Asleep on Watch

[poiu]

Originally Posted by Kenomac

Zofran is the drug of choice to stop vomiting on our boat, it's the drug of choice on cruise ships world wide to stop passengers from vomiting, and it's the "magic bullet" in hospitals to stop patients from vomiting.

But why let actual medical results obtained by healthcare professionals trump second-hand internet advice? And yes, it does work in 10-15 minutes when crushed and placed under the tongue where it's absorbed quickly. Just ask any one who's taken the magic bullet prescription drug.

I looked it up on Wikipedia. It says there that it doesn't work on motion sickness. Why do you suppose they say this as it contradicts the information you gave?

[Kenomac]

Originally Posted by poiu

I looked it up on Wikipedia. It says there that it doesn't work on motion sickness. Why do you suppose they say this as it contradicts the information you gave?

It stops nausea and vomiting. The cruise ships use it effectively and it’s worked fantastic on our boat, it stops nausea within 15 minutes... a miracle drug for anyone who’s taken it while nauseated.

I don’t know why the wikipedia contributors don’t like it.

[jtsailjt]

Originally Posted by poiu

I looked it up on Wikipedia. It says there that it doesn't work on motion sickness. Why do you suppose they say this as it contradicts the information you gave?

Wikipedia has all kinds of contributors who may or may not know what they're talking about. Ken has been hands-on in health care for many, many years and spends half of the year surrounded by other healthcare pro's, doctors, registered nurses, pharmacists, etc. and the other half of the year living on his boat, so he's probably in a better position then anyone else I know of to speak authoritatively about anything related to medicine aboard a boat. I can understand your reluctance to believe everything you hear on the Internet and it can be tough to separate the wheat from the chaff, but in this case it's pretty clear to me which to believe.

[Red Sky]

An alternative to Zofran is Compazine, trade name, Compro. An anti-nausea suppository for chemo patients. We carry it as our “magic bullet” also. It’s funny, we’ve been calling it that for years too.

[hellosailor]

Compazine has the added advantage of being available in suppository form, so if the victim is already puking and even dissolving a pill under the tongue is dicey, the compazine still stays in.

But both are considered anti-emetics. They may stop the nausea and vomiting, they do not necessarily stop all the symptoms of seasickness.

Since nausea alone can lead to a torn esophagus and internal bleeding, they're still worth considering. But both come with a list of side effects, and should only be used without an rx if there's no other option.

Over the years I've gone over pretty much ALL the "remedies" for seasickness, tried most more than once, consulted with MD's about all, and read up with interest on what NASA keeps researching. They're the folks who really have the most to lose if one crew member gets disabled by motion sickness. They've spent a lot of time and money researching it. And, they share their results. The "NASA Cocktail" requires neither gin nor tonic but the odds are neither your doctor nor your pharmacy has ever heard of it.

[sailorboy1]

Sailed 30 hours the other day. Wish I could have fallen asleep. If I could have would have got 60 hours instead!

[poiu]

So where or how do I score some? I am not on chemo right now.

[JPA Cate]

Well, poiu, if it is compazine suppositories you want, you go to a doctor, and get a prescription, and locate a pharmacy that has some in stock. Tell the doctor that it will be used only when someone is vomiting and not able to take medicine by mouth, that it is for the safety of you and your crew. Get enough for 3 days for all your crew, including yourself. The patient should eventually stop vomiting, and you can see to re-hydrating them, and then administering something to keep the seasickness away. CF has many threads on the latter subject.

In the US, compazine is a controlled substance, but for you, it is a necessary part of a ship's medicine chest. IME, doctors who are also sailors are most understanding of these kinds of unusual needs.

You may want a locking box for controlled substances, and keep the prescriptions on the containers: Customs and Quarantine have a right to see that such things are kept locked.



Ann

[StuM]

Originally Posted by Kenomac

It stops nausea and vomiting. The cruise ships use it effectively and it’s worked fantastic on our boat, it stops nausea within 15 minutes... a miracle drug for anyone who’s taken it while nauseated.

I don’t know why the wikipedia contributors don’t like it.

Its effectiveness depends on the cause of the nausea and vomiting.



