Antiemesis

The indications for antiemetic therapy include:

• motion sickness:
  • use hyoscine patches or antihistamines
    
    
• drug-induced emesis:
  
  
• gastric irritation:
  • common problem
  • take the offending drug with food, e.g. spironolactone
  • take frequent small doses
    
    
• CNS irritation:
  • due to, e.g. opiates
  • treat with:
    • phenothiazines
    • metoclopramide
      
      
• cytotoxic therapy
  
  
• post-operative:
  • ensure that the anatomy is correct, e.g. do not start antiemesis if the patient is obstructed
  • drug therapy:
    • metoclopramide
    • phenothiazines
      
      
• migraine:
  • i.v. metoclopramide promotes gastric emptying and so permits improved absorption of other therapies such as analgesics