UMEM Educational Pearls


Within the first hour after administration, ondosterone, metoclopramide and bromopride were equally efficacious.  At the 6 hour and 24 hour period after receiving the initial dose of medication, ondansetron was statistically superior to bromopride (not available in the US) and metoclopramide.  There were no reported side effects in the ondansetron group (including diarrhea or sedation).


This was a randomized control trial of children 1 year to 12 years seen in the pediatric emergency department in Brazil for vomiting and given intramuscular bromopride (0.15mg/kg to a maximum of 10 mg), metoclopramide (0.15mg/kg to a maximum of 10 mg), or ondansetron (0.15mg/kg to a maximum of 8 mg).  175 children were included.


Epifanio et al.  Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the emergency in the pediatric emergency department: a randomized control trial.  J Pediatr 2017.  Article in Press.