Haloperidol for Uraemic CTZ Nausea — SCE Palliative Medicine MCQ

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HardNausea & VomitingHaloperidol for Uraemic CTZ NauseaSCE Palliative Medicine

A patient with bilateral malignant ureteric obstruction declines nephrostomy and develops uraemic nausea without gastric-stasis or vestibular features. Which low-dose antiemetic most directly targets the likely mechanism?

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Correct answer: B — Haloperidol

Uraemic toxins produce chemical/CTZ nausea, for which the Scottish guideline recommends low-dose haloperidol, with a lower starting dose in older, frail or renally impaired people. Metoclopramide and erythromycin fit stasis, cyclizine vestibular or pressure mechanisms, and hyoscine obstruction-related secretions.

Reference: Scottish Palliative Care Guidelines: Nausea and vomiting. https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/symptom-management/nausea-and-vomiting/