1,2 Due to the high fructose and glucose content, patients with hereditary fructose intolerance and diabetes should not use phosphorated carbohydrate solutions. To maximize the effectiveness of this product, it should not be diluted. 1 Patients should be advised to take the recommended dosage at 15-minute intervals until symptoms subside, not to exceed 1 hour or >5 doses. 1 Phosphorated carbohydrate solutions can also be used to relieve symptoms of nausea and vomiting associated with upset stomach caused by viral gastroenteritis and motion sickness. Often products such as antacids, H 2-receptor antagonists, bis- muth subsalicylate, and phosphorated carbohydrate solution can be used to relieve the symptoms of nausea associated with food overindulgence. In some cases, nausea and vomiting can be attributed to excessive or disagreeable food or beverage ingestion. Per 15 mL: dextrose 4.35 g, levulose 4.17 g, sodium citrate dihydrate 0.921 g Per 5 mL: phosphoric acid 21.5 mg, dextrose 1.87 g, fructose 1.87 g Table 1: Examples of OTC Antiemetic Products The use of antihistamines may cause paradoxical stimulation and agitation in the pediatric population, as well as confusion among geriatric patients. 1 Patients should be cautioned about the increased sedative effect that may occur when antihistamines are used in conjunction with central nervous system depressants, such as alcohol, tranquilizers, and hypnotics. Patients with certain medical conditions, such as asthma, narrow angle glaucoma, or benign prostatic hypertrophy, should be counseled not to use these products unless directed by their physician. During counseling, they should also be made aware of the possible adverse effects associated with the use of these products, such as drowsiness, blurred vision, dry mouth, and urinary retention. Patients should be advised to take these products at least 30 to 60 minutes before travel to allow sufficient time for onset of action. OTC antihistamines indicated for the prevention and treatment of nausea, vomiting, and dizziness associated with motion sickness include meclizine, cyclizine, dimenhydrinate, and diphenhydramine (Table 1). Factors to consider when selecting an OTC product include the age of the patient, whether patient is pregnant or lactating, other medical conditions, and the patient’s current medication profile. Patients experiencing severe nausea and vomiting should be referred for further medical evaluation. OTC products should only be used to prevent or treat the symptoms of mild, occasional, self-treatable episodes of nausea and vomiting. 1 In addition, a host of complementary/alternative products, such as ginger, peppermint, chamomile, and other botanical products, are also often used for the treatment of nausea and vomiting. Acupressure wristbands are indicated for relief of nausea, vomiting, motion sickness, and overeating. Various nonpharmacologic products, such as Sea-Band and BioBands wristbands, which use the principles of acupressure, are also available for the treatment of nausea and vomiting. OTC products for the treatment of nausea and vomiting include antihistamines, bismuth subsalicylate, antacids, histamine 2 (H 2)- receptor antagonists, and phosphorated carbohydrate solution. Occasional nausea and vomiting can be prevented and treated with OTC therapy.įor an individual experiencing episodes of nausea and vomiting, finding immediate relief is a top priority.
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