Ondansetron tablet crushed vs ondansetron ODT
If both are given SL is there a difference in how they are metabolized? I understand ODT is absorbed in the floor of the mouth so it bypasses the liver metabolism but wouldn't this also happen with a crushed ondansetron tablet put under tongue? (Source: Student Doctor Network)
Source: Student Doctor Network - February 1, 2023 Category: Universities & Medical Training Authors: storyhill2 Tags: Pharmacy Source Type: forums
How many of you have had surgery?
Have you been on the receiving end of the scalpel? I just had my fourth orthopedic surgery yesterday. Not that I’m recommending it, but it can be pretty educational seeing what your patients go through.
Random thoughts as I’m icing at 3am:
Nausea sucks. It’s worse than pain. Zofran ODT tastes like **** though. Blahhh.
During anesthesia induction the patient is still lucid long enough to hear the OR staff chatting. Stay positive, professional, and don’t condescend. Your patients...
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Source: Student Doctor Network - December 16, 2022 Category: Universities & Medical Training Authors: NatCh Tags: Podiatric Residents & Physicians Source Type: forums
Chronic abdominal pain and nausea?
I'm taking care of an outpatient patient: 60y/o woman with chronic abdominal pain with prior history of gastric bypass, appendectomy, incisional hernia repair. Her pain had been previously controlled with oxycodone 10mg a couple times a day, but recently less effective due to emesis. GI is following now, has her on Zofran, Reglan, Promethazine but the nausea is still pretty severe. Patient is cachectic and having trouble with PO intake. Utox is appropriate.
I'm considering a Fentanyl patch...
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Source: Student Doctor Network - September 22, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums
Can I prescribe my girlfriend zofran?
I am a PGY3 internal medicine resident who's about to graduate in 2 months. My girlfriend and I are planning a vacation to Tulum, Mexico, where tap water is not drinkable. I want to prescribe zofran to my girlfriend so that in case we run into food poisoning/etc, we have zofran to take at the very least. Is there any way I can get in trouble for this? I am still under a hospital issued NPI number. (Source: Student Doctor Network)
Source: Student Doctor Network - April 30, 2021 Category: Universities & Medical Training Authors: Syndicate Tags: Internal Medicine and IM Subspecialties Source Type: forums
A PA sees a patient in the ED: Guess what happened next?
In July 2017, a sixty-four-year-old woman (“Patient A”) presented to an emergency department, where you were on duty, with complaints of abdominal pain, nausea, and vomiting after having an endoscopy performed at an outside facility earlier that same day. You evaluated Patient A and treated her with oral medications (Zofran OTD and Hydrocodone/Acetaminophen) to address the nausea and pain. After some improvement in the symptoms, you diagnosed Patient A with right upper quadrant pain and...
A PA sees a patient in the ED: Guess what happened next? (Source: Student Doctor Network)
Source: Student Doctor Network - April 22, 2020 Category: Universities & Medical Training Authors: jkdoctor Tags: Emergency Medicine Source Type: forums
Long QT, does anyone care?
Took care of a patient recently with long QT and history of postop nausea. She specifically told me not to give her Zofran because of her asymptomatic history just seen on ekg. Admittedly this is not something I’ve been generally concerned with in the past although I am familiar with the black box warning on Zofran. But the reality is every drug just about that we use for nausea has been associated with increasing QT interval and you have to give these patients something. Any thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - November 10, 2019 Category: Universities & Medical Training Authors: caligas Tags: Anesthesiology Source Type: forums
Intrathecal AND epidural morphine for C/S
A colleague of mine inserted CSE with Bupi + 0.2mg Morphine intrathecal. Then this same colleague gave 3mg morphine through epidural right at the end of case. Attending flipped out when he found out. Wanted MICU consult, etc. Patient fine but experienced vomiting in PACU despite zofran, dex etc. thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - November 15, 2017 Category: Universities & Medical Training Authors: User21218 Source Type: forums
How do you guys sort through which EMR drug interactions are legit?
I always click through zofran for SSRI patients (the most common one), but I get worried how cavalier I've become. The other day I gave diflucan to a woman on aripiprazole and some other AP....she didn't die, but I feel like we get alarm fatigue with the bull**** interaction checks. Is there a list of "real deal" med interactions? (Source: Student Doctor Network)
Source: Student Doctor Network - August 21, 2017 Category: Universities & Medical Training Authors: witzelsucht Source Type: forums
Ponv
What is your standard cocktaIl? Timing of drugs? Dose?
What's your cocktail for patients with prior PONV?
Are you following the SAMBA guidelines?
I do ondansetron 4mg, only towards the end. If prior PONV, or high risk, I toss dexamethasone 4mg at the end also. If patients still have PONV in pacu I add another dose of ondansetron 4mg, benadryl 50mg and metoclopramide 10mg.
I'm not precisely following the SAMBA guidelines but seems to work.
We don't have any of the newer antiemetics. (Source: Student Doctor Network)
Source: Student Doctor Network - November 6, 2016 Category: Universities & Medical Training Authors: urge Source Type: forums
Scary case - variceal bleed and possible intubation
So, we had a case today - GI bleed, likely (actually confirmed by GI) to be a variceal based on presentation of a lady w distended abd, etoh hx, scleral icterus. Found in our ER bathroom with a pint of blood in a bucket, bright red. HR 150, SBP 90.
So I did the usual - reglan 10 iv, zofran 4 iv, octreotide and protonix boluses and drips. IVF x2L, uncrossmatched blood x 2u, ceftriaxone 1g iv. Also, we got our airway cart ready and I had the OR bring down the glidescope. Also 2 canisters of suction ready and plugged in.
FFP ordered also.
PH was 7.5, hgb was 7.7, inr was 2.0.
Now - my question was when to intubate a...
Source: Student Doctor Network Forums - August 20, 2013 Category: Universities & Medical Training Authors: pinipig523 Tags: Emergency Medicine Source Type: forums
