PHRM 311 Lecture : 5_GI_Therapeutics_of_Nausea_and_Vomiting_(Part_3)
Document Summary
Cc: pain rated as 8/10, broke his leg playing in a softball tournament 2 days ago. Pmh: type 1 diabetes, depression, exercise induced asthma. Morphine 10 mg po q 4-6 hours prn for pain. Up to 70% of patients receiving opioid analgesics. Patients with chronic pain being treated with high doses. No evidence to indicate one opioid is more emetogenic than another. Patient response highly variable (depends on dose/route/history of use) Direct stimulation of the chemoreceptor trigger zone, the cerebral cortex or the vestibular apparatus. Addition of multiple antiemetics often helpful weigh risk of adverse effects. May require dose or addition of non-opioid analgesic. Switch to alternative opioid start with 75% of the equivalent daily dose. Nausea and/or vomiting that occurs within 24 hours following surgery. May be present immediately or begin several hours later. Incidence: 20-30% (up to 80% in high risk patients) History of ponv in 1st degree relative. Low risk (0-1 risk factors): none or 1 intervention.
