The Elizabeth Hospice Palliative Reference Cards

NAUSEA MANAGEMENT

Non-Pharmacological Management: Acupuncture, behavior modification, hypnosis, imagery, modification of eating habits / odors Pharmacological Management DA: Dopamine Antagonists H 1 : Histamine Antagonists Central Action Haloperidol 0.5‒2 mg PO / SC / IV q12‒24H Metoclopramide 10‒20 mg PO / SC / IV q6H Diphenhydramine 25‒50 mg PO / SC / IV q6H

Dexamethasone 2‒20 mg PO / SC / IV daily Dronabinol 5‒25 mg PO / 24 hr div q2‒4H Lorazepam 0.5‒2 mg PO / SC / IV q8H

Meclizine 25‒50 mg PO q6H Hydroxyzine 25‒50 mg PO q6H Promethazine 25 mg PO / PR q6H Promethazine 12.5‒25 mg IV q6H

Prochlorperazine 10‒20 mg PO q6H Prochlorperazine 25 mg PR q12H Olanzapine 5‒10 mg PO daily 5HT 3 : Serotonin Antagonists Ondansetron 4‒8 mg PO / SC / IV q6H Granisetron 1 mg PO / IV daily or q12H Dolasetron 200 mg PO / IV daily Palonosetron 0.25 mg PO / IV daily

Ach: Acetylcholine Antagonists Inoperable Obstruction

Scopolamine patch 1‒3 TD q72H Scopolamine 0.1‒0.4 mg SC/ IV q4H

Octreotide 100‒400 mcg or more SC / IV q8H or 10‒80+ mcg/ hr SC infusion Scopolamine 0.1‒1.0+ mg/ hr SC infusion Glycopyrrolate 0.1‒1.0+ mg/ hr SC infusion

Div = in divided doses

19 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024

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