Comparison of antiemetic efficacy of domperidone, metoclopramide, and dexamethasone in patients receiving outpatient chemotherapy regimens.

Cunningham, David A.; Evans, Christopher; Gazet, J.‐C.; Ford, H. T.; Pople, A.; Dearling, Jason; Chappell, Daniel; Coombes, R. Charles

doi:10.1136/bmj.295.6592.250

Cited by 22 publications

(5 citation statements)

References 4 publications

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“…Glucocorticoids are used extensively in adult and pediatric oncology as antileukemic, 1,2 antiinflammatory, 3 and antiemetic agents. [4][5][6] Although dexamethasone is useful in many settings, including in the treatment of childhood acute lymphoblastic leukemia (ALL), adverse events may be dose-limiting. 7 In other patient populations (eg, organ transplant recipients), both desired and adverse effects are dose-related and may be related to pharmacokinetic variability, but there are no prior pharmacokinetic studies of dexamethasone in patients with ALL, and there are few studies in adult patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

Asparaginase May Influence Dexamethasone Pharmacokinetics in Acute Lymphoblastic Leukemia

Yang

Panetta

Cai

et al. 2008

JCO

134

132

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Section: Introductionmentioning

confidence: 99%

Asparaginase May Influence Dexamethasone Pharmacokinetics in Acute Lymphoblastic Leukemia

Yang

Panetta

Cai

et al. 2008

JCO

134

132

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“…The first randomized double-blind study was published in 1979 and concluded that dexamethasone was superior to placebo in patients receiving non-cisplatin chemotherapy [ 70 ]. Subsequent studies supported the finding that single-agent corticosteroids possess an antiemetic effect in patients receiving chemotherapy with low and moderate emetic risk [ 55 , 71 ]. When prescribed to patients receiving chemotherapy with moderate or high emetic risk, corticosteroids improve the effect of other antiemetics such as the 5-HT 3 -receptor antagonists [ 72 , 73 ].…”

Section: Considerations When Prescribing Chemotherapy and Anti-emetics For Older Cancer Patientsmentioning

confidence: 86%

“…Metoclopramide was effective against nausea and vomiting induced by a number of non-malignant conditions [ 54 ]. In low doses (20 mg × 2–3, orally), metoclopramide was no better than placebo [ 44 ] and inferior to dexamethasone and domperidone [ 55 ]. The interest in investigating metoclopramide further was therefore modest until Gralla and coworkers [ 56 ] demonstrated the significant effect of high-dose metoclopramide (2 mg/kg intravenously [IV] × 5) against cisplatin-induced nausea and vomiting.…”

Section: Considerations When Prescribing Chemotherapy and Anti-emetics For Older Cancer Patientsmentioning

confidence: 99%

“…Consequently, the parenteral formulation was withdrawn from general use. In low IV doses or oral doses of 20 mg × 3, domperidone was superior to placebo [ 68 ], inferior [ 69 ] or superior [ 55 ] to metoclopramide, and inferior [ 69 ] or equal to dexamethasone [ 55 ]. Like metoclopramide, domperidone has a prokinetic effect on the GI tract and diarrhea is a frequent adverse effect.…”

Section: Considerations When Prescribing Chemotherapy and Anti-emetics For Older Cancer Patientsmentioning

confidence: 99%

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Prevention of Chemotherapy-Induced Nausea and Vomiting in the Older Patient: Optimizing Outcomes

2021

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Chemotherapy-induced nausea and vomiting (CINV) are still two of the most feared side effects of cancer therapy. Although major progress in the prophylaxis of CINV has been made during the past 40 years, nausea in particular remains a significant problem. Older patients have a lower risk of CINV than younger patients, but are at a higher risk of severe consequences of dehydration and electrolyte disturbances following emesis. Age-related organ deficiencies, comorbidities, polypharmacy, risk of drug–drug interactions, and lack of compliance all need to be addressed in the older patient with cancer at risk of CINV. Guidelines provide evidence-based recommendations for the prophylaxis of CINV, but none of these guidelines offer specific recommendations for older patients with cancer. This means that the recommendations may lead to overtreatment in some older patients. This review describes the development of antiemetic prophylaxis of CINV focusing on older patients, summarizes recommendations from antiemetic guidelines, describes deficiencies in our knowledge of older patients, summarizes necessary precautions, and suggests some future perspectives for antiemetic research in older patients.

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“…The efficiency of steroids as antiemetic was first established in chemotherapy including vomiting. Many studies were conducted by Rich WL, 10 Apro & Alberts D 11 and Cunningham D et al 12 to show the efficiency of Dexamethasone in preventing PONV. A dose response study by Drapkin & Soki 13 evaluated the efficiency of dexamethasone in control of delayed nausea.…”

Section: Complicationsmentioning

confidence: 99%

A Study of Single Dose Dexamethasone in Reducing Postoperative Sore Throat, Nausea and Vomiting in Patients Receiving General Anaesthesia for C a Esarean Section

Singh¹,

Patil²

2014

jemds

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Postoperative sore throat and nausea and vomiting are common complaints in patients undergoing surgery, under general endotracheal anesthesia. Some of the studies have shown potential advantages of dexamethasone in prevention of postoperative sore throat. We therefore undertook a study to evaluate the efficacy of dexamethasone 8 mg administration intravenously, in reducing the incidence and severity of postoperative sore throat nausea and vomiting in patients undergoing caesarean section under general anesthesia with endotracheal intubation. METHODS: In a randomized, double blind and placebo controlled study, 60 patients receiving general anesthesia with endotracheal intubation undergoing caesarean section were randomly assigned to two groups. Group-I, patients received dexamethasone 8 mg IV and group-II received normal saline 2 ml IV. After surgery VAS score was used to assess sore throat and nausea, number of episodes of vomiting were recorded by a blinded observer. RESULTS: The overall incidence and severity of postoperative sore throat was less at all times in study group as compared to control group (p<0.001). 22 of 30 patients in dexamethasone group had sore throat as compared to 28 of 30 patients in control group (p<0.05). Even though there was no difference in the incidence of nausea in early postoperative period as compared to delayed postoperative period, there was significant reduction in severity of nausea in delayed and early postoperative period (p<0.001). There was no difference in incidence (p>0.05), but severity of vomiting was less in early postoperative period in dexamethasone group (p<0.001). There was significant reduction in incidence and severity of dexamethasone group in delayed postoperative period. CONCLUSION: Single dose dexamethasone reduces the incidence and severity of postoperative sore throat, nausea and vomiting in patients undergoing caesarean section under general endotracheal anesthesia.

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Comparison of antiemetic efficacy of domperidone, metoclopramide, and dexamethasone in patients receiving outpatient chemotherapy regimens.

Cited by 22 publications

References 4 publications

Asparaginase May Influence Dexamethasone Pharmacokinetics in Acute Lymphoblastic Leukemia

Asparaginase May Influence Dexamethasone Pharmacokinetics in Acute Lymphoblastic Leukemia

Prevention of Chemotherapy-Induced Nausea and Vomiting in the Older Patient: Optimizing Outcomes

A Study of Single Dose Dexamethasone in Reducing Postoperative Sore Throat, Nausea and Vomiting in Patients Receiving General Anaesthesia for C a Esarean Section

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