16th February 2025

A 91-year-old woman with a background of type 2 diabetes presents after a fall. A CT scan shows a periprosthetic fracture

A 91-year-old woman with a background of type 2 diabetes presents after a fall. A CT scan shows a periprosthetic fracture. She is treated with a 15 mcg/24 h buprenorphine patch.

During the admission, she develops indolent abdominal pain and nausea. A CT abdomen shows gastric and duodenal distension. The gastroenterology team advise keeping her nil by mouth and inserting a Ryles tube. An OGD shows no obstructing masses and barium meal shows slow transit through the stomach after 4 hours.

She does not tolerate the Ryles tube, pulling it out on multiple occasions, and she says she would like to eat and does not want further tubes inserted. She understands the risks associated with this and has capacity to make this decision. Which is the most appropriate anti-sickness medication to prescribe?

Select the SINGLE most appropriate option from the list below. Select ONE option only.