Ativan usage?

We only use Ativan for agitation and DT prevention (my floor is oncology, urology, med/surg). Our chemo patients have had great success with anzemet for nausea.

I work on an oncology floor in a university hospital. Of course many of our patients complain of nausea. Now, I have been working on this floor for two months and notice there is a very high use of ativan for nausea here. We use it so much, some are calling it "vitamin A"! I was wondering how much is it used in other oncology floors. I was reading it really isnt all that good for nausea. Any opinons or info would be great!

Thanks!

Pearl

I've given quite a bit of the old vitamin A, along with vitamin H and C to form a combined vitamin HAC --haldol, ativan, cogentin. As for giving ativan for nausea I once had a pt who swore it was the only thing which relieved his bloating/nausea. I think from a medical point of view, it works because ativan is an anxiolytic and since anxiety often has GI implications (upset stomach) it should relieve such symptoms. I am in no way an oncology nurse, but if I recall back to my student days during the onco unit, many many cancer patients on chemo experience n/v in anticipation of the chemo, without even having a dose infusing. If I'm correct, the use of ativan makes that much more sense.

Ativan has long been used in chemo patients for nausea when I first started nursing 15 years ago. I think since then better ones like Zofran have come along and I didn't think it was all that common for nausea.

As a recent synovial sarcoma survivor, I can attest to the powerful anti-nausea properties of ativan/benzodiazepines. I had mets in my lung so the treatment was rather wicked and aggressive (dose dense, every two weeks for 28 weeks). While in the hospital, I received 2 mg/m^2 ifex/mesna infusion daily for 7 days. By the 3rd day, the room spinning would become uncontrollable. 1-2 mg of ativan stopped that better than anzemet or zofran ever did. Also, when at home and experiencing hardcore breakthrough nausea, a bar or two of xanax or a marijuana cigarette worked much better than compazine. It may depend on the type of nausea...mine was not a retching kind but a dizziness and room spinning, leading to a retching. Once the room stopped spinning and I calmed down (with xanax, pot or ativan), I was fine.

We frequently give ativan for pts receiving chemo. It is never the only antiemetic, but it is an important one. It really helps with the anticipatory nausea.

We also give ativan quite a bit on our onc floor. When compazine and phergan aren't working, we often go to ativan. We use zofran quite a bit as a premed for IV and IT chemo.

not on our first line. it does work when we do use it. usually after zofran, phenergan and vistaril (the latter two usually do it)

Larry i hope that you continue to do well....wometimes we have to go through some rough times...i had breast-ca this time last year...i was lucky it was non aggressive type with no lymph node envolvement..still needed radiation...you are never the same after you go through something like this....

for the rest of you...thanks for the info...we have some smart..knowledgeable people in here...it is always a privilege to learn something we may need for our pts.

We use ativan as well, but never as first line treatment. We use anzemet and zofran for preventing nausea. We use ativan, haldol, stemetil and maxeran for prn nausea.

In my stem cell tranplant land we use huge amounts of Ativan and benedryl - sometimes RTC so the patient is getting one or the other q 3 hours. WHy so much? The nausea the transplant pt expereinces is not necessarily from chemo it could be Graft vs. host disease, it could be from radiation, actaully a host of potential and real nausea issues.

At any rate we use more ativan than any other unit in a large universtiy teaching hospital setting. Course we give more blood products too...

Hi

We use quite a bit of ativan where I work; Not so much for the antiemetic qualities but for use in anticipatory nausea; also for it;s amnesic qualities.

If a pt. doesn't remember how sick he felt, it will help the pt's sence of well-being & again, he won't anticipate any problems.

I remember the days before we had Ativan for heme/onc patients. I thought it was wonderful from the very beginning but it was when I had it given to me in the ER for dystonia caused by compazine that I was taking for the flu nausea,that I really saw it's benefit. Not only did it immediatley stop the dystonia but I had such a wonderful floating feeling that I my anxiety disappeared. Now, I recommend it to our patients not only for nausea but for anxiety. Pain causes suffering but so does the high level of anxiety that being treated for cancer. Our patients deserve Ativan!!