Antiemetics in CAH - CARES Foundation, Inc.

Winter 2007	CARES Foundation, Inc.

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The Use of Antiemetics to Prevent Dehydration in CAH		NEW Medic Alert Cards CARES has developed wallet-sized Medical Alert cards for CAH patients. The cards feature ER instructions, as well as areas for personal information and emergency contacts. If you have not already received a card, or would like additional copies, please email Erin Anthony, erin@caresfoundation.org or call (toll free) 866-227-3737. Remember, everyone with CAH should wear a medical ID and carry a medical alert card.

contributors Henry Anhalt, D.O. Mitchell Geffner, M.D. Phyllis Speiser, M.D. Maria I. New, M.D.

Recently, CARES has received several inquiries from families about the use of antiemetics (drugs effective against vomiting and nausea) by patients with CAH. With no published reports either recommending or discouraging their use in this population, we posed the question to our Medical Advisory Board. There are many different types of antiemetics. Some you might be familiar with are: Zofran (Ondansetron), Tigan (Trimethobenzamide), and Compazine (Prochlorperazine). According to our advisors, while these medications are often effective in treating nausea and vomiting, physicians should be very hesitant to prescribe them in cases of CAH. Using these medications may mask the need for stress dosing or Solu-Cortef injection and delay a visit to the emergency room for intravenous re-hydration, which is usually required in a patient with salt-wasting CAH. Additionally, nausea and vomiting can be symptoms of an adrenal crisis which, if covered-up, could lead to a false sense of security and the overlooking of dehydration and shock. Acutely ill patients with CAH must always be given a stress dose of steroids (or Solu-Cortef injection when necessary) and seek medical attention immediately.



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