"Ondansetron is used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery. Ondansetron is in a class of medications called serotonin 5-HT3 receptor antagonists. It works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting."


Motion sickness is histamine, not serotonin related (hence the effectiveness of anti-histamine treatments) and Zofran etc very unlikely to be effective in that situation.



Histamine H1-receptors are involved in the development of the symptoms and signs of motion sickness, including emesis. On provocative motion stimulus, a signal for sensory conflict activates the histaminergic neuron system, and the histaminergic descending impulse stimulates H1-receptors in the emetic center of the brain stem.

The histaminergic input to the emetic center through H1-receptors is independent of dopamine D2-receptors in the chemoreceptor trigger zone and serotonin 5HT3-receptors in the visceral afferent, which are also involved in the emetic reflex.


Footnote: There are studies which indicate that low serotonin activity may actually be a factor in motion sickness. In which case, a serotonin blocker would the last thing to use. It may well exacerbate the symptoms.

[StuM]

Originally Posted by Red Sky

An alternative to Zofran is Compazine, trade name, Compro. An anti-nausea suppository for chemo patients. We carry it as our “magic bullet” also. It’s funny, we’ve been calling it that for years too.

Same sort of answer as Zofran, except that Compazine is a dopamine antagonist, not a serotonin antagonist.


Little effect on histamine related nausea.

[Red Sky]

All I can tell you is we call Compro a magic bullet for a reason. 15 minutes or less after insertion, you are no longer nauseous. I know of three different instances it was used and it was effective in all three cases. ¯\_(ツ)_/¯ YMMV

Ann’s advice is spot on.

[JPA Cate]

Originally Posted by StuM

Same sort of answer as Zofran, except that Compazine is a dopamine antagonist, not a serotonin antagonist.


Little effect on histamine related nausea.

Correct, but it will, eventually stop the vomiting from the seasickness, if not the nausea, or flu or onset of malaria, at which point, you have to deal with dehydration in the patient, by re-hydration [Google rehydration fluids] and, eventually, something that will make the seasickness go away.

Since it is a histamine reaction, I'd imagine that even diphenhydramine (Benedryl) would work, or Phenergan, maybe even Zyrtec, but for Jim and me the "magic bullet" is cinnarizine HCL, "Stugeron". Recommended to be taken 2 hrs (minimum) before leaving the dock. It is available over the counter in England, and from some other sources.

And now, we've come a long way from "asleep on watch." Except for this: with the anti-histamines, some people get extremely sleepy from them, so that crew person just might not be available after taking them. For me, sometimes I'll take a half hour nap after taking one stugeron, to let it start to be effective.


Ann

[Kenomac]

Originally Posted by StuM

Its effectiveness depends on the cause of the nausea and vomiting.



"Ondansetron is used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery. Ondansetron is in a class of medications called serotonin 5-HT3 receptor antagonists. It works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting."


Motion sickness is histamine, not serotonin related (hence the effectiveness of anti-histamine treatments) and Zofran etc very unlikely to be effective in that situation.



Histamine H1-receptors are involved in the development of the symptoms and signs of motion sickness, including emesis. On provocative motion stimulus, a signal for sensory conflict activates the histaminergic neuron system, and the histaminergic descending impulse stimulates H1-receptors in the emetic center of the brain stem.

The histaminergic input to the emetic center through H1-receptors is independent of dopamine D2-receptors in the chemoreceptor trigger zone and serotonin 5HT3-receptors in the visceral afferent, which are also involved in the emetic reflex.


Footnote: There are studies which indicate that low serotonin activity may actually be a factor in motion sickness. In which case, a serotonin blocker would the last thing to use. It may well exacerbate the symptoms.

Then don’t take it if you’re going to worry about all this. It’s that simple.

[Kenomac]

Originally Posted by poiu

So where or how do I score some? I am not on chemo right now.

Ask your family MD for a perscription.

[StuM]

Originally Posted by Kenomac

Then don’t take it if you’re going to worry about all this. It’s that simple.

I don't


I'm with Ann - Stugeron (available OTC here in PNG) is my preferred medication.