Research forum abstractPoster session 2: Pharmacology126: Safety and Effectiveness of Intravenous Low-Dose Prochlorperazine for Nausea and Vomiting in the Emergency Department
Section snippets
Study Objectives
Prochlorperazine (PCZ) has been accepted as an effective antiemetic for more than 50 years, although its therapeutic success has been limited by the akathisia that occurs frequently with intravenous (IV) use. Slow infusion of PCZ does not decrease the incidence of these adverse effects. However, no studies have been done to determine whether the incidence of akathisia is reduced by decreasing the dose of PCZ. The purpose of this pilot study was to determine if reducing the IV dose of CPZ
Methods
The design was a prospective, descriptive study set in an academic, tertiary-care medical center over a one-week study period. All adult patients (> 18 years) who received IV CPZ for treatment of nausea/vomiting were enrolled in the study. The initial dosage of PCZ (2.5-10 mg) was chosen at the discretion of the treating clinician and infused by slow intravenous injection at a rate not exceeding 5 mg/minute. Primary endpoints were akathisia (defined as a strong subjective feeling of
Results
A total of 93 patients were enrolled, representing 8% of the adults presenting to the ED during the study period. Sixty-seven patients (72%) were initially treated with 2.5 mg PCZ, eleven (12%) received 5mg PCZ, and 15 (16%) received a 10 mg dose. Nine patients (13%) given low-dose PCZ required a second dose to control nausea. Six patients (6%) required another antiemetic and were considered treatment failures. Only two patients (2%) experienced akathisia in the ED, both had received a 10 mg
Conclusion
This is the first clinical study to demonstrate that low-dose (2.5 mg) prochlorperazine is an effective antiemetic. Despite the small sample size, data suggests that this dose is results in a much smaller incidence of akathisia.