Isopropyl alcohol (IPA) aromatherapy by means of inhaling the vapors from an IPA pad has been a simple bedside practice used to relieve nausea. Several studies suggest that IPA inhalation can provide a quick, modest reduction in nausea severity in an inexpensive, safe, and easy-to-administer intervention. However, other trials and…
Promethazine (Phenergan) is an oral, intramuscular (IM), rectal, and intravenous (albeit with caution!) phenothiazine derivative that is both a first-generation antihistamine (H1 receptor antagonism) and a weak typical antipsychotic (D2 receptor antagonism). It also demonstrates antagonism of muscarinic acetylcholine receptors (anticholinergic) and NMDA receptors (similar to ketamine), conferring some degree…
Scopolamine is a tertiary amine that crosses the blood-brain barrier to exert its anticholinergic effects in the central nervous system (antiemetic, sedative, amnestic) and the periphery. It is available PO, subcutaneously, intravenously, and transdermally – classically a “patch” used for motion sickness and nausea effectively for up to three days.…
Dexamethasone (Decadron) is synthetic adrenocortical steroid roughly 25 times more potent than hydrocortisone and devoid of mineralcorticoid (“sodium retaining”) properties. Therefore, it’s primarily used for long acting, anti-inflammatory effects.
Ondansetron (Zofran) is a common oral and IV medication I use for post-operative nausea/vomiting prophylaxis. It works by antagonizing serotonergic (5-HT3) receptors located in peripheral vagal terminals and in the medulla’s area postrema within the chemoreceptor trigger zone (same place propofol works as an anti-emetic).
