Control of cancer chemotherapy-induced nausea and vomiting

Eyre, Harmon J.; Ward, John H.

doi:10.1002/1097-0142(19841201)54:2+<2642::aid-cncr2820541408>3.0.co;2-u

Cited by 21 publications

(7 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since anticipatory nausea and vomiting may occur in 20% of patients receiving chemotherapy, attempts to diminish recall of previous chemotherapy may improve tolerance to further drug infusions. 10,22,[29][30][31][32] Patients receiving combined antiemetics had significantly less vomiting episodes and nausea. Although sedation and amnesia were more common with the use of lorazepam, these effects were easily tolerated by study patients.…”

Section: Discussionmentioning

confidence: 99%

Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis

Gordon¹,

Pazdur²,

Ziccarelli³

et al. 1989

Cancer

View full text Add to dashboard Cite

Sixty-four patients treated with cisplatin-containing regimens were entered into a randomized, doubleblinded study examining the antiemetic efficacy of metoclopramide with and without lorazepam for control of cisplatin-induced emesis. Metoclopramide was administered to all patients at 2 mg/kg, intravenously, 30 minutes before chemotherapy and 1 5 3 . 5 , and 5.5 hours posttreatment. Patients randomized to receive combined antiemetic therapy were administered lorazepam at 2 mg/m2 (maximum, 4 mg dose) intravenously, 30 minutes before chemotherapy. Those patients not receiving lorazepam were given normal saline placebo. Degree of nausea and number of vomiting episodes were recorded on a data flow sheet with a visual analogue scale. Drug toxicities were evaluated before each administered dose. Patients receiving both metoclopramide and lorazepam experienced significantly less vomiting episodes (P < 0.05) and nausea (P < 0.01) when compared to patients given metoclopramide alone. Forty-four percent of those receiving the combined therapy reported no nausea or vomiting episodes compared to only 22% receiving metoclopramide alone. Sedation was significantly more common in patients receiving lorazepam (88%) as opposed to patients receiving only metoclopramide (43%), P < 0.01. Amnesia was seen in 25% receiving lorazepam.No significant difference in diarrhea, dystonia, or disinhibition was observed between the two arms. The authors conclude that the combination of lorazepam and metoclopramide was superior to metoclopramide alone in the prevention of cisplatin-induced nausea and vomiting, with sedation and amnesia more commonly observed in the combined regimen.Cancer 63578-582,1989.REATER THAN 75% of patients receiving cisplatin-G containing chemotherapy will experience nausea and vomiting.' Inadequate control of these potentially disabling toxicities may interfere with quality of life and decrease patient compliance in chemotherapeutic prog r a m~.~,~ Metoclopramide is an effective agent in decreasing the gastrointestinal toxicities associated with cislat tin.^-* To potentiate the antiemetic property of this

show abstract

Section: Discussionmentioning

confidence: 99%

Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis

Gordon¹,

Pazdur²,

Ziccarelli³

et al. 1989

Cancer

View full text Add to dashboard Cite

show abstract

“…Although limited success has been reported with some anti-emetics alone and particularly in combination (e.g. phenothiazines, benzamides, cannabinloids or steroids), the wealth of papers on comparative regimes testifies to the fact that no totally effective anti-emetic therapy exists (Siegel & Longo, 1981;Penta et al 1981;Eyre & Ward, 1984). Furthermore some of the regimes giving satisfactory control of emesis are accompanied by marked sedation of the patient.…”

Section: Introductionmentioning

confidence: 99%

“…The cytotoxic agents chosen for this study were cyclophosphamide and cis-platin, since both are widely used clinically and are reported to produce severe nausea and vomiting in patients (Frytak & Moertel, 1981;Siegel & Longo, 1981;Penta et al 1981;Eyre & Ward, 1984).…”

Section: Introductionmentioning

confidence: 99%

THE ROLE OF THE ABDOMINAL VISCERAL INNERVATION AND 5‐HYDROXYTRYPTAMINE M‐RECEPTORS IN VOMITING INDUCED BY THE CYTOTOXIC DRUGS CYCLOPHOSPHAMIDE AND CIS‐PLATIN IN THE FERRET

1988

View full text Add to dashboard Cite

SUMMARYWe have used the ferret as an animal model to investigate the emetic action of the cytotoxic drugs cyclophosphamide and cis-platin. Using selective nerve lesions, a crucial role for the abdominal innervation in the genesis of retching and vomiting in response to these agents has been demonstrated. A combination of bilateral abdominal vagotomy and greater splanchnic nerve section can totally abolish retching and vomiting in response to intraperitoneal cis-platin or intravenous cyclophosphamide. Intraperitoneal cyclophosphamide still produced retching but vomiting was markedly reduced, demonstrating complex and probably separate control mechanisms for retching and vomiting. The effect of a widely used anti-emetic, metoclopramide, was compared to that of nerve lesions. While effective this compound did not totally control retching or vomiting to either drug. Recent studies have attributed metoclopramide's action to its ability to antagonize 5-HT M-receptors (5-HT-3 receptors). Therefore we investigated BRL 24924, a gastro-kinetic agent with more specific 5-HT M-receptor antagonist properties. This agent was extremely potent in almost totally abolishing retching and vomiting in response to cyclophosphamide, given by either an intravenous or intraperitoneal route, and totally abolished cis-platin-induced vomiting for at least 4 h. Clearly the abdominal visceral innervation plays a complex and major role in the emesis produced by these two cytotoxic drugs; circumstantial evidence suggests that 5-HT M-receptors on visceral afferent nerves mediate this action, but other possibly central sites of action of the 5-HT M-receptor antagonists cannot be excluded.

show abstract

“…Psychologic predisposition in patients who had had severe vomiting during chemotherapy courses given with less powerful antiemesis might play a role (17).…”

Section: Discussionmentioning

confidence: 99%

Antiemetic Regimens in Outpatients Receiving Cisplatin and Non-Cisplatin Chemotherapy: A Randomized Trial Comparing High-Dose Metoclopramide Plus Methylprednisolone with and Without Lorazepam

et al. 1991

View full text Add to dashboard Cite

Control of cancer chemotherapy-induced nausea and vomiting

Cited by 21 publications

References 37 publications

Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis

Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis

THE ROLE OF THE ABDOMINAL VISCERAL INNERVATION AND 5‐HYDROXYTRYPTAMINE M‐RECEPTORS IN VOMITING INDUCED BY THE CYTOTOXIC DRUGS CYCLOPHOSPHAMIDE AND CIS‐PLATIN IN THE FERRET

Antiemetic Regimens in Outpatients Receiving Cisplatin and Non-Cisplatin Chemotherapy: A Randomized Trial Comparing High-Dose Metoclopramide Plus Methylprednisolone with and Without Lorazepam

Contact Info

Product

Resources

About