R11 + (Z51.5)
See: Nausea and vomiting, non-specific.
DESCRIPTION
Nausea and vomiting may have many causes in palliative care patients e.g. medication, constipation, anxiety, infection and raised intracranial pressure.
GENERAL MEASURES
Refer to a dietician if available.
MEDICINE TREATMENT
Treat the underlying cause and rehydrate the patient if necessary.
Deliver medicines via an appropriate route and regularly.
Adults:
- Metoclopramide oral, 10 mg, 8 hourly as needed.
Children:
- Metoclopramide, oral, 0.1 mg/kg/dose, 8–12 hourly.
|
Weight kg |
Dose mg |
Syrup 5 mg/5 mL |
Age months/years |
|---|---|---|---|
| ˃9–11 kg | 1 mg | 1 mL | ˃12–18 months |
| ˃11–14 kg | 1.2 mg | 1.2 mL | ˃2–3 years |
| ˃14–17.5 kg | 1.6 mg | 1.6 mL | >3–5 years |
| ˃17.5–25 kg | 2 mg | 2 mL | >5–7 years |
| ˃25–35 kg | 3 mg | 3 mL | >7–11 years |
| ˃35–55 kg | 4.5 mg | 4.5 mL | >11–15 years |
Use with caution as extrapyramidal side effects may occur (especially at higher doses).
REFERRAL
- All patients with a diagnosed or suspected underlying cause that requires treatment at a higher level of care.
- Consult a palliative care trained doctor if nausea and vomiting persist despite treatment.