Authors: Rudolph M Navari
Publish Date: 2013/02/13
Volume: 73, Issue: 3, Pages: 249-262
Abstract
Chemotherapyinduced nausea and vomiting CINV is associated with a significant deterioration in quality of life The emetogenicity of the chemotherapeutic agents repeated chemotherapy cycles and patient risk factors significantly influence CINV The use of a combination of a serotonin 5HT3 receptor antagonist dexamethasone and a neurokinin 1 NK1 receptor antagonist has significantly improved the control of acute and delayed emesis in singleday chemotherapy Palonosetron a secondgeneration 5HT3 receptor antagonist with a different halflife a different binding capacity and a different mechanism of action than the firstgeneration 5HT3 receptor antagonists appears to be the most effective agent in its class Aprepitant the first and only agent clinically available in the NK1 receptor antagonist drug class has been used effectively as an additive agent to the 5HT3 receptor antagonists and dexamethasone to control CINV Rolapitant and netupitant are other NK1 receptor antagonists that are currently in phase III clinical trials Despite the control of emesis nausea has not been well controlled by current agents Olanzapine a USFDA approved antipsychotic has emerged in recent trials as an effective preventative agent for CINV as well as a very effective agent for the treatment of breakthrough emesis and nausea Clinical trials using gabapentin cannabinoids and ginger have not been definitive regarding their efficacy in the prevention of CINV Additional studies are necessary for the control of nausea and for the control of CINV in the clinical settings of multipleday chemotherapy and bone marrow transplantation
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