Neuropharmacology of Chemotherapy-induced Emesis

Borison, Herbert L.; McCarthy, Lawrence E.

doi:10.2165/00003495-198300251-00003

Cited by 123 publications

(30 citation statements)

References 9 publications

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“…[13][14][15][16][17][18][19][20] The mechanism of postoperative nausea and vomiting includes vestibulo-cochlear stimulation, triggering of the central chemoreceptor trigger zone, and local gastrointestinal mechanisms. Both Greif et al 3 and Goll et al 4 hypothesized that supplemental intraoperative oxygen may attenuate bowel ischemia from surgical stress and bowel manipulation during intra-abdominal procedures.…”

Section: Discussionmentioning

confidence: 99%

Supplemental oxygen does not prevent postoperative nausea and vomiting after gynecological laparoscopy

McKeen

Arellano

O’Connell

2009

Can J Anesth/J Can Anesth

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Purpose Postoperative nausea and vomiting are among the most common and distressing side effects of general anesthesia. Supplemental intraoperative 80% oxygen reduces postoperative nausea and vomiting following open and laparoscopic abdominal surgery. However, this benefit has not been observed in other patient populations. We undertook this study to evaluate the effect of 80% supplemental intraoperative oxygen on the incidence of postoperative nausea and vomiting following ambulatory surgery for laparoscopic tubal ligation. Methods Following Research Ethics Board approval, 304 subjects were enrolled into one of two arms of a randomized prospective controlled study. The intervention group (n = 147) breathed 80% oxygen and the control group (n = 145) breathed routine 30% oxygen (balance medical air) while both groups were receiving a standardized general anesthetic. Nausea was assessed as: none, mild, moderate, or severe; vomiting was any emetic episode or retching. Any assessment either greater than none (nausea) or greater than zero (vomiting) was considered positive. Results The incidence of postoperative nausea and vomiting up to 24 hr following surgery was 69% in the 80% oxygen intervention group and 65% in the 30% oxygen control group (P = 0.62). There were no differences in nausea alone, vomiting, or antiemetic use in the postoperative anesthetic care unit or at any time (pre-or postdischarge) up to 24 hr after surgery. Conclusions This trial of 304 women did not demonstrate that administering intraoperative supplemental 80% oxygen during ambulatory surgery for laparoscopic tubal ligation prevented postoperative nausea or vomiting during the initial postoperative 24 hr compared with women who received routine 30% oxygen.

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Section: Discussionmentioning

confidence: 99%

Supplemental oxygen does not prevent postoperative nausea and vomiting after gynecological laparoscopy

McKeen

Arellano

O’Connell

2009

Can J Anesth/J Can Anesth

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“…Research on the pathophysiology of chemotherapy-induced vomiting has demonstrated the role of serotonin (5-hydroxytryptamine). Serotonin is released by enterochromaffin cells in the upper gastrointestinal tract, where it can act on specific receptors recognised as 5-HT3 (Borison & McCarthy, 1983). Studies on the ferret have shown the efficacy of 5-HT3 receptor antagonists against chemotherapy-induced vomiting (Blower, 1990).…”

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confidence: 99%

Dose finding study of granisetron in patients receiving high-dose cisplatin chemotherapy

Rivière

1994

Br J Cancer

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Summary The efficacy and safety of three different doses of granisetron (2pjgkg-', group A; 10;Lgkg-', group B; 40jiygkg-', group C) were compared in a randomised, double-blind study of 157 patients due to receive high-dose cisplatin therapy (mean dose >97 mg m-2). In each group, up to two 3 mg rescue doses of granisetron were allowed if more than mild nausea or vomiting occurred. In group A 30.8%, in group B 61.5% and in group C 67.9% of patients were complete responders (i.e. no vomiting or nothing worse than mild nausea) during the first 24 h. These differences are significant between groups A and B, and A and C. There were no statistically significant differences in any efficacy variable between the 10 g kg-' and 40 jig kg-groups, although in each case the trend favoured the higher dose. Additional rescue doses resulted in resolved or improved symptoms in 95.3% for the first rescue dose and 93.3% for the second. Over the 7 days of the study, 82.7%, 82.7% and 86.8% of patients in groups A, B and C respectively were treated with granisetron alone. Headache was the most common side-effect, reported by 9.6% of patients; the majority of headaches were mild. There was no difference between the treatment groups regarding the adverse event rate. We concluded that prophylactic doses of 10 or 40 jig kg-' lead to a safe and satisfactory degree of control of nausea and vomiting induced by high-dose cisplatin.

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“…10 It is a general assumption, that the vomiting centre (VC) in the medulla oblongata, the chemoreceptor trigger zone (CTZ) in the area postrema (AP) on the caudal margin of the IVth ventricle, the visceral afferent neurons and abdominal vagal afferent neurons, form the central emetic pathway. 11 The VC is representing anatomical structures at the level of the nucleus tractus solitarius (NTS) and the visceral and somatic motor nuclei. Another acceptation is that CINV results from directly activation of the NTS by visceral afferent neurons and/or by inputs from the CTZ.…”

Section: Neuropharmacology Of Emesismentioning

confidence: 99%

Casopitant: a novel NK1-receptor antagonist in the prevention of chemotherapy-induced nausea and vomiting

Ruhlmann¹,

Herrstedt²

2009

TCRM

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Chemotherapy-induced nausea and vomiting (CINV) are among the most feared and distressing symptoms experienced by patients with cancer. The knowledge of the pathogenesis and neuropharmacology of CINV has expanded enormously over the last decades, the most significant discoveries being the role of 5-hydroxytryptamine (5-HT) 3 -and neurokinin (NK) 1 receptors in the emetic reflex arch. This has led to the development of two new classes of antiemetics acting as highly selective antagonists at one of these receptors. These drugs have had a huge impact in the protection from chemotherapy-induced vomiting, whereas the effect on nausea seems to be limited. The first NK 1 receptor antagonist, aprepitant, became clinically available in 2003, and casopitant, the second in this class of antiemetics, has now completed phase III trials. This review delineates the properties and clinical use of casopitant in the prevention of CINV.

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Neuropharmacology of Chemotherapy-induced Emesis

Cited by 123 publications

References 9 publications

Supplemental oxygen does not prevent postoperative nausea and vomiting after gynecological laparoscopy

Supplemental oxygen does not prevent postoperative nausea and vomiting after gynecological laparoscopy

Dose finding study of granisetron in patients receiving high-dose cisplatin chemotherapy

Casopitant: a novel NK1-receptor antagonist in the prevention of chemotherapy-induced nausea and vomiting

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