Gastric Volvulus Medication

Updated: Mar 08, 2021
  • Author: William W Hope, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Medication Summary

Medications are used in gastric volvulus to treat associated symptoms, most notably pain, nausea, and vomiting. Commonly used pain medications include morphine sulfate and hydromorphone. Commonly used antiemitics include promethazine and ondansetron.



Class Summary

Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and prevents exacerbations in tachycardia and hypertension.

Morphine sulfate (Duramorph, Astramorph, MS Contin, Avinza, Kadian)

Morphine is the drug of choice for narcotic analgesia due to its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. Like fentanyl, morphine sulfate is easily titrated to desired level of pain control.

Morphine sulfate administered IV may be dosed in a number of ways. It is commonly titrated until the desired effect is obtained.

Hydromorphone (Dilaudid)

Hydromorphone is a potent semisynthetic opiate agonist similar in structure to morphine. It is approximately 7-8 times as potent as morphine on mg-to-mg basis, with a shorter or similar duration of action.



Class Summary

As dopamine antagonists, these agents are effective if nausea and vomiting are prominent features. They also may act as prokinetics to increase gastric motility and enhance absorption.

Promethazine (Phenergan, Phenadoz)

Promethazine is a phenothiazine derivative that possesses antihistaminic, sedative, antimotion sickness, antiemetic, and anticholinergic effects.

Ondansetron (Zofran)

Odansetron is a selective 5-HT3-receptor antagonist that blocks serotonin both peripherally and centrally. It prevents nausea and vomiting, including that associated with emetogenic cancer chemotherapy (eg, high-dose cisplatin) and complete body radiotherapy.