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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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I am having trouble finding an anti nausea/anti vomiting med

Customer Question

I am having trouble finding an anti nausea/anti vomiting med for my daughter. She has a long history of gastroparesis and chronic constipation. She has a horrible track record with absorption, so oral medications (even though she takes a slew of them) are not reliable as system of delivery. Complicating matters, she as a propensity for a prolonged QTC, thereby eliminating an old standby, Zofran iv or sublingual. She has a mediport and has access to home nurses to provide weekly dressing changes or she can go to our local infusion center. Weve discussed this at length with her GI doc and has directed his nurses to research possible options and determine their availability. Im not terribly confident that
JA: What medications do you take daily? Are you allergic to any medications?
Customer: linzess, pot choloride, dilaudid, amatiza, Colace, vit d, armour thyroid, midodrine (postural orthostatic hypotension) reglan, vit b, turmeric, alpha lipoic acid, vit b-12, creon (also have chronic pancreatitis) sodium chloride tabs bid, titanzanine (sp?, muscle relaxer) albuterol, insulin pump
JA: Anything else in your medical history you think the doctor should know?
Customer: diabetes (type 1) since2004 ; Hashimoto's hypothyroid since 2004; gastroparesis six months prior to onset of IDDM, chronic consitipation, ewing sarcoma resulting in BKA in 2012; petscans clear as of 1/13
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. David replied 11 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 11 months ago.

ondasatron has only a small chance for prolonging QT prolongation.

has she tried promethazine or prochlorperazine which can help with nausea?

Customer: replied 11 months ago.
isn't prochlorperazine another name for Compazine? She takes that now, alternating with reglan, but we've found many of these, completely intact, in her stools. There is no rhyme or reason to what she actually absorbs. That's why we're looking for something that is sublingual, via iv, or by injection so that we can be sure it's getting into her system.
Expert:  Dr. David replied 11 months ago.

she may not have enough stomach acid to be breaking down her medication.

is she on stomach acid blockers? protonix? nexium? omeprazole? these can reduce stomach acid and make her not properly digest foods. we need stomach acid to break down foods for absorption.

diabetes can damage nerves which help the stomach work properly.

there are implantable stomach stimulating medications which could help her gastroparesis work better

compazine can be given via rectal suppository form to be absorbed through the veins in the rectum which could be better than oral pills.