Ondansetron Versus Dexamethasone/Ondansetron to Treat Acute Nausea in the Emergency Department
Condition: Nausea; Abdominal Pain
MeSH terms: Emergencies; Nausea; Abdominal Pain
Intervention: Ondansetron; Dexamethasone
Intervention description: Patients receive intravenous ondansetron (4mg) followed by two 5ml normal saline flushes; Patients receive intravenous ondansetron(4mg) followed by intravenous dexamethasone (4mg), followed by a single 5ml normal saline flush
Intervention MeSH terms: Dexamethasone; Ondansetron
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Enrollment: 127.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: ondansetron; dexamethasone

Summary:

      Nausea is a common complaint in patients who present to the emergency department (ED).
      Although the number of conditions that can present with nausea are numerous, the mainstay of
      treatment has become intravenous ondansetron (Zofran), not only due to its rapid onset but
      also its availability. One of the major drawbacks to using this form is that it often needs
      to be redosed. This study aims to compare intravenous (IV) ondansetron alone versus IV
      ondansetron given with IV dexamethasone (Decadron) as another viable option when treating
      patients with nausea in the emergency department.

      Previous studies in patients undergoing surgical procedures have shown that when IV
      dexamethasone is given with IV ondansetron to post-operative patients they have less nausea
      and vomiting than ondansetron alone, and were even found to show decreased post-operative
      pain associated with nausea. It has also been shown to decrease the need to re-dose
      antiemetic medication. Although this combination has not been tested in the emergency
      department it is believed by these investigators that the additional use of dexamethasone may
      decrease the need to use repeated doses of ondansetron.

      The investigators believe this may change the way physicians currently approach the nauseated
      patient in regards to treatment. That rather than possibly giving multiple doses of one
      medication over and over to reduce a patient's nausea, physicians can give two medications
      together at one time. The investigators hope to demonstrate that by giving intravenous
      dexamethasone and ondansetron together, it may be possible to reduce the number of patients
      who need additional doses of nausea medication.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Chief Complaint of nausea or abdominal pain with nausea

          -  Inability to tolerate oral nausea medication

          -  Patients with a negative pregnancy test

        Exclusion Criteria:

          -  Patients younger than 18 years of age

          -  Patient's chief complaint includes headache, chest pain, or dizziness

          -  Patients with whom there are contraindications to using the studied medicine
             (allergies, known adrenal disease)

          -  Blood sugar greater than 300

          -  Non-English speaking subjects