dolasetron
dolasetron
[do-las´ĕ-tron]dolasetron
(dol-a-se-tron) dolasetron,Anzemet
(trade name)Classification
Therapeutic: antiemeticsPharmacologic: five ht3 antagonists
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (antiemetic effect)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| PO | unknown | 1–2 hr | up to 24 hr |
| IV | unknown | 15–30 min | up to 24 hr |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- headache (increased in cancer patients)
- dizziness
- fatigue
- syncope
Cardiovascular
- cardiac arrest (life-threatening)
- torsade de pointes (life-threatening)
- ventricular arrhythmias (life-threatening)
- bradycardia
- heart block
- hypertension
- hypotension
- PR interval prolongation
- QRS interval prolongation
- QT interval prolongation
- tachycardia
Gastrointestinal
- diarrhea
- dyspepsia
Genitourinary
- oliguria
Dermatologic
- pruritus
Miscellaneous
- chills
- fever
- pain
Interactions
Drug-Drug interaction
Concurrent diuretic or antiarrhythmic therapy or cumulative high-dose anthracycline therapy may ↑ risk of conduction abnormalities.Blood levels and effects of hydrodolasteron are ↑ by atenolol and cimetidine.Blood levels and effects of hydrodolasetron are ↓ by rifampin.↑ risk of QT interval prolongation with other agents causing QT interval prolongation.Route/Dosage
Prevention of Chemotherapy-Induced Nausea/VomitingAvailability
Nursing implications
Nursing assessment
- Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and after administration.
- Monitor vital signs after administration. IV administration may be followed by severe hypotension, bradycardia, and syncope.
- Monitor ECG in patients with HF, bradycardia, underlying heart disease, renal impairment, and elderly patients.
- Lab Test Considerations: Monitor serum potassium and magnesium prior to and periodically during therapy.
Potential Nursing Diagnoses
Imbalanced nutrition: less than body requirements (Indications)Implementation
- Do not confuse Anzemet with Avandamet.
- Oral: Administer within 1 hr before chemotherapy.
- Injectable dolasetron may be mixed in apple or apple-grape juice for oral dosing for pediatric patients. Recommended oral dose in patients 2 to 16 yr of age is 1.2 mg/kg (maximum 100 mg) given within 2 hr before surgery. The diluted product may be kept up to 2 hr at room temperature before use. May be stored at room temperature for 2 hr before use.
Intravenous Administration
- Correct hypokalemia and hypomagnesemia before administering.
- Intravenous: Administer 15 min before cessation of anesthesia, or postoperatively if nausea and vomiting occur shortly after surgery.
- Diluent: May be administered undiluted.Concentration: 20 mg/mL.
- Rate: Administer 100 mg over at least 30 sec.
- Intermittent Infusion: Diluent: May be diluted in 50 mL of 0.9% NaCl, D5W, dextrose/saline combinations, D5/LR, LR, or 10% mannitol solution. Solution is clear and colorless. Stable for 24 hr at room temperature or 48 hr if refrigerated after dilution.
- Rate: Administer each dose as an IV infusion over up to 15 min.
- Y-Site Compatibility: acetaminophen, alfentanil, amifostine, amikacin, amiodarone, anidulafungin, argatroban, aztreonam, bivalirudin, bleomycin, bumetanide, buprenorphine, busulfan, butorphanol, calcium chloride, calcium gluconate, carboplatin, carmustine, caspofungin, ceftazidime, chlorpromazine, ciprofloxacin, cisplatin, clindamycin, cyclophosphamide, cyclosporine, cytarabine, daptomycin, dacarbazine, dactinomycin, daptomycin, daunorubicin, dexmedetomidine, dexrazoxane, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doxacurium, doxorubicin hydrochloride, doxycycline, enalaprilat, ephedrine, epinephrine, epirubicin, epfitibatide, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, gemcitabine, gentamicin, haloperidol, hetastarch, hydromorphone, idarubicin, ifosfamide, imipenem/cilastatin, irinotecan, isoproterenol, leucovorin caclium, levofloxacin, levorphanol, lidocaine, linezolid, lorazepam, magnesium sulfate, mannitol, mechlorethamine, meperidine, mesna, methotrexate, metoclopramide, metronidazole, midazolam, milrinone, mitomycin, mitoxantrone, morphine, moxifloxacin, mycophenolate, nalbuphine, naloxone, nesiritide, nicardipine, nitroglycerin, nitroprusside, octreotide, oxaliplatin, oxytocin, paclitaxel, pamidronate, pancuronium, pemetrexed, pentamidine, phenylephrine, potassium acetate, potassium chloride, procainamide, prochlorperazine, promethazine, propranolol, quinupristin/dalfopristin, ranitidine, rocuronium, sodium acetate, streptzocin, sufentanil, tacrolimus, teniposide, theophylline, thiopental, thiotepa, tigecycline, tirofiban, tobramycin, vancomycin, vecuronium, verapamil, vinblastine, vincristine, vinorelbine, voriconazole, zidovudine, zoledronic acid
- Y-Site Incompatibility: Manufacturer recommends not admixing with other medicationsacyclovir, alemtuzumab, aminocaproic acid, aminiphylline, amphotericin B colloidal, amphotericin B lipid complex, amphotericin B liposome, pantoprazole
Patient/Family Teaching
- Advise patient to notify health care professional if nausea or vomiting occurs.
- Advise patient to notify health care professional symptoms of abnormal heart rate or rhythm (racing heart beat, shortness of breath, dizziness, fainting) occur.
Evaluation/Desired Outcomes
- Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy.
- Prevention and treatment of postoperative nausea and vomiting.