It seems Zofran is the standard antiemetic choice these days for multiple implications (ie post op nausea, opioid administration etc) and while it seems to work amazingly for some people it seems to be a hit or miss for others. Sometimes it works others it doesn't.
Phenergan on the other hand despite issues with it causes intense sedation, mild akathisia and burning on injection seems to be the "golden ticket" in terms of anti-emetics and rarely seems to fail to do its job unless the etiology of vomiting is unknown and requires multiple antiemetics that hit multiple targets in the brain.
I'm going to weigh in as a patient with a tiny sample size and anecdotal experience.
My mother (I'm 55) always kept a box of phenargan suppositories in the house when we were growing up, and I've done the same since the day I moved out in 1979. My experience:
Periodically, I'm beset by acute episodes of something in my gut (partial blockage from scar tissue from previous surgeries or something....CTs have been inconclusive). Uncontrollable vomiting and serious pain are the symptoms, and it always lasts about 18 hours. That's a long time when one is wretching up their organs every five minutes. It's a day in the hospital, if for no other reason than the IV fluids cut the recovery time to a couple of days instead of a week or more. Anyway.....
My ex had a seizure while taking Zofran, so I've tried to stay away from it, but phenargan causes more than a little akathisia and, combined with the other stuff going on, it just drives me mad. The last trip via ambulance, they shot me up with Zofran and it seemed to work at least as well as phenargan, no akathisia, but it didn't make me sleepy. Drowsiness is a welcome side effect when one has been up all night, so once I arrived at the ER, I asked for something that would sedate me. Good lord, you'd have thought I had asked to be transported to an opium den. I was not asking for pain meds, just something that would let me close my eyes for awhile. No love until I got to my room, at which time they administered some kind of sleepy time medicine and a pretty huge dose of morphine (I didn't ask for it, so chill out). Peace at last.
Nurses, I know you guys get patients who are seeking drugs. I know your job is difficult and I know that there are patients who are in worse condition than me. I try to not be a nuisance, but if you're paying attention, you know that I'm thinking death would be a better alternative than my present condition. I don't need compassion, empathy, sympathy, or a sponge bath. I need to stop throwing up and I need to go to sleep. Please try to help me make that happen. I know it's ultimately the doctor's decision, but you have input. Please use it!
SierraBravo
547 Posts
Were you referring to my post?