Anti-emetic

  • Anti-emetic

    Posted by Cynthia Meteyer on October 17, 2013 at 11:46 pm

    What are my anti-emetic options for a 19 month-old patient with Ph+ ALL who can’t take Zofran due to concurrent use of Dasatinib?  I’m concerned about paradoxical reactions with diphenhydramine and extrapyramidal reactions with Compazine, Phenergan, or Reglan and I can’t find indications for Kytril in a patient < 2 years old.  Anyone have any other tricks up their sleeves?  

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    Cynthia Meteyer
    Haslett, MI
    United States
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    Elizabeth Sonnenblick replied 10 years, 2 months ago 4 Members · 3 Replies
  • 3 Replies
  • Jessica Whitlock

    Member
    October 18, 2013 at 6:34 am

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    Jessica Whitlock
    Fairborn, OH
    United States
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    We do use Kytril in patients < 2 years, however I think you’ll find the same interaction with Dasatinib as Zofran since both are the same class. Ativan would be an option – although the side effect of sedating. Have you considered Decadron? I realize neither of these meds are ideal – will continue to investigate. What a challenge!

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    Original Message:
    Sent: 10-17-2013 11:46 PM
    From: Cynthia Meteyer
    Subject: Anti-emetic

    What are my anti-emetic options for a 19 month-old patient with Ph+ ALL who can’t take Zofran due to concurrent use of Dasatinib?  I’m concerned about paradoxical reactions with diphenhydramine and extrapyramidal reactions with Compazine, Phenergan, or Reglan and I can’t find indications for Kytril in a patient < 2 years old.  Anyone have any other tricks up their sleeves?  

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    Cynthia Meteyer
    Haslett, MI
    United States
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  • Amy Forsythe

    Member
    February 12, 2014 at 6:11 pm

    We gave vistaril in one patient, but he was a teenager.  I haven’t used it enough in the younger ones to be aware of possible paradoxical reactions though the adverse reaction list for vistaril is much smaller than benadry.  Let us know what you tried and if it worked!

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    Amy Forsythe
    Madison, MS
    United States
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    Original Message:
    Sent: 02-12-2014 06:08 PM
    From: Cynthia Meteyer
    Subject: Anti-emetic

    What are my anti-emetic options for a 19 month-old patient with Ph+ ALL who can’t take Zofran due to concurrent use of Dasatinib?  I’m concerned about paradoxical reactions with diphenhydramine and extrapyramidal reactions with Compazine, Phenergan, or Reglan and I can’t find indications for Kytril in a patient < 2 years old.  Anyone have any other tricks up their sleeves?  

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    Cynthia Meteyer
    Haslett, MI
    United States
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    • Elizabeth Sonnenblick

      Member
      February 12, 2014 at 6:15 pm

      We have given PO Vistaril to children that age without any adverse reactions.  You can also try Dexamethasone as an antiemetic

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      Elizabeth Sonnenblick
      St Joseph’s Regional Medical Center
      Paterson, NJ
      United States
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      Original Message:
      Sent: 02-12-2014 06:13 PM
      From: Amy Forsythe
      Subject: Anti-emetic

      We gave vistaril in one patient, but he was a teenager.  I haven’t used it enough in the younger ones to be aware of possible paradoxical reactions though the adverse reaction list for vistaril is much smaller than benadry.  Let us know what you tried and if it worked!

      ——————————————-
      Amy Forsythe
      Madison, MS
      United States
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      ——————————————-
      Original Message:
      Sent: 02-12-2014 06:08 PM
      From: Cynthia Meteyer
      Subject: Anti-emetic

      What are my anti-emetic options for a 19 month-old patient with Ph+ ALL who can’t take Zofran due to concurrent use of Dasatinib?  I’m concerned about paradoxical reactions with diphenhydramine and extrapyramidal reactions with Compazine, Phenergan, or Reglan and I can’t find indications for Kytril in a patient < 2 years old.  Anyone have any other tricks up their sleeves?  

      ——————————————-
      Cynthia Meteyer
      Haslett, MI
      United States
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