Selecting a Treatment Regimen
Figure 2. Treatment Algo Gastrop
using 4 hour scintigraphy, o (documented by dela
Prokinetics
Metoclopramide po/subcut/iv
No response
Consider dose increase No response
• Domperidone po • Erythromycin po/iv
No response
Refer to specialized center for further evaluation/ clinical trials /feeding jejunostomy/gastric electrical stimulator
Antiemetics
• Promethazine po/pr/iv • Prochlorperazine po/pr/iv • Trimethobenzamide po/pr • Scopolamine transdermal patch
No response
Optimize prokinetics
No response
• Low Dose tricyclic antidepressants* (desipramine, nortriptyline) antagonists po/iv/patch
• 5-HT3 No response
• Aprepitant po • Lorazepam po/iv • Cannabinoids po
* Doses exceeding 25-50 mg daily may have anticholinergic effects and delay gastric emptying.
