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Professional Management
Reviewed: December 2006
 Because nausea and vomiting can have serious medical consequences, it is important that you keep your doctor, nurse or pharmacist informed about your physical condition at all times.
If nausea and vomiting become very bad, you may need to visit the clinic for medications. Sometimes your doctor will also order blood tests and x-ray films to find out why you are vomiting. Most of the time your doctor and nurse will be able to get your vomiting under control and you can take medication to manage it.
Communication is Key
Always tell your doctor, nurse, or pharmacist about any unusual or disturbing symptoms that you experience. As with pain, each person has a different response to nausea. Even at different times and under different circumstances you may feel varying levels of nausea with the same condition.
Communication with your health care team and family is necessary for best nausea management. The use of a consistent nausea scale (0 = no nausea, 10 = worst nausea imaginable) helps to best communicate the intensity of nausea a patient experiences.
|
Nausea Intensity Scale |
| 0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| I l l |
| No Nausea Moderate Nausea Worst Nausea |
Other Important Questions
- When did the nausea begin?
- What have you tried to relieve the nausea?
- What makes your nausea worse?
- Describe what your vomit looks like?
- When was your last bowel movement?
- Do you feel bloated?
- Are you passing gas?
- Is your nausea associated with meals, or any of the medications you are taking?
Medications for Nausea/ Vomiting
As with pain, nausea is managed in accordance with what is causing it. Nausea can be caused by:
- Gastric stasis - happens often with taking opioid medications - the digestive system slows down, and undigested food can sit in the stomach for much longer than usual causing bloating and nausea
- Toxins in the blood - cancer growth, cancer decay due to the cancer treatment working, and some medications release chemicals into the blood that cause people to feel nauseated
- Movement - some people are sensitive to movement (like sea-sickness)
- Other - increased pressure in the head caused by cancer growth, hypersensitivity to sights and smells.
Your care team will spend some time trying to find out what makes you nauseated to match the right medication with the right cause. Often, patient's nausea will be caused by more than one thing, therefore you may need to be treated with more than one medication. Here are a list of some medications used for nausea:
Ondansetron - used mostly for acute nausea caused by chemotherapy which tends to last for 2-3 days. Very expensive, and usually sent home with the patient after their treatment.
Metoclopramide - used mostly for chronic nausea caused by chemotherapy, or for nausea related to gastric statis caused by opioids.
Haloperidol or prochlorperazine - used for nausea caused by chemical toxins in the blood.
Gravol - used mostly for nausea caused by movement, but is also helpful for nausea caused by toxins in the blood.
Cannabinoids - derivatives from marijuana (real or synthetic) - used to modify the brains response to the vomiting signal.
The BC Cancer Agency maintains a database on commonly used unconventional therapies available to cancer patients.
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