chemotherapy-induced nausea and vomiting
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chemotherapy-induced emesis
An adverse effect of many chemotherapeutics, which is usually self-limited and rarely life-threatening.Highly emetogenic
Cisplatin, carmustine, dacarbazine, dactinomycin, mechlorethamine (nitrogen mustard), streptozocin.
Moderately emetogenic
Azacitidine, arparginase, carboplatin, cyclophosphamide, doxorubicin, mitomycin.
Management
Dopamine (D2 high-dose metoclopramide), serotonin (5-HT3 receptor antagonists—e.g., ondansetron),
chemotherapy-induced nausea and vomiting
Vomiting that occurs after the administration of drugs used to treat cancer. Although its causes are complex, it appears to result from both direct irritation of the gastrointestinal tract by cytotoxic drugs, and the release of chemical mediators, such as 5-hydroxytryptamine (5-HT), from the gastrointestinal tract. 5-HT antagonists are among the most effective treatments. Dopaminergic effects in the central nervous system are also involved in chemotherapy-induced nausea and vomiting, and drugs that antagonize these effects, such as phenothiazines and other neuroleptics, can be used to treat the syndrome. Endocannabinoid drugs, corticosteroids (such as dexamethasone), antianxiety drugs (such as lorazepam) also have selected uses. Drugs that block receptors for neurokinins (such as aprepitant) are esp. effective in treating emesis that occurs more than 24 hours after chemotherapy.