[SCgirl1962]

This patient is already on Phenergan, Haldol, Compazine, Reglan, Protonix, and Ativan. Felt that it was due to a mechanical obstruction, so I did get his permission to put in an NG tube. This has helped, and we are trying to get him scheduled to have a G-tube put in so he doesn't have the aggravation and discomfort from a long term NG. Thanks for all of your suggestions. I'll be printing these off and referring to them for future references when I have other patients with intractable nausea.

[Allow Mystery]

Leslie,
You mention sc continuous infusion; what medication
do you use for the infusion?
Thanks

Originally Posted by earle58

have you tried a combination of anti-emetics, using ones that act at different receptor sites?
i've had pts using 2 or 3 different ones.
also, high-dose steroids have been helpful for those w/intractible nausea.
sometimes a pt needs sc continuous infusions.
and finally, one time i had a pt who had a celiac plexus block...(i think it's contraindicated in bowel obstxn however). this would be the absolute last resort.
but a palliative g-tube would also be a consideration.

best of luck to you and your pt.

leslie

[earle58]

Originally Posted by Allow Mystery

Leslie,
You mention sc continuous infusion; what medication
do you use for the infusion?
Thanks

we use different ones, depending on etiology and hx of txs.

cyclizine, haldol, zofran, dexamethasone, hyoscine butyl/hydrobromides, octreotide, methotrimeprazine, metoclopramide.

maybe more.
this is off the top of my head.

leslie

[shrinky]

I have had success with Marinol when other drugs are not effective. We have also used ABHR gel every 6 hours with success. Good luck.

[AtlantaRN]

i have the same problem with a patient in his late 40's with pancreatic cancer, i've tried abhr suppositories, levsin, phenergan, nexium 40mg bid, and nothing will touch him

[finn11707]

Have you tried decadron? It work for some when other meds don't