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Chlorpromazine–ketamine combo provides rapid relief of nausea, vomiting

07 Oct 2019

Use of the combination of chlorpromazine plus ketamine leads to rapid, definitive cessation of symptoms in patients presenting with intractable nausea and vomiting, as shown in a recent study.

The study population comprised 28 patients with unexplained nausea and vomiting. They presented with severe symptoms, such that median scores of pain and nausea were both 10. Most of the patients (n=23; 82 percent) reported using cannabis at least weekly, with 19 reporting daily use.

All patients were given slow intravenous infusion of ketamine 15 mg and chlorpromazine 12.5 mg over 15 minutes. Following treatment, the mean pain score decreased by 4.1 (95 percent CI, 3.2–5.0) over 120 minutes. Mean nausea score, on the other hand, dropped by 4.9 (4.0–5.8).

The treatment protocol was safe, and there were no adverse events recorded. All 28 patients were very satisfied with the medications, saying that they would want to receive them again.

The findings indicate that the combination of chlorpromazine plus ketamine may be used to treat nausea and vomiting without the need for opioids or benzodiazepines, researchers said.

A dopamine antagonist antiemetic, chlorpromazine was originally used to treat neurosis (sedation in psychiatric patients) and as preanaesthetic medication, inhibiting nausea, vomiting and shock. It also enhances the effects of anaesthetics and ketamine. [Front Pharmacol 2018;9:913]

Ketamine, on the other hand, is a nonopioid analgesic that has distinct sympathomimetic, vagolytic pharmacological properties. The substance is commonly used for analgesia and sedation. [Egypt J Anaesth 2012;28:169-174]

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Most Read Articles
Pearl Toh, 10 Oct 2019
Adding a LAMA* to the double combination therapy of ICS** plus LABA*** in a single inhaler improves lung function and reduces exacerbations in patients whose asthma is inadequately controlled with the combination treatment, according to the TRIMARAN and TRIGGER# studies presented at ERS 2019.
23 hours ago
Environmental quality and exposure to pollution may play a small part in the development of metabolic diseases, such as diabetes, a new study has found.
Tristan Manalac, 2 days ago
Sleep deprivation impairs adolescents’ long-term retention of classroom material, according to a recent Singapore study.
4 days ago
Eating alone may help in weight management as findings of a recent study suggest that eating with friends lead to higher food intake.