With the patient's comfort and quality of life being the ultimate goal of hospice care, an injection or suppository may not be the most comfortable way of meeting those needs. This is a popular product in both pediatrics and obstetrics/gynecology practices, because it is less likely to cause drowsiness and discomfort than the tablet, suppository, or injection forms of promethazine.Īnother area in which compounding can be of great benefit is hospice care. For example, many compounding pharmacies have had great success incorporating promethazine into a transdermal gel, which is applied to a thin-skinned area such as the wrist. A compounding pharmacist may be able to provide other solutions (Table).Ĭompounded treatments for nausea and vomiting are numerous, offering physicians increased flexibility in meeting the needs of individual patients.
For those who are unable to keep a tablet down, a suppository is an unpleasant alternative. For example, a pregnant woman who is working full-time might not be able to manage the drowsiness that is a common side effect of promethazine. Additional options include metoclopramide, chlorpromazine, and haloperidol.Īlthough commercial medications can be very effective, these medications will not be appropriate in every situation. For motion sickness, scopolamine is a highly effective anticholinergic agent. Commercially available options include dopamine-2 antagonists such as promethazine and prochlorperazine (Compazine), as well as 5-hydroxytryptamine-3 antagonists such as ondansetron (Zofran) and granisetron (Kytril). When OTC treatments fail to provide the needed relief, a prescription medication may be more appropriate. Emetrol (consisting of dextrose, fructose, and phosphoric acid), can be effective in treating nausea.
Dimenhydrinate (Dramamine) and meclizine (Bonine) are perennial favorites for treating symptoms associated with motion sickness. Today's technology offers more choices, both commercially and through compounding.Ī few OTC treatments are available that can be helpful in relieving nausea, vomiting, and dizziness. Until recently, symptoms of nausea almost always were treated with promethazine (Phenergan) suppositories. Symptoms tend to leave patients in a weakened or fatigued state, and illnesses with accompanying nausea may require a somewhat longer recovery period. Nausea and vomiting (or emesis) can occur with pregnancy, as a side effect of medications, or as a result of a gastrointestinal disturbance or other disease state, or it may be caused by environmental factors, as in the case of motion sickness. One of the most universally distressing symptoms of illness is nausea, which may or may not be accompanied by vomiting.
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