The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 7: Gastrointestinal SymptomsTable 7-3: Antiemetic AgentsDrug Class26 picasButyrophenonesPhenothiazinesDrug and DosageHaloperidol: 0.5 to 2.0 mg 2 to 4 times/day(may be given PO or IM)Prochlorperazine: 5 to 10 mg q 6 to 8 hours(may be administered IV, rectally or PO)Promethazine: 12.5 to 25 mg q 4 to 6 hours(may be administered IV, rectally, PO or SC)Substituted BenzamidesMetoclopramide: 5 to 10 mg q 4 to 6 hours(may be administered IV, PO or SC)VIISerotonin AntagonistsAnticholinergic AgentsAntihistaminesOndansetron: 4 to 8 mg PO or IV q 8 to 12 hoursGranisetron: 1 to 2 mg PO or 10 mg/kg IVq 12 hoursDolasetron: 50 to 100mg PO or 12.5to 100mg IV qdScopolamine: 1.5 mg transdermal patch q 3 daysCyclizine: 50 mg PO q 4 to 6 hoursDiphenhydramine: 25 to 50 mg q 4 to 6 hoursHydroxyzine: 25 to 100 mg 3 to 4 times a dayMeclizine: 25 to 100 mg daily in divided dosesGlucocorticoids Dexamethasone: 4 to 12 mg/day in 3 to 4divided dosesCannabinoidsBenzodiazepinesDronabinol: 5 mg 3 times/dayLorazepam: 0.5-2.0 mg q 4 to 6 hoursDysphagia and odynophagia are important symptoms that must be addressed aggressively in thepalliative care setting. If inadequately managed, these symptoms will likely cause a significantdiminution in the patient’s quality of life and lead to other complications such as anorexia,weight loss, malnutrition and the inability to take oral medications. Almost all esophageal infectionsin patients with AIDS are treatable and in many instances palliation of symptoms will bebest achieved by treating the underlying disorder; attempts at symptom amelioration that fail toaddress the underlying pathology will often be unsuccessful.U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 163