Aprepitant to control nausea and vomiting in the Pediatric ICU setting

Abstract

During critical illness, various secondary end-organ ad- verse effects may occur related to the primary disease process, secondary end-organ involvement, or treatment regimens. Nausea and vomiting may be a particularly disturbing secondary symptom in the critically ill patient. While the pathogenesis is frequently multifactorial and an exact etiology difficult to determine, symptomatic treatment is frequently employed. We present anecdotal experience with the successful use of the novel anti- emetic agent, aprepitant (Emend®, Merck & Co, Kenil- worth, NJ) in two Pediatric ICU patients. The basic phar- macology of aprepitant is discussed, its clinical use with a focus on pediatrics patients is reviewed, and dosing rec- ommendations presented.

Keywords

• aprepitant
• nausea
• vomiting
• pediatric