Table 2

Medications for treatment of obstruction

CATEGORY	MEDICATION	DOSAGE
Analgesic drugs	Opioids (SQ or transdermal)	As needed to control symptoms
	Steroids (eg, dexamethasone)	See below
	Antispasmodic-anticholinergics	See below
Antisecretory agents	Dexamethasone	6–20 mg/d SQ trial for 3–5 d
	Octreotide	100–1500 μg/d SQ
	Antispasmodic-anticholinergics
	• Hyoscine butylbromide	40–120 mg/d SQ
	• Glycopyrrolate	0.1–0.4 mg/d SQ
	• Scopolamine	0.2–2 mg/d SQ or 1–2 transdermal patches of 1.5 mg every 3 d
	H₂-receptor antagonists (eg, famotidine, ranitidine)	As needed to control symptoms
	Proton pump inhibitors	As needed to control symptoms
Antiemetic drugs	Metoclopramide (if no colicky pain)	40–240 mg/d SQ
	Haloperidol	5–15 mg/d SQ
	Olanzapine	2.5–20 mg/d SL
	Phenothiazines (sedation)
	• Chlorpromazine	50–100 mg rectally or IM every 8 h
	• Prochlorperazine	25 mg rectally every 8 h
	• Methotrimeprazine	6.25–50 mg/d SQ
	Dimenhydrinate	50–100 mg/d SQ, IV, or rectally
	Ondansetron	4–8 mg twice daily IV
Other	Laxative suppositories, enemas	As needed to control symptoms
Other	Amidotrizoate⁷	A single 50-mL oral dose with metoclopramide, octreotide, dexamethasone SQ in partial obstruction

IM—intramuscularly, IV—intravenously, SL—sublingually, SQ—subcutaneously.
Data from Hanks et al,³ Downing and Wainwright,⁴ Soriano and Davis,⁵ and Glare et al.¹⁴