Two New Arrows in the Quiver or Better Living through Chemistry

Ondansetron for nausea and Quitiapen for a sleep aid. How are they working?

Ondansetron Hydrochloride

The drug for nausea – Ondansetron – seems to work very well. I have adjusted when Cheryl takes it a bit. The instructions merely say three times a day and at first I interpreted that to mean 7AM, 1PM and 7PM which are normal times for her to take meds. For the past couple days I have given her the evening pill at about 5PM which is 45 minutes to an hour before we would ordinarily eat dinner. It seems to be working for her. I have repeatedly asked her about stomach issues and she reports no issues with her stomach.

This report – no funny stomach – is very encouraging since it has been her main complaint for months. I can empathize. Over the past couple years she has lost approximately thirty-five pounds of weight. The dyskinesia puts her body in constant exercise but the combination of no sense of smell and a slightly uncomfortable stomach keeps her from eating much. (During this whole time she has not vomited but as she says, it is right there.)

Quetiapine Fumarate – 25mg

The drug used as a sleep aid – Quetiapine – might or might not be working as hoped. She is prescribed 1/4 of this little pill before bedtime (10PM). Shown above it is approximately 1/8 inch in diameter. We have a pill spliter but these are not scored for cutting in half as many pills are and certainly not scored for quarters.

The first night she took this she slept completely through the night. This was the first time in approximately two years. The second night she got up once. The third night she got up once and seemed restless for a bit when returning to bed. The fourth night was similar to nights before she started taking it. I am not convinced that she is getting the same dose each evening, so I will find a way to slit these tiny little pills as uniform as possible.

An update: Last night seemed better. She used the walking frame for stability. Only once.

Zofran — From Wikipedia —

Ondansetron, sold under the brand name Zofran among others, is a medication used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery.[2] It is also effective for treating gastroenteritis.[3][4] It is ineffective for treating vomiting caused by motion sickness.[5] It can be given by mouth or by injection into a muscle or into a vein.[2]

Common side effects include diarrhea, constipation, headache, sleepiness, and itchiness.[2] Serious side effects include QT prolongation and severe allergic reaction.[2] It appears to be safe during pregnancy but has not been well studied in this group.[2] It is a serotonin 5-HT3 receptor antagonist.[2] It does not have any effect on dopamine receptors or muscarinic receptors.[6]

Ondansetron was patented in 1984 and approved for medical use in 1990.[7] It is on the World Health Organization’s List of Essential Medicines.[8] It is available as a generic medication.[2] In 2017, it was the 83rd most commonly prescribed medication in the United States, with more than nine million prescriptions.[9][10]

Seraquel — From Wikipedia —

Quetiapine, sold under the brand name Seroquel among others, is an atypical antipsychotic medication used for the treatment of schizophrenia, bipolar disorder, and major depressive disorder.[6][7] Despite being widely used as a sleep aid due its sedating effect, the benefits of such use do not appear to generally outweigh the side effects.[8] It is taken by mouth.[6]

Common side effects include sleepiness, constipation, weight gain, and dry mouth.[6] Other side effects include low blood pressure with standing, seizures, a prolonged erection, high blood sugar, tardive dyskinesia, and neuroleptic malignant syndrome.[6] In older people with dementia, its use increases the risk of death.[6] Use in the third trimester of pregnancy may result in a movement disorder in the baby for some time after birth.[6] Quetiapine is believed to work by blocking a number of receptors including serotonin and dopamine.[6]

Quetiapine was developed in 1985 and approved for medical use in the United States in 1997.[6][9] It is available as a generic medication.[10] In the United States, the wholesale cost is about US$12 per month as of 2017.[11] In the United Kingdom, a month’s supply costs the NHS about £60 as of 2017.[10] In 2017, it was the 76th most commonly prescribed medication in the United States, with more than ten million prescriptions.[12][13]

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