Articles: nausea.
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Curr Opin Support Palliat Care · Mar 2008
ReviewOptimizing antiemetic therapy in multiple-day and multiple cycles of chemotherapy.
Only a few studies have investigated the effect of antiemetic therapy in patients treated with multiple-day or multiple cycles of chemotherapy. The present review will assess the available data, highlight the current recommendations and draw attention towards the remaining problems in this field of antiemetic treatment. ⋯ The development of the NK1-receptor antagonist aprepitant has significantly improved the antiemetic control in patients treated with multiple cycles of chemotherapy. Far too many patients still experience considerable emetic side effects. The effect of aprepitant in multiple-day chemotherapy has yet to be defined. The effect of new antiemetic agents such as palonosetron and olanzapine also needs to be investigated in randomized trials.
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Chemotherapy-induced nausea and vomiting (CINV) affects many cancer patients and has a great influence on quality of life. CINV involves coordination of several organs of the gastrointestinal tract, the peripheral and central nervous systems. Many neurotransmitters are involved in this process, and the predominant receptors are serotonin, neurokinin-1 and dopamine receptors. ⋯ Medications for breakthrough symptoms include dopamine antagonists, lorazepam, metoclopramide, haloperidol, droperidol and other agents. Options for treatment of refractory CINV include olanzapine, dronabinol, nabilone, gabapentin. New evidence from non-controlled studies supports the use of olanzapine, casopitant and gabapentin in controlling the symptoms of CINV.
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Rev Esp Anestesiol Reanim · Feb 2008
Review Meta Analysis[Supplemental oxygen for the prevention of postoperative nausea and vomiting: a meta-analysis of randomized clinical trials].
Despite the development of antiemetic drugs, the incidence of postoperative nausea and vomiting remains between 20% and 30%. This meta-analysis examines the hypothesis that perioperative administration of supplemental oxygen reduces the incidence of these complications. ⋯ Supplemental oxygen reduces the incidence of postoperative vomiting. Administration of supplemental oxygen could be an effective method of reducing postoperative vomiting but does not replace current indications for pharmacologic prophylaxis.
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Expert Opin Investig Drugs · Jan 2008
ReviewOral nabilone capsules in the treatment of chemotherapy-induced nausea and vomiting and pain.
Nabilone has been approved to treat chemotherapy-induced nausea and vomiting. Recent studies have explored cannabinoids in pain management. ⋯ Nabilone is superior to placebo, domperidone and prochlorperazine but not metoclopramide or chlorpromazine. Cannabinoids do not add to benefits of 5-HT(3) receptor antagonists. Side effects are greater for nabilone than for prochlorperazine, in most studies patients prefered nabilone over prochlorperazine. Nabilone is ineffective in acute pain but benefits in neuropathic pain and central hypersensitization. Recent guidelines place nabilone as a second to fourth line drug for neuropathic pain.