Zofran

zofran

I rank Zofran 14 out of the 33 drugs I carry.

Zofran is an anti-emetic. When I started as a medic, we had Dramaine for motion-sickness, nausea. Then we got Reglan, then we got Phenergan, and now (once it went generic) finally we have Zofran. All I can say is Horray for Zofran!

I gave Zofran to more patients (41) last year than any other drug, more than aspirin, more than nitro, more than breathing treatments. It is a excellent drug. I give it to anyone who is vomiting or nauseaous. While it hasn’t worked on every patient, since we got Zofran, it is an extremely rare event that I got vomitted on. And while a few patients may continue to feel nauseous, most say they feel better.

In putting together this list, it is hard to weigh all the variables: does the drug safe lives? does it do something that needs to be done right away? does it make the patient feel better? does it truly work? and often do I use it?

I can’t say that Zofran is a life-saving drug, but it is an excellent comfort drug. It is rare that I am ever nauseous, but the few times I have been, it is a truly awful experience. It makes you feel subhuman, pathetic, and puny. Zofran gives patients their dignity back, in addition to keeping the floor of my ambulance clean.

I keep a stash of Zofran in my bench seat IV tray, next to the Aspirin and Nitro, so it is right there at the handy.

“This should help with your nausea,” I say.

Horray for Zofran!

***

Ondansetron (Zofran)

Class: Antiemetic; Serotonin Receptor Antagonist, 5-HT3

Action: Selectively antagonizes serotonin 5-HT3 receptors

Indication: Nausea; Vomiting

Contraindication: Hypersensitivity to Ondansetron

Precautions: Hypersensitivity to other selective 5-HT3 antagonists
Adverse effects: Headache (40% incidence)
QTc Prolongation
Tachycardia; Anginal chest pain (rare)
Constipation; diarrhea; dry mouth
Dizziness (5% incidence)
Transient Blindness (rare)
Pregnancy Class: B

Adult Dose: 4 mg or Slow IV over 2 – 5 minutes

Pediatric Dose: 0.1 mg/kg (max. single dose of 4 mg) IM or slow IV over 2 –
5 minutes

Routes: Slow IV over 2 – 5 minutes

Notes: Ondansetron causes less sedation and incurs minimal risk of
dystonia as compared to other antiemetics such as
Promethazine (Phenergan ®), prochlorperazine
(Compazine®), or Metoclopramide (Reglan®).

3 Comments

  • Ralph says:

    Peter,

    I do love Zofran. There is an argument here locally about it`s use with ETOH and the famous “drunk college kids” we see a lot. One side of the argument is….”oh, this poor kid, I`ll give Zofran and stop the puking” OR (ER nurse) “Why didn`t you give Zofran!?!?! I don`t want him puking all over my ER, now I have to clean it up”…. (ER doc) “obviously the body wants to rid itself of the poisen, if the airway is patent, don`t give Zofran”….(medic on the car) “man, I don`t want him ralphing in my car, but obviously his body wqants to poisen out” (he`s not butt kissing the ER doc, just voicing his opinion).

    Yes, Zofran should be used more in my region. It`s use goes medic to medic, depending on if a particular medic is too lazy to “crack a box”. Most of the “street wise” medics I work with utilize Zofran a lot. ETOH, sometimes, sometimes NOT. Each call is different, so is each pt and the pt`s needs. If and or when I ever get the medic lisc, I know I`ll be using it a lot. If anything, the pt sees it as we are “doing something” to help.

    I`m just an old dipchit EMT-B coming back to the job after 19 years away. So what I say may not mean much…lol..

  • Laura says:

    Ondansetron to treat opioid addiction – an interesting use -

    http://med.stanford.edu/news_releases/2009/february/opioid.html

  • medicthree says:

    I too use Zofran more than any drug in my truck. Nothing gets me going like a dose of puke on my boots at 3 am…

    My only complaint is when my company buys from a new supplier and the vial changes size and color…

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Peter Canning

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