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…

1 Trackback

Leave a Reply

Your email address will not be published. Required fields are marked *

background image Blogger Img

Peter Canning

JEMS Talk: Google Hangout

Recent Posts
Lights and Sirens December 20, 2014
Thoughts on Ebola October 23, 2014
STEMI Call October 14, 2014
Ebola October 2, 2014
Categories
  • ems-health-safety (7)
  • ems-topics (698)
  • hazmat (1)
  • Uncategorized (413)
  • Comments
    Josh
    EMS Drugs
    Great list. I was surprised to see Fentanyl left off the list since it seems to have become the go to prehospital analgesic over Morphine. I have been in EMS for 7 years and a medic for about a year and have seen/given Fentanyl far more often than Morphine for pain.
    2014-12-20 10:58:42
    EMS Artifact
    STEMI Call
    Medical calls are just far more interesting and challenging than trauma calls. I've heard of, but never seen anyone use Cabrera format. It certainly can throw you off if you're not looking very carefully. As to the rest of the call, sometimes nothing seems to go right. You did your job, you're not responsible for…
    2014-12-03 23:27:43
    Jordan Collins
    Morphine
    I know this is from a while ago but I like reviewing your drug rankings. I have found, even in the 10-15mg range, Morphine has little effect on pain. I would estimate maybe 1 in 5 patients feels any sort of pain relief. It's frustrating not getting people their relief, while jumping through all of…
    2014-12-02 22:46:44
    Karim
    STEMI Call
    Patients make liars out of paramedics! And yeah, sometimes the cath lab nurses are so mean.
    2014-11-29 15:17:55
    Dan
    STEMI Call
    Initially I thought my eyes were deceiving me while reading the ECG until I figured it out. I've run similar atypical STEMIs. Good job! Interesting blog!
    2014-11-26 20:52:20

    Now Available: Mortal Men

    Mortal Men is available as an electronic book for Kindle, Nook or any other e-reader. Here is a link to some of the places to buy it. The book sells for $3.99. Barnes and Noble Amazon Smashwords Scribd Also Available from iBooks

    Order My Books

    Support EMS Bloggers, Buy Their Books

    Google

    Order Books and Movies

    FireEMS Blogs eNewsletter

    Sign-up to receive our free monthly eNewsletter

    LATEST EMS NEWS

    HOT FORUM DISCUSSIONS