Hyperemesis Cannabinoid Syndrome Chart Review

Purpose: The purpose of this research study is to determine if the combination of Compazine and Benadryl is a superior method of treatment for patients who present with nausea and vomiting symptoms due to a diagnosis of Hyperemesis Cannabinoid Syndrome. Based on patient charts from a regional hospital emergency department in Oklahoma, an analysis was performed to determine if this combination of medications is more effective in quickly reducing the nausea, vomiting, and other symptoms associated with cannabis use.Methods: An agreement was created between a regional hospital in Duncan Oklahoma and The University of North Texas Health Science Center which allowed students at the Texas College of Osteopathic Medicine to review and analyze a total of 75 patients’ charts from the regional hospital. IRB approval was obtained for this project. The chart review process consisted of evaluating the patient's age, chief complaint, abnormal lab values, history of present illness (HPI), and medications administered in the emergency department. The important variables that assisted in this study were drug screening values, and the medications administered. The main outcome for which statistical efficacy of drug treatment was measured by duration of stay in the emergency department and whether or not an additional dose of medication was given. Results: This chart review showed that the 12 patients that used the Benadryl and Compazine combination had a decreased time spent in the emergency department by an average of 56 minutes when compared to 38 patients who received alternative medications. The average time spent in the emergency department for those who received Benadryl and Compazine was 127 minutes vs the average time spent for those using an alternative medication was 183 minutes. The typical dose was 50 mg of Benadryl and 10 mg of Compazine. While using an ANOVA statistical analysis these doses showed a significantly statistical relationship by decreasing provider-to-discharge time with a p value of 0.012. It was also found while using a logistic regression analysis that those patients who received this combination as their initial dose were less likely to receive a second dose. This relationship also was statistically significant with a p value of 0.005. It was also noted in the logistic analysis that females were more likely to receive a second dose when compared to men. This relationship also showed a relationship with significance and a p value of 0.037. Conclusions:The findings from this study recommend and encourage providers who are in a setting where Hyperemesis Cannabinoid Syndrome is prevalent to consider the medication combination of 50 mg of Benadryl and 10 mg of Compazine when providing treatment. There may be multiple ways to alleviate the discomfort and symptoms that patients may present with, however the combination stated above appears most effective to reduce provider-to-discharge time 56 minutes and eliminate second doses of medication based off of the data reviewed from the charts provided.