Comparative Efficacy and Safety of Ondansetron, Droperidol, and Metoclopramide for Preventing Postoperative Nausea and Vomiting

Domino, Karen B.; Anderson, Emily C.; Polissar, Nayak L.; Posner, Karen L.

doi:10.1213/00000539-199906000-00032

Cited by 171 publications

(43 citation statements)

References 82 publications

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“…41 However, metoclopramide prevented postoperative vomiting in only 35% of patients compared with 50% of those using ondansetron (p < 0.001). In addition, metoclopramide was inferior to droperidol in preventing both postoperative nausea and vomiting.…”

Section: Substituted Benzamidesmentioning

confidence: 93%

“…43 The overall incidence of adverse effects is estimated to be between 10% and 20%. 3 In light of metoclopramide's adverse effect profile and because of the availability of more effective antiemetics in the setting of 72 I The Annals of Pharmacotherapy I 2007 January, Volume 41 www.theannals.com PONV, metoclopramide is not routinely recommended for the prevention or treatment of PONV.…”

Section: Substituted Benzamidesmentioning

confidence: 99%

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Prevention of Postoperative Nausea and Vomiting

2007

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The first step in the prevention of PONV is assessment and reduction of risk factors. Although nonpharmacologic therapies may play a role in the treatment of PONV, the mainstay of therapy for PONV is pharmacologic modalities. Patients at moderate to high risk for PONV need prophylactic antiemetic therapy. High-risk patients may require combination therapy with 2 or 3 agents from different antiemetic classes. Rescue antiemetic therapy is needed by patients who actually develop PONV. The agents of choice in such cases should be from antiemetic classes different from those used for prophylaxis of PONV.

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Section: Substituted Benzamidesmentioning

confidence: 93%

Section: Substituted Benzamidesmentioning

confidence: 99%

Prevention of Postoperative Nausea and Vomiting

2007

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“…Other reported adverse responses, which are rare but serious, include electrocardiography alteration involving sodium channels changes, central nervous changes such as dyskinesias, and elevated liver enzymes (Goodin and Cunningham 2002; Kovac 2002). In contrast, side-effects reported with metoclopramide such as headaches, high levels of sedation, and extrapyramidal symptoms occurred with statistically significant greater frequency (Domino et al 1999). Droperidol profile is less favorable secondary to more pronounced side-effects such as somnolence and a theoretical increased risk of cardiac arrhythmia in children.…”

Section: Postoperative Nausea and Vomitingmentioning

confidence: 93%

An overview of the clinical use of ondansetron in preschool age children

Cohen

2007

Therapeutics and Clinical Risk Management

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Abstract:The introduction of 5-HT 3 receptor antagonist has revolutionized the prevention and treatment of nausea and vomiting in preschool aged children. These distressing symptoms, arising from multiple etiologies such as anesthesia, chemotherapy, and viral infection, are a major concern of patients and their families. Clinical research has demonstrated the antiemetic effectiveness of ondansetron in children. Although most of these studies focus primarily on preventing vomiting across the pediatric age group, they provide strong evidence for the use of ondansetron in preschool age children. For children at high risk, pediatric practice guidelines recommend ondansetron in conjunction with other antiemetics to achieve complete control of symptoms.

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“…They may be used in patients with postoperative nausea and vomiting, and in the treatment of anticipatory and acute chemotherapy-related nausea and vomiting [20]. Standard dosage Droperidol: a short-acting drug, with typical dose being 1.25 mg to 5 mg intramuscularly.…”

Section: Butyrophenonesmentioning

confidence: 99%

Nausea and vomiting

Fraga

Malagelada

2002

Curr Treat Options Gastro

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Nausea and vomiting are rather stereotyped symptoms. The challenge is that nausea and vomiting have many different causes and, in some patients, management may be rather complex. The clue is to determine the causal factor early. It helps to separate acute vomiting (<48 hours onset) from chronic vomiting. In acute vomiting, the causal factor or factors are most often evident. Symptomatic treatment with parenteral central-type antiemetics is the preferred treatment. Histamine-1 receptor antagonists, phenothiazines, butyrophenones, and corticosteroids are suitable drugs. For specific types of acute vomiting, for example, chemotherapy-related vomiting, the 5-HT3 receptor antagonists are costlier but effective drugs with minimal side effects. Sometimes, oral and parenteral administration of the above-mentioned drugs may be combined. The origin of chronic vomiting is often obscure, requires specialized investigation, and the causative factor may be uncorrectable. Symptomatic treatment requires a value judgement. If delayed gastric emptying is a contributing factor, prokinetic agents (metoclopramide, erythromycin, cisapride in special cases, if authorized) may prove useful. Otherwise, symptomatic treatment with central antiemetics is the only recourse. Some patients with unexplained vomiting present with psychological disturbances that act as magnifying or contributing factors and may be helped by psychotherapeutics.

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Comparative Efficacy and Safety of Ondansetron, Droperidol, and Metoclopramide for Preventing Postoperative Nausea and Vomiting

Cited by 171 publications

References 82 publications

Prevention of Postoperative Nausea and Vomiting

Prevention of Postoperative Nausea and Vomiting

An overview of the clinical use of ondansetron in preschool age children

Nausea and vomiting

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