What is your favorite antiemetic?

[Kay28]

Hi. I had a patient today who was on day two of detoxing off of a heavy dose of methadone. She was vomiting violently, and couldn't keep down the PO zofran that the physician had prescribed. I asked for an order for something else, and was given an order for 25 mg compazine PR. This helped the nausea, but did not completely stop it. What are your favorite antiemetics to use, especially in a detoxing patient? Thanks for your responses.

[Esme12, ASN, BSN, RN]

This might be better answered in the addictions Specialities section. Addictions Nursing for Nurses | Nursing Students

With the absence of an IV, Compazine or phenergan PR.

[rn/writer, RN]

Moved to Addictions Nursing in the hope of getting knowlegeable responses.

[amybeets05]

what about dissolvable zofran...it is a sublingual very small tablet that has a good taste.

[Meriwhen, ASN, BSN, MSN, RN]

Phenergan IM usually works wonders for the vomiting patient. Downsides are that it must be given in a large muscle, it's a painful shot even in that large muscle, and some patients can get a bit of a buzz from the med.

[tom7044]

by far, phenergan (promethazine hcl); at my place of employment we can choose between compazine, ondansetron (zofran) and promethazine hcl. i generally use phenergan po or im for these patients that are having severe nausea and vomiting from withdrawal because in my experience, it works faster, gives more complete relief, is less sedating than zofran and doesn't have the potential for eps that compazine does. compazine would be my last choice for these patients

[Yulie]

I would agree with the Phenergan for nausea / Vomiting in an addicted patient, but have never heard that it is less sedating than Zofran. That is actually one reason it (phenergan) might be preferred for an addicted pt. (that they might be able to rest some)

[Creamsoda, ASN, RN]

I would agree with the Phenergan for nausea / Vomiting in an addicted patient, but have never heard that it is less sedating than Zofran. That is actually one reason it (phenergan) might be preferred for an addicted pt. (that they might be able to rest some)

Yeah I thought it was quite the opposite. Zofran doesn't have sedating properties. Why do you think the drug seekers always want phenergan.

[Meriwhen, ASN, BSN, MSN, RN]

Yeah I thought it was quite the opposite. Zofran doesn't have sedating properties. Why do you think the drug seekers always want phenergan.

Ditto. Phenergan can also give them a high. And you can tell the patients who are experiencing that high: they insist they need their their phenergan q4h on the dot, yet have no problems polishing off a plate of ice cream and a tankard of coffee.