Which antiemetic do you use? Which one would you like to use?

[Arctickat]

We used to carry Phenergan and I loved it but the local ER's didn't. They were concerned about necrosis from infiltration if not given correctly. We now carry Zofran but I haven't used it yet.

That's odd, considering how hard it is to screw up an IM injection.

We're stuck with Dimenhydrimate because our provincial formulary doesn't have any other injectible anti-emetics.

[ERDoc]

That's odd, considering how hard it is to screw up an IM injection.

She's talking about giving it IV, not IM.

[Arctickat]

She's talking about giving it IV, not IM.

I understood that, but since IM is the preferred route, wouldn't it make sense to just give it by that route rather than IV? It's far less complicated than setting up an infusion. Using this doctor's logic, D50W should be prohibited as well, just in case of extravasion.

[chbare]

Where exactly did the doc say or imply d-glucose 50%W should be prohibited? We are talking about two different medications and aside from oral or more exotic enteral routes, IV is the only other option for said medication. I fail to see the logic in making a valid comparison based on the doc's statement.

[Arctickat]

Where exactly did the doc say or imply d-glucose 50%W should be prohibited? We are talking about two different medications and aside from oral or more exotic enteral routes, IV is the only other option for said medication. I fail to see the logic in making a valid comparison based on the doc's statement.

Read my post prior to that. My comparison might make a little more sense then.

[medicgirl05]

IM phenergan has an onset time of 20 minutes where the IV route has a 5 minute onset. We did not have protocols to give it IM. Protocols advised to give 12.5 slow IV push initially, followed with another 12.5 if N/V continued.

[croaker260]

I did a search but didn't seem to find anything addressing this specifically. I'm just curious which antiemetics are used most commonly and if you are happy with what your service uses or if there is something you would prefer.

It seems like we're a bit behind the rest of the world with our continued use of dimenhydrinate in Ontario...

Here in Idaho, we currently se Zofran with Benadryl as a back up. In the past we have had Phenergan and iapsine, and one local agency also arries Zofran ODT, wich is awsome.

If I had my "druthers" I would carry Inapsine (it works the best), followed by Zofran ODT and IV, followed by Benadryl as a third line.

Phenergan wasnt bad really WHEN you diluted it and used it properly...but the strong sedative properties made it a problem in peds and with co-administation of opioids. A benifit of Phnergan is it i also an H1 inhibitor, so it could pull double duty....

[Fenta]

we use dimenhydrinate and metoclopramide.

[cfaulknor]

I have typically used Zofran and had good success. We do carry Reglan as a backup as well. In the ER setting, I've had great success with Phenergan.

[Steve Whitehead]

I'm currently using Zofran (Ondansetron) 4mg SIVP which I prefer over Reglan (Metclopramide). I'm presonally a huge fan of Inapsine and I used it frequently both as an anti-emetic and a chemical restraint for years without any issues. Inapsine was black boxed about ten years ago but I've heard talk that it might get released for use again in the near future. That would be a good day. 1.25mg of Inapsine was like turning off the vomit button. I don't care if I have to put a cardiac monitor on every patient I give Inapsine to, it would be worth it.