Which medication is used for treating intractable vomiting syndromes?

• A. Haloperidol
• B. Ondansetron
• C. Metoclopramide
• D. Promethazine

Answer: (A)

Intractable vomiting often requires a medication that can strongly suppress the central vomiting trigger in the brain. Haloperidol is a potent dopamine D2 receptor antagonist that acts on the chemoreceptor trigger zone to halt the emetic signal. Because of this central action, it provides robust antiemetic effect even when other agents fail, making it a common choice for refractory or difficult-to-treat vomiting, especially in acute or palliative care settings. It tends to work quickly when given by IV or IM, which is helpful in urgent situations.

Other antiemetics target different pathways ( serotonin receptors, prokinetic mechanisms, or histamine receptors), and while they can be effective, they may not adequately control vomiting that is resistant to standard therapy. Haloperidol’s strong central blockade gives it an advantage in these intractable cases. Be mindful of potential side effects such as extrapyramidal symptoms and QT prolongation, and use the lowest effective dose with appropriate monitoring.