Articles: nausea.
-
Oncology nursing forum · Aug 1997
ReviewNonpharmacologic management of chemotherapy-induced nausea and vomiting.
To review the nonpharmacologic interventions indicated to prevent or control chemotherapy-induced nausea and vomiting. ⋯ These behavioral interventions can be effective in reducing anticipatory and post-treatment nausea and vomiting. Oncology nurses must learn these nonpharmacologic techniques and teach their patients to use them in combination with their prescribed antiemetic therapy.
-
Review Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Value of the combination of oral ondansetron with methylprednisolone as soon as the first cure in mild emetogenic chemotherapy. Groupe français d'étude de l'ondansétron].
This multicentre randomized single-blind parallel group study compared the efficacy of oral ondansetron plus methylprednisolone (OND+MPS) with conventional antiemetic strategies (TH) over 4 consecutive courses in moderately emetogenic chemotherapy. This study was conducted in naive patients receiving a minimum of 3 cytotoxics including adriamycin (> or = 35 mg/m2) and cyclophosphamide (> or = 500 mg/m2) plus an other alkylating agent. Of the 364 patients included in the study, 70% had a breast cancer and 30% a lymphoma. ⋯ Ninety-two percent of patients from OND+MPS group preferred to continue their treatment versus 76% in the TH group (p < 0.001). Concerning the quality of life assessed by FLIC and FLIE questionnaires, the analysis showed a significant difference at the end of the treatment in favor of OND+MPS (p = 0.037 and 0.0075 respectively). This study showed the interest in using the combination OND+MPS right from the first course of moderately emetogenic chemotherapy.
-
To promote accurate patient assessment, effective patient teaching, and useful research design and outcomes by defining the concepts of nausea, vomiting, and retching; to review the usefulness of self-care guides in assessing the patient's symptom experience. ⋯ Effective management of the patient's symptom experience depends on the oncology nurse's ability to differentiate occurrence and distress of the individual symptoms and to implement current knowledge not only of chemotherapy, antiemetic drugs, and nonpharmacologic interventions but of unerring ongoing assessments that lead to cost-effective, clinically useful patient outcomes. Basic scientific knowledge for research, practice, and education necessitates reliable, valid measurement tools that differentiate the components and dimensions of the individual symptoms.
-
Despite common clinical opinion that patient-controlled analgesia should be renamed 'patient-controlled nausea', there is little evidence in support of the notion that postoperative nausea and vomiting are exacerbated by the method. Indeed, data indicate that opioid-sparing techniques are not associated with less postoperative nausea and vomiting. Although some evidence suggests that certain opioids are less emetogenic than others, this too does not stand scrutiny when compared across patients, although research is still required to find whether individual patients are better treated with a particular opioid. Similarly, the emerging practice of combining anti-emetics with patient-controlled analgesia needs wider study before it can be supported.
-
With the increasing prevalence of chemotherapy in the treatment of neoplasia, antiemetic therapies have become essential and sophisticated: phenothiazines, benzodiazepines, steroids, substituted benzamides, butryphenones, anticholinergics and antihistamines, cannabinoids, and the 5-HT 3 receptor antagonist are reviewed.