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Antiemetics & Children

Antiemetics in children are controversial. Antiemetics are medications that are used to reduce nausea and vomiting symptoms in children and adults. However, they are primarily intended for use in adults. Continued nausea and vomiting that is the result of postoperative reaction to anesthesia, gastroenteritis and influenza can result in dehydration and severe negative health outcomes for patients experiencing these symptoms. Often, doctors who prescribe antiemetics for children are doing so off-label and against the recommendation of the American Academy of Pediatrics.

  1. Identification

    • According to a study printed in the Journal of Emergency, Trauma and Shock by Jacob Manteufell, M.D., antiemetics are medications that are given when individuals cannot stop vomiting or when acute nausea is present. Antiemetics stop the neuotransmitters that send the messages to the brain that induce nausea and vomiting and settle the stomach. These are also medications that are commonly prescribed to help with the nausea and vomiting associated with chemotherapy.

    Symptoms

    • Antiemetics are prescribed as a result of acute nausea and vomiting. According to an article by Zachary Flake, M.D., Robert D. Scalley Pharm D. and Austin G. Bailey, M.D. of the American Academy of Family Physicians, the process that triggers nausea and vomiting is that either dopamine or histamine acetylcholine induced. These are two neurotransmitters that are produced by the brain and produce the feeling of nausea or the need to vomit.

    Controversy

    • According to Jacob Manteufell, M.D., the majority of antiemetics that are available on the market today are what are known as "black box" medications. This means that they have a medical warning on them; in this case, the medical warning is that they should not be used in patients younger than 2 years of age. However, it is not uncommon for doctors to use these medications with children as young as one year old. This is where the controversy lies--the American Academy of Pediatrics and the FDA do not recommend antiemetics be used on very young children and infants. However, many doctors find them helpful and effective for children this young.

    Medications

    • The choice of what mediation to prescribe and use is largely determined by the specific symptoms that a patient is experiencing. According to Dr. Flake and colleagues, if a patient is experiencing headache along with nausea, the correct medication is Regalan or Compozine. If a patient is experiencing gastroenteritis, either of these drugs would also be appropriate, if controversial. If a patient is experiencing postoperative nausea and vomiting, then the appropriate medication would be Inapsine.

    Side Effects

    • According to Dr Flake and colleagues, there are significant side effects from using antiemetics in children. Common side effects include sedation, urinary retention, blurred vision, seizures, changes to heart rate and high blood pressure. Before prescribing these medications, it is important for a doctor to throughout discuss the potential side effects and negative consequences of using antiemetrics in children.

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