Non-Pharmacological Counseling 

  • Eat small, frequent meals 

  • Eat slowly 

  • Drink liquids ≥ 30 minutes before or after eating solid foods 

  • Eat a low-fat, low-fiber diet 

  • Sip cola or ginger ale 

  • Avoid fat, greasy, fried foods, caffeine, alcohol, and sweet foods 

Additional antiemetics for chemotherapy-related nausea 

  • Benzodiazepines 

  • Butyrophenones  

  • Droperidol and haloperidol  

  • Agitation, restlessness, sedation 

  • Dronabinol 

  • Adverse effects include ataxia, dizziness, euphoria, hypotension, sedation 

  • Corticosteroids 

  • Dexamethasone 

  • NK1 receptor antagonist 

  • Aprepitant, fosaprepitant 

  • Olanzapine 

Links

Nausea and Vomiting- Your Doctor Friends Podcast

Evaluation of Nausea and Vomiting

ASCO Antiemetics Guideline

A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options | Medical Principles and Practice | Karger Publishers

Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association - PubMed (nih.gov)

References  

Li K, Vo K, Lee BK, Addo N, Coralic Z. Effect of a single dose of i.v. ondansetron on QTc interval in emergency department patients. Am J Health Syst Pharm. 2018;75(5):276-282. doi:10.2146/ajhp161070 

Freedman SB, Uleryk E, Rumantir M, Finkelstein Y. Ondansetron and the risk of cardiac arrhythmias: a systematic review and postmarketing analysis. Ann Emerg Med. 2014;64(1):19-25.e6. doi:10.1016/j.annemergmed.2013.10.026 

Erdogan-Ongel E, Heung Y, Rozman de Moraes A, Geng Y, Bruera E. Inhalation of Isopropyl Alcohol for the Management of Nausea and Vomiting: A Systematic Review. J Palliat Med. 2023;26(1):94-100. doi:10.1089/jpm.2022.0332 

Bischoff SC, Renzer C. Nausea and nutrition. Auton Neurosci. 2006;129(1-2):22-27. doi:10.1016/j.autneu.2006.07.011 

Patanwala AE, Amini R, Hays DP, Rosen P. Antiemetic therapy for nausea and vomiting in the emergency department. J Emerg Med. 2010;39(3):330-336. doi:10.1016/j.jemermed.2009.08.060 

Glare P, Miller J, Nikolova T, Tickoo R. Treating nausea and vomiting in palliative care: a review. Clin Interv Aging. 2011;6:243-259. doi:10.2147/CIA.S13109