If an etiology is identified, a targeted therapy can be provided; however, delays in evaluation may require empiric treatment for patient comfort. 1 It is reasonable to begin with a trial of a phenothiazine, such as prochlorperazine, because these medications are effective in a range of clinical situations. A trial of a prokinetic agent (., metoclopramide [Reglan]) may then be beneficial. Serotonin antagonists (., ondansetron [Zofran]) are effective and are better tolerated than phenothiazines and prokinetics, but their high cost (approximately $20 per dose, even for the recently approved generic ondansetron) makes long-term use impractical. Trials determining the specific effectiveness of medications for nausea and vomiting are limited; therefore, a trial of any medication may be reasonable on an individual basis. 1 Antiemetic agents commonly used for nausea and vomiting are listed in Table 4 1 , 2 , 6 ; therapies for known etiologies of nausea and vomiting are listed in Table 5 2 , 20 – 26 ; and alternative therapies are listed in Table 6 . 22 , 27 – 29
There are no well controlled studies with HALDOL (haloperidol) in pregnant women. There are reports, however, of cases of limb malformations observed following maternal use of HALDOL along with other drugs which have suspected teratogenic potential during the first trimester of pregnancy. Causal relationships were not established in these cases. Since such experience does not exclude the possibility of fetal damage due to HALDOL, this drug should be used during pregnancy or in women likely to become pregnant only if the benefit clearly justifies a potential risk to the fetus. Infants should not be nursed during drug treatment.