Treatment Plan

• Reassurance: Symptoms may resolve within a few weeks If severe symptoms:

Short-term treatment options:

• Buccal or IM prochlorperazine
  • Contraindications: heart failure, hypothyroidism, Parkinson’s, myasthenia gravis, venous acidosis
  • Side effects: extrapyramidal symptoms, hyperprolactinaemia, QT prolongation
    o IM cyclizine

• Less severe symptoms:

Oral options: prochlorperazine, cyclizine, promethazine
•     If nausea/vomiting persists despite anti-emetics: admit
•    Refer if:

• Symptoms present after 6 weeks
  o No improvement after 1 week of treatment
  o Atypical features present