Generic Name: Ondansetron Trade name: Zofran

Pharmacologic Class: Antiemetic, 5-HT Receptor Antagonist Usual dose:

PO: 4-8 mg, higher for chemo-induced N/V (up to 24 mg)
IV/IM: 4 mg
IV push: over 2-5 mins (slower the better)
*not to exceed 8 mg per day in patients with hepatic
impairment

Action (What does it do? How long does it take to work?): Uses for this medication: prevents nausea & vomiting (caused
Serotonin 5-HT3 receptor antagonist - works by blocking the by cancer chemotherapy, radiation therapy, surgery),
action of serotonin, a natural substance that may cause nausea gastroenteritis
and vomiting

Common side effects: drowsiness/sedation, dizziness, headache, constipation, agitation, loss of appetite, hyperexcitability (Peds)

Serious side effects: serotonin syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis (TENS)

Clinical Judgment
Pre-administration assessment: What should the nurse assess before administering the medication?
- Hx of liver concerns & liver function tests (ALT & AST – when high in blood indicate liver damage)
- GI assessment: degree of N/V, abdominal distension
- EKG & electrolyte abnormalities (hypokalemia or hypomagnesemia)
- Vital signs, Fluid balance (I/O)

How will the nurse know if it is appropriate to administer?

- Presence of N/V, no medication contraindications, within safe dosage range, no hepatic impairment, no hypokalemia or
hypomagnesemia, no drug allergies

Post- administration assessment: What should the nurse assess after administering the medication? How will you know if the
medication is effective?
- Monitor improvements in GI symptoms (decreased N/V, increased appetite)
- Monitor ECG in clients with electrolyte abnormalities
- Monitor for S&S of serotonin syndrome (hallucinations, mental status change)
- Assess motor function and report any extrapyramidal reactions (tardive dyskinesia, pseudo parkinsonism, akathisia,
dystonia)
- Assess dizziness and drowsiness that might affect gait, balance, other functional activities

Nursing considerations:
- Older clients may become drowsy  Falls risk
- *SAFETY CRITCAL: Rapid IV infusion causes fatal dysrhythmias (IV push > 5 mins, 6-8 mins)
- Use with apomorphine increases risk of severe hypotension and loss of consciousness – contraindicated
- Advise client to notify physician of irregular heartbeat, serotonin syndrome, or involuntary movement of eyes, face,
limbs
- Drugs that prolong QT intervals may result in ventricular arrhythmias when used with this drug
- Be careful to only touch the disintegrating tablet with dry hands, otherwise it will start to dissolve
- Do not swallow disintegrating tablets or films – dissolve and swallow with saliva
- Give tablets 30 min prior to chemotherapy and 1–2 h prior to radiation therapy
- Do NOT push orally disintegrating tablet through blister foil. Peel foil back and remove tablet. Tablets will disintegrate
with/without liquid