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American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 3, 184-189 (2008)
DOI: 10.1177/1049909108315909

Efficacy of a Scheduled IV Cocktail of Antiemetics for the Palliation of Nausea and Vomiting in a Hospice Population

Geetika Kumar, MD

Department of Internal Medicine, Dayton Veterans Affairs Medical Center Hospice and Palliative Care, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, Geetika.Kumar{at}va.gov

Kathleen A. Hayes, MS, RNC, CHPN

Department of Internal Medicine, Dayton Veterans Affairs Medical Center Hospice and Palliative Care, Boonshoft School of Medicine, Wright State University, Dayton, Ohio

Rosemary Clark, MS, RN, CHPN

Department of Internal Medicine, Dayton Veterans Affairs Medical Center Hospice and Palliative Care, Boonshoft School of Medicine, Wright State University, Dayton, Ohio

This is a retrospective analysis of 10 mg metoclopramide, 25 mg diphenhydramine, and 4 mg dexamethasone given intravenous piggyback every 6 hours for nausea or vomiting. Outcome measures were rapidity of symptom relief based on the self-report of the patient and nursing documentation of relief from symptoms of nausea or vomiting. Seven hundred and ninety seven patients were admitted to the inpatient hospice unit during a 2-year period. Sixty-three patients developed nausea or vomiting requiring the cocktail. Fifty-seven patients (90%) had objective response as reflected in nursing notes. Symptom relief was usually noted within 2 days with improvement in oral intake and enjoyment in activities, such as parties and family interactions. Partial relief was noted in patients with gastrointestinal malignancies and peritoneal carcinomatosis even with the addition of other antiemetics to the cocktail.

Key Words: nausea • vomiting • metoclopramide • dexamethasone • cocktail • hospice


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