Dosage, Route & Frequency Drug-Drug & Adverse

Side Effects
Drug Action Drug-Food Indications Contraindications Reactions (By
Recommended Prescribed (By System)
Interactions System)
Nausea and Nausea and Selective serotonin Drug-herb. Prevention of Contraindicated in CNS: headache, CNS: headache,
Vomiting Vomiting (5-HT3) receptor Horehound: nausea and patients fever, malaise, fatigue,
antagonist. May enhance vomiting hypersensitive to lightheadedness, dizziness,
Adult: PO 8 mg 4mg IV push
30 min before Serotonin receptors serotonergic associated with drug. Use dizziness, sedation, anxiety,
q6h PRN
chemotherapy, are located effects. initial and cautiously in tiredness, agitation, fever,
then q8h times 2 centrally in the Discourage repeated patients with drowsiness, oculogyric crisis.
more doses chemoreceptor use together. courses of hepatic failure. weakness
CV: chest pain,
Adult/Child: IV 6 trigger zone (CTZ) cancer Orally
Drug: EENT: blurred hypotension.
mo–18 y, 0.15 and peripherally on chemotherapy, disintegrating tablet
Rifampin may vision
mg/kg or 32 mg the vagal nerve including high- contains GI: diarrhea,
decrease
infused over 15 terminals. dose cisplatin; aspartame; use GI: diarrhea, constipation,
min beginning 30 ondansetron
Serotonin is postoperative cautiously in constipation abdominal pain,
min before start levels.
released from the nausea and patients with xerostomia.
of chemotherapy, Musculoskeletal:
wall of the small vomiting. phenylketonuria.
followed by 0.15 muscle spasm GU: urine
mg/kg 4 and 8 h intestine and
retention,
after first dose of stimulates the vagal Skin: rash
gynecologic
ondansetron, efferents through
may also give 8 disorders.
the serotonin
mg bolus, then 1
receptors and Musculoskeletal:
mg/h by
continuous initiates the musculoskeletal
infusion (max: 32 vomiting reflex. pain.
mg/d), or 32 mg
as single dose Pharmacokinetics Respiratory:
hypoxia.
Child: PO >4 y, 4 Absorption:
mg 30 min before Absorption is Skin: rash,
chemotherapy, variable with oral injection-site
then q8h times 2
administration; reaction.
more doses
bioavailability is
Other: chills,
Nausea & 50% to 60%.
Vomiting with anaphylaxis.

Highly Emetogenic Distribution: 70% to

Chemotherapy 76% protein-bound.

Adult: PO Single Metabolism:

24-mg dose 30 Extensively
min before
metabolized by
administration of
hydroxylation on
single-day highly
emetogenic the indole ring,

chemotherapy followed by
glucuronide or
Postoperative
sulfate conjugation.
Nausea and
Vomiting Excretion: 5%
Adult: PO 8–16 recovered in urine
mg 1 h as parent
preoperatively IM compound. Half-life
4 mg injected
in adults is 3 1/2 to
immediately prior
6 hours.
to anesthesia
induction or once
postoperatively if
patient
experiences
nausea/vomiting
shortly after
surgery IV 4 mg
by slow IV push,
may repeat q8h
as needed

Child: IV 1 mo–
12 y, 0.1 mg/kg

Hyperemesis
Gravidarum

Adult: PO/IV 4–8

mg 2–3 times per
day
Hepatic
Impairment

Maximum dose 8
mg/d PO/IV in
patients with
severely
impaired liver
function
according to
Child-Pugh
criteria

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
ASSESSMENT: IV Administration

● Assess patient for nausea, vomiting, abdominal distention, and bowel
sounds prior to and following administration.
● Assess patient for extrapyramidal effects (involuntary movements,
facial grimacing, rigidity, shuffling walk,trembling of hands) periodically
during therapy.
● Monitor ECG in patients with hypokalemia, hypomagnesemia, HF,
bradyarrhythmias, or patients taking concomitant medications that
● IV Push: Administer undiluted (2 mg/mL) immediately before induction of
anesthesia or postoperatively if nausea and vomiting occur shortly after surgery.
Rate: Administer over at least 30 sec and preferably over 2– 5 min.
EVALUATION:
 Prevention of nausea and vomiting associated with emetogenic cancer
chemotherapy.
prolong the QT interval.  Prevention of postoperative nausea and vomiting.

● Monitor for signs and symptoms of serotonin syndrome (mental status
changes [agitation, hallucinations, delirium, coma], autonomic instability
[tachycardia, labile BP, dizziness, diaphoresis, flushing, hyperthermia],
neuromuscular symptoms [tremor, rigidity, myoclonus, hyperreflexia,
incoordination], seizures, gastrointestinal symptoms [nausea, vomiting,
diarrhea]. If symptoms occur, discontinue therapy.
● Lab Test Considerations: May cause transientq
 Prevention of nausea and vomiting due to radiation therapy.
PATIENT/FAMILY TEACHING:
 Instruct patient to take ondansetron as directed.
 Advise patient to notify health care professional immediately if symptoms of
irregular heart beat, serotonin syndrome, or involuntary movement of eyes,
face, or limbs occur.

in serum bilirubin, AST, and ALT levels.

DIAGNOSIS:

 Imbalanced nutrition: less than body requirements (Indications)

 Diarrhea (Side Effects)

 Constipation (Side Effects)

PLANNING:

IMPLEMENTATION:

● First dose is administered prior to emetogenic event.

● PO: For orally disintegrating tablets, do not attempt to push through foil
backing; with dry hands, peel back backing and remove tablet.
Immediately place tablet on tongue; tablet will dissolve in seconds, then
swallow with saliva. Administration of liquid is not necessary.