How can PONV and PDNV be prevented or treated?

A variety of medications can be used to prevent PONV and PDNV. These medications may also be used to treat PONV and PDNV if they occur. Because PDNV occurs after hospital discharge, medications for PDNV can be convenient for use if needed at home.

Medications that are used to prevent and treat nausea are called "antiemetics." In people at high risk of PONV and PDNV, a combination of two different antiemetics is usually used to prevent PONV and PDNV. In people at lower risk, a single medication is often used.

There are many different types of antiemetics. These medications work by interrupting the natural processes involved in nausea and vomiting.

Selective serotonin (5HT3) antagonists, such as ondansetron, granisetron, and dolasetron are available in both injectable and tablet forms. The main side effects are headache, constipation, and flushing.

Dexamethasone, a corticosteroid, may be used in combination with antiemetics such as 5HT3 antagonists for added benefits in people with a high risk of PONV and PDNV. Dexamethasone is available in injection and tablet forms. The main short-term side effects include stomach discomfort, mood changes, metallic taste, increased blood sugar, and headache. If used for a long period of time, corticosteroids can cause more severe side effects, including osteoporosis, decreased immune function, stomach ulcers, and possibly cataracts.

Antihistamines, such as dimenhydrinate, can be given by mouth, rectally, or by injection. Dimenhydrinate taken by mouth is available over the counter (without a prescription) and may be used at home. Its main side effects include drowsiness, dry mouth, and constipation. Since it can cause drowsiness, it can affect a person's ability to drive and perform other activities requiring alertness.

Anticholinergics, such as scopolamine, are another type of antiemetic. Scopolamine is available as an injection or as a disc. The disc may be used at home. It is applied to the skin behind the ear. Its main side effects include drowsiness, dry mouth, difficulty urinating, and skin rash.

Dopamine antagonists, such as metoclopramide, are a type of antiemetic that helps food move through the stomach more quickly. Metoclopramide is given by mouth or as an injection. Its main side effects are drowsiness, dizziness, and headache. Less commonly, it can also cause a more severe type of side effect known as extrapyramidal symptoms (EPS). These include restlessness, grimacing, eye rolling, trouble swallowing, slowed movement, tremors, and rigidity.

Prevention of PONV is not effective for everyone. If you have experienced PONV or think you are more prone to it than most people, consult with your doctor about what is appropriate for you.

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