Note to myself: This is an awesome podcast with awesome show notes. You can’t review them too often. And it is really best to go directly to the show notes to review. I just post excerpts because doing so helps me fix the material in my mind. It also makes it easier for me to find past topics using my Search box.
Here is the link to this episode’s podcast.
Here are links to the IBCC chapter & cast – Nausea & antiemitcs [This link is to the awesome show notes] of August 17, 2020 by Dr. Josh Farkas.
Each of the links below link directly to that section of the IBCC chapter:
- Differential diagnosis of nausea and vomiting
- Summary table
- Questions & discussion
- PDF of this chapter (or create customized PDF)
And here are excerpts:
- If the patient doesn’t respond to one antiemetic, switching to a different agent may not work (especially to a different agent with a similar mechanism of action). Rather, it may be more effective to add a second agent that acts at a different receptor.(25841474)
- Avoid rapid IV pushes of antiemetic agents, as this may increase the risk of side effects (especially QT prolongation with ondansetron, or extrapyramidal side effects with D2 receptor antagonists).
- Avoid D2 receptor antagonists in patients with Parkinson’s disease.
- Be extremely cautious about the intravenous use of promethazine (or perhaps avoid this entirely). Extravasation or inadvertent intra-arterial administration of promethazine can cause tissue necrosis.
[Review the differential diagnosis of nausea and vomiting here. Didn’t copy it because it’s just a great review. Note to myself: Review again.]
Review the above again before continuing with
Evaluation of the patient with nausea and vomiting