Antiemetic Use in the Emergency Department

Abstract

Nausea and vomiting are 2 of the most common complaints of patients presenting to the emergency department (ED). In addition, antiemetics are the most commonly prescribed medications in the ED behind analgesics. Treating these conditions can be complex, especially as one considers that nausea and/or vomiting could be the primary presenting illness or simply a symptom of a more complex etiology. Although there is a wide variety of pharmacotherapeutic options in the armamentarium to treat these conditions, very few consensus recommendations exist to help guide the use of antiemetic agents in the ED, leading to wide variability in medication use. Contributing to these variations in practice is the extended spectrum of etiologies and potential physiological factors that contribute to the development of nausea or vomiting. A thorough understanding of the pharmacology and administration of these agents can help practitioners devise tailored antiemetic regimens based upon the underlying etiology.

Ondansetron-induced pseudoallergy with non-ischemic myocardial injury: A rare case report of Kounis Syndrome

“…Ondansetron is considered as a first-line agent in the ED to manage nausea and vomiting, with a relatively low risk of side effects compared to other antiemetics (12,13) . Despite the high safety profile of ondansetron, emerging literature on ondansetron toxicity has reported hypersensitivity reactions leading to skin rashes and urticaria (14) .…”

Ondansetron‐induced pseudoallergy with non‐ischemic myocardial injury: A rare case report of Kounis syndrome

“…Ondansetron is considered as a first‐line agent in the ED to manage nausea and vomiting, with a relatively low risk of side effects compared with other antiemetics. 12 , 13 Despite the high safety profile of ondansetron, emerging literature on ondansetron toxicity has reported hypersensitivity reactions leading to skin rashes and urticaria. 14 It is entirely possible that with a combination of bronchospasms, hypotension, and urticaria‐like rash at the site of injection, this patient had an allergic reaction to ondansetron prompting hydrocortisone administration.…”

“…Ondansetron is considered as a first‐line agent in the ED to manage nausea and vomiting, with a relatively low risk of side effects compared with other antiemetics 12,13 . Despite the high safety profile of ondansetron, emerging literature on ondansetron toxicity has reported hypersensitivity reactions leading to skin rashes and urticaria 14 .…”