Nausea and vomiting are common in palliative care but they are not diagnoses in themselves.
In this episode, we look at how to work backwards from the symptom and ask what is actually causing it. Gastric stasis, opioids, constipation, metabolic disturbances, vestibular problems, raised intracranial pressure and bowel obstruction can all cause nausea and they do not all need the same treatment.
We unpack where commonly used antiemetics such as metoclopramide, haloperidol, ondansetron, prochlorperazine and cyclizine fit, why metoclopramide can be helpful in gastric stasis but problematic in complete bowel obstruction, and why route of administration matters when oral medicines are no longer reliable.
As always, we finish with reflective questions for clinicians using the episode as part of their CPD.
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