From the FDA Drug Label
In general, dosages in the lower range are sufficient for most elderly patients. Since they appear to be more susceptible to hypotension and neuromuscular reactions, such patients should be observed closely Dosage should be tailored to the individual, response carefully monitored, and dosage adjusted accordingly. TO CONTROL SEVERE NAUSEA AND VOMITING Adjust dosage to the response of the individual. Begin with lowest recommended dosage IM Dosage Initially 5 mg to 10 mg (1 to 2 mL) injected deeply into the upper, outer quadrant of the buttock.
The recommended IM antinausea medication for a 96-year-old male is prochlorperazine. The initial dose should be 5 mg to 10 mg injected deeply into the upper, outer quadrant of the buttock, and repeated every 3 or 4 hours if necessary, with a maximum total IM dosage of 40 mg per day 1.
From the Research
For a 96-year-old male requiring IM antinausea medication, prochlorperazine 5-10 mg IM is recommended as a first-line option due to its efficacy and cost-effectiveness, as evidenced by a study comparing ondansetron and prochlorperazine for the prevention of postoperative nausea and vomiting 2. The choice of medication should be based on the patient's specific needs and medical history. Considerations should include the potential for extrapyramidal side effects with prochlorperazine, as well as the patient's renal function, hepatic function, and current medications to avoid drug interactions. Key points to consider when selecting an IM antinausea medication for this patient include:
- Efficacy in preventing nausea and vomiting
- Potential side effects, such as extrapyramidal symptoms
- Cost-effectiveness
- Patient's medical history and current medications
- Renal and hepatic function Non-pharmacological approaches, such as proper positioning, small frequent meals, and adequate hydration, should also be implemented alongside medication to help manage nausea and vomiting. It is essential to investigate and address the underlying cause of nausea, as medication is primarily for symptomatic relief. In cases where prochlorperazine is not suitable, other options like haloperidol or ondansetron may be considered, taking into account their respective efficacy, safety profiles, and potential interactions 3, 4, 5, 6.