Articles: nausea.
-
Ann Acad Med Singap · Mar 1994
ReviewManagement of common opioid side effects during long-term therapy of cancer pain.
For most patients with cancer pain, the primary goal of opioid pharmacotherapy is a satisfactory balance between analgesia and side effects. Consequently, the assessment and treatment of opioid side effects is a fundamental aspect of therapy, which may increase the likelihood of a favourable treatment outcome, potentially allow higher and more efficacious opioid doses, and improve quality of life by reducing other uncomfortable symptoms. This review describes the presentation, assessment and management of adverse neuropsychological and gastrointestinal effects due to opioid drugs. These common side effects pose the major challenge for the clinician who undertakes the long-term opioid therapy of patients with cancer pain.
-
Comparative Study
Cost and cost-effectiveness analysis of ondansetron versus metoclopramide regimens: a hospital perspective from Italy.
In a large double-blind study of antiemetic therapy conducted in Italy, 289 patients underwent 3 consecutive cycles of cisplatin chemotherapy. Antiemetic treatment with ondansetron plus dexamethasone was more efficacious and better tolerated, but also more expensive, than treatment with metoclopramide plus both dexamethasone and diphenhydramine. To evaluate the different costs of the 2 antiemetic regimens, we conducted a retrospective cost-effectiveness analysis from a hospital perspective. ⋯ Corresponding figures for the metoclopramide regimen were 59.5 and 50.4%, 53.6 and 37.1%, and 46.8 and 27.3%, respectively. Thus, the cost per successfully treated (completely protected) patient was 2.43- and 2.34-fold higher, respectively, for ondansetron at the first cycle, 2.23- and 1.99-fold higher, respectively, at second cycle, and 1.82- and 1.36-fold higher, respectively, at third cycle. In conclusion, the study demonstrates that, while ondansetron has a greater acquisition cost than metoclopramide, the ondansetron regimen costs per successfully-treated patient substantially decrease when all direct hospital costs are taken into account.
-
To evaluate the presence and the relationship between postoperative nystagmus and nausea. ⋯ The presence of nystagmus in the early part of recovery from general anesthesia is associated with a higher incidence of nausea and vomiting during the first postoperative day.
-
Current research on chemotherapy-induced nausea and vomiting in cancer patients is reviewed, and some hypotheses to explain why anticipatory and post-chemotherapy nausea and vomiting appear are suggested. Methodological problems are also discussed. It is suggested that future research should focus on post-chemotherapy nausea and emesis, rather than anticipatory nausea and emesis, in order to achieve a deeper understanding of the psychological factors involved in the development of chemotherapy-induced nausea and vomiting.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A randomized, multicenter study comparing the efficacy and tolerability of tropisetron, a new 5-HT3 receptor antagonist, with a metoclopramide-containing antiemetic cocktail in the prevention of cisplatin-induced emesis.
Chemotherapy-induced emesis is one of the most disturbing side effects in cancer therapy. Thus, antiemetic treatment is a mandatory adjunct in emetogenic chemotherapy. ⋯ Tropisetron was easier to administer and better tolerated than the cocktail, and it seems to be a highly efficacious and safe new antiemetic drug.