![]() ![]() Prochlorperazine (Compazine) 5 to 10 mg oral or IV every six to eight hours or 25 mg rectally every 12 hours Reasonable agent for treating nausea multiple uses for haloperidol in palliative medicine Haloperidol (Haldol) 0.5 to 2 mg orally two to four times per day Meclizine (Antivert) 12.5 to 25 mg orally every six to eight hours These agents more useful if nausea related to ambulation Antihistamines are the preferred management option should pharmacotherapy treatment be required.Äiphenhydramine (Benadryl) 25 to 50 mg orally or IV every four to six hours ![]() Pruritus may develop, but it is generally not considered an allergic reaction. Minimizing unnecessary medications and judicious use of stimulants and antipsychotics are used to manage the central nervous system side effects. Underlying disease states or other centrally acting medications often will compound the opioid’s adverse effects. Sedation and cognitive changes occur with initiation of therapy or dose escalation. Monotherapy with stool softeners often is not effective a stool softener combined with a stimulant laxative is preferred. Physicians should minimize the development of constipation using prophylactic measures. Constipation is considered an expected side effect with chronic opioid use. Understanding the mechanism for opioid-induced nausea will aid in the selection of appropriate agents. Patients who do develop nausea will require antiemetic treatment with an anti-psychotic, prokinetic agent, or serotonin antagonist. Nausea occurs in approximately 25 percent of patients prophylactic measures may not be required. ![]() Strategies to minimize adverse effects of opioids include dose reduction, symptomatic management, opioid rotation, and changing the route of administration. Opioid analgesics are useful agents for treating pain of various etiologies however, adverse effects are potential limitations to their use. ![]()
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