Q: What is the utility of an atypical antipsychotic agent in refractory nausea and vomiting due to opioids in patients with advanced cancer?
Answer: End of life care is an integral part of ICU work. In patients who are going through compassionate care may develop side effects from opioid administration. The most common is refractory nausea and vomiting. In such cases, one option is to use atypical antipsychotic agents. The dose of risperidone is 1 mg daily and is very useful in refractory nausea and vomiting. Olanzapine can also be used. These agents are also found to be helpful in chemotherapy-induced nausea and vomiting.
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#gastroenterology
References:
1. Okamoto Y, Tsuneto S, Matsuda Y, et al. A retrospective chart review of the antiemetic effectiveness of risperidone in refractory opioid-induced nausea and vomiting in advanced cancer patients. J Pain Symptom Manage 2007; 34:217.2. Navari RM, Qin R, Ruddy KJ, et al. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting. N Engl J Med 2016; 375:134.
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