amitriptyline and clomipramine may t propafenone levels. Propafenone and these TCAs inhibit CYP2D6-mediated metabolism of each other Avoid co-administration... 

ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinupristin/ dalfbpristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS - arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine S. ANTIEMETICS-dolasetron 6. ANTIFUNGALS - fluconazole, posacon-azole, voriconazole 7. ANTIHISTAMINES-terfenadine, hydroxyzine, mizolastine... 

If associated with severe nausea or vomiting, pretreat with antiemetic consider use of suppository, parenteral or intranasal formulation... 

Several other synthetic cannabinoids have reached the clinical stage. Levonantradol (9), which was discussed above, is, in addition to being an analgetic, also a potent antiemetic [169-171], It is the only cannabinoid available for parenteral use. This is of considerable clinical importance, as oral administration is certainly not efficient in patients who are already vomiting. It appears to be slightly more effective than THC however, because of the pronounced side-effects, it will probably not be introduced as a drug on the market. 

In 19 patients with malignant disease taking high doses of morphine (daily doses of 500 mg or more orally or 250 mg or more parenterally), an analysis was made of the relationship between myoclonus and the use of supplemental drugs. In the 12 patients with myoclonus, 8 patients were taking antidepressants (amitriptyline, doxepin) or antipsychotics (chlorpro-mazine, haloperidol) compared with none of 6 patients without myoclonus. In addition, there was a higher use of NSAIDs (indometacin, naproxen, piroxicam, aspirin) and an antiemetic (thiethylperazine). The reasons are not understood, and the findings of this paper have been questioned. ... 

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