Therapeutic target
Improvement of symptomatology
Therapy recommendations
- The following are therapy recommendations according to severity.
Severity 1
- Nutritional counseling ev. dietary changes:
- Low-fat
- High in carbohydrates
- Frequent small meals
- Morning meal lying in bed
- Avoid:
- Acidic foods
- Unpleasant odors
- Psychosomatic care, if necessary
- Drug therapy with antiemetics
Severity 2
- Early inpatient admission
- Elimination of possible emesis (vomiting)-inducing stimuli by absolute food abstinence
- Electrolyte substitution (sodium, potassium, calcium).
- Volume substitution about 3,000 ml/die (eg,1,500 ml Ringer’s solution + 1,500 ml glucose solution 5-10% + multivitamin administration).
- Parenteral delivery of carbohydrate and amino acid solution (about 8,000-10,000 kJ/die).
- Antiemetics (drugs against nausea and vomiting, see below).
- Evtl.Sedatives
These therapeutic measures can be reduced with the simultaneous onset of a slow diet, after compensation for exsiccosis (dehydration), as well as electrolyte and other metabolic derailments. The frequency of vomiting should be < 3/die. The following are the agents/drugs used for treatment:
- Vitamin B6 (pyridoxine).
- Antihistamines (medications that attenuate or reverse the effects of the endogenous neurotransmitter histamine by blocking histamine receptors) – such as dimenhydrinate, diphenhydramine, doxylamine, or meclozine
- Antiemetics (medications designed to suppress nausea and vomiting) – such as:
- Dopamine antagonists (domperidone).
- Serotonin antagonists (ondansetron).
If vomiting is refractory to therapy, a trial of diazepam or hydrocortisone may be attempted.
Further notes
- Odansetron use in the first trimester (third trimester of pregnancy) was associated with a slightly increased risk of cleft lip and palate (LKGS clefts). Cardiac malformations (malformations of the heart) and general malformation risk were not increased.
Phytotherapeutics
- Ginger preparations
See also under “Further therapy“.
