Hyperemesis vorbeugen oder abmildern - Empfehlungen

mara @, Mittwoch, 03. Januar 2018, 17:20 (vor 2276 Tagen) @ mara

Stage 4 of treatment: Hospitalization and/or PICC line (peripher eingeführter zentraler Venenkathether). I have yet to find a woman who followed this protocol and still needed these options but it is possible as there are just horrifically severe cases of HG and other health issues could complicate treatment and get a woman to this point. The reason I include the PICC in this category as a last resort is because of the risks that come with it. The picc is a line placed placed deep into a vein that extends up the vein towards the heart. Constant meds and nutrition can be administered long term with great effectiveness through a PICC. The problem with the PICC is that it comes with a very high risk, as high as 50%, of blood clots and infection, both are dangerous for baby and harder to treat and prevent in pregnant women as powerful antibiotics and blood thinners come with significant risks as well. The goal is to avoid a PICC but it does greatly help many severe cases and is an option if other methods of treatment have failed. Good analysis of ng tube vs picc: http://www.helpher.org/forum3/viewtopic.php?t=962

For info on all med options, dosages and side effects - http://www.helpher.org/mothers/treatments/medications.php
Common Medications as sorted by class:

Mild H1 antihistamines - to be used as very early treatment or in combination with other more powerful meds, all are available OTC in the States. Takes much longer (a week or two) to build up to full effectivity
-Meclizine (bonine, cyclizine - not available in the USA, is a more powerful version – in Deutschland nicht zugelassen; nicht so stark sedierend aber nicht unkritisch, siehe Wikipedia)
-Benadryl ( Diphenhydramine) (Schlafmittel, daß auch antiemetisch wirkt, wie vomex)
-Dramamine ( Dimenhydrinate, Gravol) (Wirkstoff Dimenhydrinat , Vomex)
-Doxylamine Succinate (diclegis, unisom, diclectin)

Seretonin Antagonists - Very effective immediately, best for treating vomiting, side effects are common, always start a daily stool softener to prevent severe constipation on these meds.
-Zofran (odansetron)
-Kyrtil (granisetron)

-Phenergan (Promethazine) - effective for nausea (Promethazin = Atosil, auch in Deutschland gelegentlich eingesetzt)
-Metoclopramide (Reglan) - really good at treating nausea and vomiting after eating, keeps digestion moving (Metoclopramid = MCP – als Tropfen, Tablette oder i.V. imTropf)
-Scopolamine Patch (hyoscine) - sticks on the skin so no risk of vomiting it up and is a unique drug class so might work for women who have a bad reaction to other drugs. There is a shortage so may be hard to get a hold of. (Hyoscin oder Scopolamin, schwierig, siehe Embryotox. Evlt. Eine Möglichkeit)

Steriods - http://www.helpher.org/hyperemesis-gravidarum/treatments/steroid.php

Anti reflux meds - do not really treat HG but can help with symptoms that come with frequent vomitting
-Pepcid
-Zantac

Notes on HG meds - This is not by any means an exhaustive list but these are the most common options. Often times, not always, a combo of a med from each category can be very effective. Bad reactions and uncomfortable side effects are common! Please keep your doctor informed, some are okay and some might require you switch to a different med. Don't get discouraged if you have to stop a certain med. There are lots of options and I've had to switch before and have still had good treatment. If you have tried a med in the past and it didn't work, don't give up on it. Often meds started too late or without a good combo are ineffective but started early and in a combo can help greatly. This has been true for me and many other women.


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