QUESTION: Can I give a Meyer’s for a pregnant patient experiencing nausea and hyperemesis?
ANSWER: A “Meyer’s” (whatever that means) is typically a mildly to greatly hypertonic IV which accentuates dehydration and nausea. (occasionally not – but not usually a winner). We see lots of PG with Hyperemesis and never use more than a 300 mOsm/L usually around 250. As we see so many PG with this issue we find that the following are common threads:
- Actual hydration is necessary so under 300 mOsm/L is needed
- Typical nausea items all work variably and often aggravate during the first IV but not later. These include Amino’s, Hydration, Mg/Ca/K, B-vits incl B6, H-1 blockers and HIS reducers (methylators) etc etc.
- A slow infusion of 500 – 1000 mL of a 250-300 mOsm/L solution is first. Often on the first one we do IV Zofran (which with the IV often works when it didn’t before) or a low dose Benadryl (12.5 – 25 IV) is helpful.
In 95 % of our severely emetic PG women these basics work – but the first IV can be rough ’cause they are so bad off. IV isn’t the only thing but as we do so many PG IV’s and it’s one of my “things” I thought I’d save you some trial and error.
Here’s a paper for more information Click here to download file or view below