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Ondansetron: Class, Trade Name:
Antiemetic, Ondansetron, Zofran
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Ondansetron Description:
Antiemetic, 5-HT3 antagonist
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Ondansetron Therapeutic Action/Mechanism:
Ondansetron is a selective 5-hydroxytryptamine subtype 3 (5-HT3) antagonist. The 5-HT3 receptor is located in central and peripheralnervous tissue, and on pre and post synaptic neurons. When agonized, anxiety, autonomic nerve activity and emesis occur.
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Ondansetron Uses/ Indications:
Intractable Nausea and /or vomiting unrelieved by patient positioning
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Ondansetron Pharmacokinetics:
- Onset: 5 to 15 minutes IV.
- Peak effect 30 minutes IV
- Duration 4 – 8 hr
- Half-life: 3.5 – 5.5 hr (linear correlation to pt. age)
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Ondansetron Contraindications/ Precautions:
Known sensitivity to ondansetron (Zofran), dolasetron (Anzemet) orpalonosetron (Aloxi).
- Caution with patients taking:
- Antiemetics: Granisetron, Tropisetron. Gastroprokinetics: Alosetron,Batanopride, Metoclopramide (high doses), Renzapride, Zacopride.
Antidepressants: Mianserin, Mirtazapine.
Antipsychotics: Clozapine,Olanzapine, Quetiapine. Others: Memantine (Alzheimer's diseasemedication). These may have additive effects.
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Ondansetron Adverse/ Side Effects:
- CNS: Dizziness
- CV: hypotension, tachycardia, headache, bradycardia, heart block.Over dosage of up to 10 times the normal prescriptive amount has notdemonstrated significant adverse effects.
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Ondansetron Interactions:
May have additive effects with other 5-HT3 receptor antagonists (see list above)
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Ondansetron Adult Dosage:
4 mg IM, PO (dissolvable tablet) or slow IV (over 30 sec) for patients 4 years or older. May repeat with medical directionapproval.
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Ondansetron Pediatric Dosage:
Not used for children under 4 years.
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Ondansetron Administration:
May be administered IM, IV or PO
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Ondansetron Notes:
Protect from light and heat. Pregnancy category B, doses of 4 mg/dayshow no adverse effects on fertility or fetal health
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Oxygen Class, Trade Names:
Gas; Oxygen, Oxygen U.S.P.
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Oxygen Description:
Oxygen is an odorless, tasteless, colorless gas necessary for cellularmetabolic oxidative phosphorylation.
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Oxygen Therapeutic Action/ Mechanism:
Oxygen is required for the efficient breakdown of glucose and othernutrient materials necessary for metabolism. Increased concentrationof oxygen in the alveolus subsequently leads to increased oxygensaturation of hemoglobin.
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Oxygen Uses/Indications:
Hypoxia or suspected hypoxia. Oxygen is indicated in all forms oftrauma, medical emergencies, chest pain, respiratory difficulty,childbirth and for any critical patient
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Oxygen Pharmacokinetics:
- Onset: Immediate.
- Peak effect in < 1 min.
- Duration < 2 min. following termination of delivery.
- Half-life: N/A
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Oxygen Contraindications/Precautions:
- No contraindications
- Oxygen should be used cautiously in patients with chronicobstructive pulmonary disease and in neonates. Prolonged highconcentrations of oxygen in these patients may be harmful.
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Oxygen Adverse/Side Effects:
- CNS: None under normal barometric pressure
- CV: None
- Resp: Prolonged high flow oxygen without humidification may causedrying of mucus membranes. Use humidified oxygen when possible
- GI/GU: None
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Oxygen Interactions:
There are no interactions associated with oxygen administration,however, oxygen may increase the toxicity of certain herbicides suchas paraquat or diquat. Oxygen does support combustion and oxidation.
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Oxygen Adult Dosage:
35% (COPD) - 100%
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Oxygen Pediactric and Neonatal Dosage:
- Pediatric dose: Same as for adult.
- Neonatal dose: Not to exceed 40%
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Oxygen Administration:
Nasal cannula (1-6 lpm - 24-44%), simple facemask(6-10 lpm - 40 – 60%),venturi mask (4-12 lpm - 24-50%), partialrebreather mask (6-10 lpm - 35-60%), non-rebreather mask (6-15 lpm -60 – 95%), BVM (with reservoir) (15 lpm - 40-90/100%)
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Oxygen Notes:
Oxygen administration should be guided by oximetric measurementswhen possible, however, oxygen should not be withheld from dyspneic patients.
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