Ondansetron/pantoprazole/sodium chloride
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Lack of efficacy: case report A 40-year-old man exhibited lack of efficacy during treatment with ondansetron, pantoprazole and sodium chloride for vomiting, abdominal pain and hyponatraemia, respectively [not all routes stated; frequencies not stated]. The man presented to the emergency department with chief complaints of vomiting and generalised abdominal pain mostly in the epigastric region and generalised weakness. He described the pain as cramping and had vomited eight times on the day of presentation. He said, he was afraid to drink water due to fear of vomiting. He denied fever or diarrhoea and had no recent travel or sick contacts at home. He denied any medical history, but his social history was positive for cannabis consumption for 20 years. He had momentary symptom relief with hot showers. He had presented to emergency department 3 times in the current month for the same symptoms. His most recent visit was 24 hours prior. He returned for persistent abdominal pain and vomiting inspite taking home medications pantoprazole [Protonix] 40mg and oral disintegrating/dissolving tablet ondansetron [Zofran] 8mg. He was in moderate distress. He was noted with non-bloody non-bilious vomit. He was found to have hyponatraemia and mild dehydration, which was consistent with a likely decreased oral intake. He received IV sodium chloride [NS] 0.9% fluid bolus twice, IV pantoprazole [Protonix] 80mg and IV ondansetron 8mg in the emergency department. In spite of maximal treatment, he had intractable vomiting and abdominal pain. Thus, he was planned to be admitted for IV fluid resuscitation and further evaluation of retractable vomiting with hyponatraemia. On admission, he was diagnosed with cannabinoid hyperemesis syndrome. Abrams T, et al. Marijuana Use: Early Recognition for a Cannabinoid Hyperemesis Syndrome. Advanced Emergency Nursing Journal 42: 30-36, No. 1, Jan-Mar 2020. 803518110 Available from: URL: http://doi.org/10.1097/TME.0000000000000283
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Reactions 28 Nov 2020 No. 1832
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