How often do pain meds cause vomitting?

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So I have a patient that is on Vicodin and fentantyl patch,he has been throwing up lately..I was wonderig if it is common for a patient on vicodin or fentanyl to vomitt also my patient has a cancer and has a hiccups but is not on chemo drugs right now,he just got of hospita couple days ago,he do experience hiccups (pancreatic cancer).Do you think that excessive hiccups could have caused the vommiting or is it because they probably gave him chemo couple days ago and it is still in the system or is it the pain meds responsible for that?,patient also is just started Lantus and Nexium as well as new blood pressure med (ACE-inhibitor).He is also on other meds like Plavix,aspirin,diuretic,Ambien as needed and Reglan as well as Bystolic and two oral diabetic meds (his metformin was reduced lately ito half dose) and he used to take glipizide but it was changed to Juvania (wrong spelling?) Also the patient is administering Lantus to himself in the arm he does have a pancreatic cancer,is it safe to teach him to administer insulin the subcutanously in the part of lower stomach?

Specializes in Health Information Management.

Fentanyl could well be the cause. I can speak from personal experience about the patch - when I started it and we were figuring out an appropriate dosage, it made me extremely nauseated for a few days. Also, while the patches work well to deliver a constant dose of medication, the first day after a patch is applied, it seems to cause a higher chance of nausea/vomiting. One last note: make sure your patient isn't running a fever. If you use a patch while running a substantial fever (usually above 103*F), the patch can start to deliver too much medication - which of course could easily lead to nausea and vomiting, among other problems. Best of luck to you and your patient.

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What does your supervisor think? Shouldn't you be getting extra support since you're a new grad? I would run it by him/her also to keep them informed and they might also have some advice too. I wouldn't base your patients care and what could be wrong with him by what anonymous people advise on an online forum.

Well he thinks that fentanyl didnt cause my patient to vommit. Also he suggested to run through the medication list with my patient and determine which drugs might be new to the patient.

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it probably wouldn't hurt you to read up on the meds you'll be suggesting...

especially about their labeled and unlabeled uses.

you'll be better prepared with your pt and the doctor.

leslie

I did look them up.I'm thinking I will suggest the less potent ones first like Baclofen and then maybe Haldol or thorazine.

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Specializes in Hospice.
I did look them up.I'm thinking I will suggest the less potent ones first like Baclofen and then maybe Haldol or thorazine.

Um why a muscle relaxant? Generally with nausea Zofran or compazine is where they start. Im just curious as to your reasoning for baclofen? Good luck i hope you get him some relief!!

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I did look them up.I'm thinking I will suggest the less potent ones first like Baclofen and then maybe Haldol or thorazine.

i disagree but it's your call.

haldol and thorazine would actually be more broad spectrum in that it would address the hiccups and n/v, whereas baclofen is just for hiccups.

and, haldol and thorazine aren't more potent, since they're in different classifications altogether...so they're not even comparable.

Um why a muscle relaxant? Generally with nausea Zofran or compazine is where they start. Im just curious as to your reasoning for baclofen? Good luck i hope you get him some relief!!

diaphragm is a muscle.

hiccups could be caused by irritated diaphragm.

baclofen is a muscle relaxer.

leslie

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Specializes in Hospice.

diaphragm is a muscle.

hiccups could be caused by irritated diaphragm.

baclofen is a muscle relaxer.

leslie

Thanks i didn't see the hiccup part.

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What does your supervisor think? Shouldn't you be getting extra support since you're a new grad? I would run it by him/her also to keep them informed and they might also have some advice too. I wouldn't base your patients care and what could be wrong with him by what anonymous people advise on an online forum.

I'm asking for extra support and thanks to this forum I was able to turn the information I received from some of the nurses here into a positive for my patients.

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Fentanyl could well be the cause. I can speak from personal experience about the patch - when I started it and we were figuring out an appropriate dosage, it made me extremely nauseated for a few days. Also, while the patches work well to deliver a constant dose of medication, the first day after a patch is applied, it seems to cause a higher chance of nausea/vomiting. One last note: make sure your patient isn't running a fever. If you use a patch while running a substantial fever (usually above 103*F), the patch can start to deliver too much medication - which of course could easily lead to nausea and vomiting, among other problems. Best of luck to you and your patient.

Yeah I check his temp and it was regular (no fever) i think it was his 3 day on the patch or second. I also think Fentanyl is new to him,and he was on Vicodin for some time now.

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i disagree but it's your call.

haldol and thorazine would actually be more broad spectrum in that it would address the hiccups and n/v, whereas baclofen is just for hiccups.

and, haldol and thorazine aren't more potent, since they're in different classifications altogether...so they're not even comparable.

diaphragm is a muscle.

hiccups could be caused by irritated diaphragm.

baclofen is a muscle relaxer.

leslie

I'm just wondering if hiccups could produce vomitting that is all...Than maybe Zofran and baclofen would be enough? I never took care of a cancer pt so I really cant tell which drug is best for them and what causes him tovomit,I notice this particular trend his hiccups start around 12 afternoon and then they get more and more intense and he start puking. Also I feel like I'm playing with a fire here,I feel this patient will be unstable,my boss told me I should increase the frequency of my visits and see him twice a week,am I setting my self for failure with this patient since I'm a new grad?

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I'm just wondering if hiccups could produce vomitting that is all...Than maybe Zofran and baclofen would be enough? I never took care of a cancer pt so I really cant tell which drug is best for them and what causes him tovomit,I notice this particular trend his hiccups start around 12 afternoon and then they get more and more intense and he start puking. Also I feel like I'm playing with a fire here,I feel this patient will be unstable,my boss told me I should increase the frequency of my visits and see him twice a week,am I setting my self for failure with this patient since I'm a new grad?

is he on hospice, or are you acting as a 'hospice' nurse?

even the most experienced nurses are challenged by ca pts, since ea pt is unique in their presentation and their etiologies.

a nurse really needs to stay one step ahead with this population.

if i was a new grad, i'd be reading about pancreatic ca/late-stage ca, as there are sev'l issues involved...

the pathophys, psychosocial, functional, spiritual.

but if you feel you're up to this, it'll be a tremendous learning opportunity for you.

that said, i really wish he was on hospice.

leslie

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ok, here's an excellent overview on palliative care in pancreatic cancer.

if you're not registered, i strongly suggest you do so...

medscape's articles are well worth it.

your pt deserves the very best that nsg has to offer.

so if that means for you to walk the extra mile in providing that care, i'll be here to help you...

as well as others, i am sure.

i started the link at section 4 (as opposed to section 1:)), where i felt 4-10, were most relevant to your pt.

Palliative Care in Pancreatic Cancer

Log In Problems

(just click on it, have no idea why it says "log in problems")

leslie

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