Mon22November0925AM 10

A 57-year-old woman with Parkinson's Disease complains of nausea shortly after waking from a general anaesthetic for a minor gynaecological procedure.

Which of the following is the most appropriate anti-emetic to prescribe?

(Please select 1 option)

Intravenous droperidol 12.5mg

Intravenous haloperidol 2.5mg

Intramuscular cyclizine 50mg Correct

Intramuscular prochlorperazine

Intravenous metoclopramide 10mg

Explanation

Haloperidol, metoclopramide, prochlorperazine and droperidol reduce post-operative nausea and vomiting (PONV) by inhibiting the release of dopamine from within the brain. Suppressing this in patients with Parkinson's Disease may exacerbate their condition. Since cyclizine is a histamine (H1) receptor antagonist and does not cross the blood brain barrier, it can be used safely in these patients.