lOMoARcPSD|50207110
Antiemetics:
General Use/Action:
Act on the chemoreceptor trigger zone to inhibit nausea and vomiting. Scopolamine acts
as antiemetics mainly by diminishing motion sickness. Metoclopramide ↓ nausea and
vomiting by its effects on gastric emptying.
Drug- Drug Interactions:
CNS Depressants, antibiotics can cause toxicity, other PO drugs, anti- phsycotic
agents, other anticholinergics, general anesthesia
Nursing Implications:
• Assess nausea, vomiting, bowel sounds, and abdominal pain before and
following administration.
• Monitor hydration status and intake and output. Patients with severe nausea
and vomiting may require IV fluids in addition to antiemetics.
Family Teaching:
• Advise patient and family to use general measures to decrease nausea (begin with
sips of liquids and small, nongreasy meals; provide oral hygiene; and remove noxious
stimuli from environment).
• May cause drowsiness. Advise patient to call for assistance when ambulating and to
avoid driving or other activities requiring alertness until response to medication is
known.
• Advise patient to make position changes slowly to minimize orthostatic hypotension.
● Metoclopramide (Reglan) Special Considerations
○ Prevention of chemotherapy induced emesis
○ May alter hepatic function labs
○ Access for signs of depression
○ Monitor for Neuroleptic Malignant Syndrome
○ Monitor for Parkinson- like side effects
○ May be taken IV, IM, and PO
● Scopolamine Special Considerations
○ Anticholinergic (DRY MOUTH, BLURRED VISION, ORAL HEALTH)
○ Used for prevention of motion sickness, postop nausea/ vomiting
○ Apply 4 hrs prior to travel
○ Avoid hot weather and use caution while exercising
○ Transdermal patch (Apply to clean, hairless area behind ear after
washing hands, effective for 3 days, remove patch and reapply
behind other ear)
○ Watch Anticholinergic effects w/ Antihistamines, antidepressants,
quinidine, CNS depressants etc.
Downloaded by Samuel Gero ()
, lOMoARcPSD|50207110
Antiarrhythmics:
General Use/ Action:
● Correct cardiac arrhythmias by a variety of mechanisms, depending on the group
used
● Choice of agent depends on etiology of arrhythmia and individual patient
characteristics. Treatable causes of arrhythmias should be corrected before
therapy is initiated (e.g., electrolyte disturbances, other drugs).
Drug- Drug Interactions:
↑ anticholinergic effects with other anticholinergics, including antihistamines, tricyclic
antidepressants, quinidine, and disopyramide. Anticholinergics may alter the absorption
of other orally administered drugs by slowing motility of the GI tract. Antacids ↓
absorption of anticholinergics. May ↑ GI mucosal lesions in patients taking oral
potassium chloride tablets. May alter response to beta-blockers.
Nursing Implications:
● Monitor ECG, pulse, and BP continuously throughout IV administration and
periodically throughout oral administration.
● Take apical pulse before administration of oral doses. Withhold dose and notify
physician or other health care professional if heart rate is <50 bpm
Family Teaching:
● Instruct patient to take oral doses around the clock, as directed, even if feeling
better.
● Instruct patient or family member on how to take pulse. Advise patient to report
changes in pulse rate or rhythm to health care professional.
● Caution patient to avoid taking OTC medications without consulting health care
professional.
● Advise patient to carry identification describing disease process and medication
regimen at all times.
● Emphasize the importance of follow-up exams to monitor progress.
Downloaded by Samuel Gero ()
Antiemetics:
General Use/Action:
Act on the chemoreceptor trigger zone to inhibit nausea and vomiting. Scopolamine acts
as antiemetics mainly by diminishing motion sickness. Metoclopramide ↓ nausea and
vomiting by its effects on gastric emptying.
Drug- Drug Interactions:
CNS Depressants, antibiotics can cause toxicity, other PO drugs, anti- phsycotic
agents, other anticholinergics, general anesthesia
Nursing Implications:
• Assess nausea, vomiting, bowel sounds, and abdominal pain before and
following administration.
• Monitor hydration status and intake and output. Patients with severe nausea
and vomiting may require IV fluids in addition to antiemetics.
Family Teaching:
• Advise patient and family to use general measures to decrease nausea (begin with
sips of liquids and small, nongreasy meals; provide oral hygiene; and remove noxious
stimuli from environment).
• May cause drowsiness. Advise patient to call for assistance when ambulating and to
avoid driving or other activities requiring alertness until response to medication is
known.
• Advise patient to make position changes slowly to minimize orthostatic hypotension.
● Metoclopramide (Reglan) Special Considerations
○ Prevention of chemotherapy induced emesis
○ May alter hepatic function labs
○ Access for signs of depression
○ Monitor for Neuroleptic Malignant Syndrome
○ Monitor for Parkinson- like side effects
○ May be taken IV, IM, and PO
● Scopolamine Special Considerations
○ Anticholinergic (DRY MOUTH, BLURRED VISION, ORAL HEALTH)
○ Used for prevention of motion sickness, postop nausea/ vomiting
○ Apply 4 hrs prior to travel
○ Avoid hot weather and use caution while exercising
○ Transdermal patch (Apply to clean, hairless area behind ear after
washing hands, effective for 3 days, remove patch and reapply
behind other ear)
○ Watch Anticholinergic effects w/ Antihistamines, antidepressants,
quinidine, CNS depressants etc.
Downloaded by Samuel Gero ()
, lOMoARcPSD|50207110
Antiarrhythmics:
General Use/ Action:
● Correct cardiac arrhythmias by a variety of mechanisms, depending on the group
used
● Choice of agent depends on etiology of arrhythmia and individual patient
characteristics. Treatable causes of arrhythmias should be corrected before
therapy is initiated (e.g., electrolyte disturbances, other drugs).
Drug- Drug Interactions:
↑ anticholinergic effects with other anticholinergics, including antihistamines, tricyclic
antidepressants, quinidine, and disopyramide. Anticholinergics may alter the absorption
of other orally administered drugs by slowing motility of the GI tract. Antacids ↓
absorption of anticholinergics. May ↑ GI mucosal lesions in patients taking oral
potassium chloride tablets. May alter response to beta-blockers.
Nursing Implications:
● Monitor ECG, pulse, and BP continuously throughout IV administration and
periodically throughout oral administration.
● Take apical pulse before administration of oral doses. Withhold dose and notify
physician or other health care professional if heart rate is <50 bpm
Family Teaching:
● Instruct patient to take oral doses around the clock, as directed, even if feeling
better.
● Instruct patient or family member on how to take pulse. Advise patient to report
changes in pulse rate or rhythm to health care professional.
● Caution patient to avoid taking OTC medications without consulting health care
professional.
● Advise patient to carry identification describing disease process and medication
regimen at all times.
● Emphasize the importance of follow-up exams to monitor progress.
Downloaded by Samuel Gero ()
