Ondansetron (GR38032F) plus dexamethasone: effective anti-emetic prophylaxis for patients receiving cytotoxic chemotherapy

Smith, D. B.; Newlands, ES; Spruyt, Odette; Begent, R. H. J.; Rustin, G. J. S.; Mellor, B.; Bagshawe, K. D.

doi:10.1038/bjc.1990.62

Cited by 49 publications

(10 citation statements)

References 7 publications

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“…The 2 hourly application of Sea Bands prolongs the antiemetic action. Best results were obtained from the 2 hourly self-administration of 5 min of transcutaneous electrical stimulation of P6 using a simple battery-operated TENS machine (15 Hz) to activate a large, easy-to-place surface electrode and increasing current until Qi is elicited.…”

mentioning

confidence: 99%

Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy

Dundee¹,

Yang²,

McMillan³

1991

J R Soc Med

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The beneficial effects of transcutaneous electrical stimulation of the P6 antiemetic point (Neiguan) as an adjuvant to standard antiemetics was studied in over 100 patients in whom chemotherapy-induced sickness was not adequately controlled by antiemetics alone. Although the results were not quite as good as with invasive acupuncture, more than 75% patients achieved considerable benefit from what was a nontoxic procedure. The use of large diffuse low impedence electrodes simplifies the technique. The 2 hourly application of Sea Bands prolongs the antiemetic action. Best results were obtained from the 2 hourly self-administration of 5 min of transcutaneous electrical stimulation of P6 using a simple battery-operated TENS machine (15 Hz) to activate a large, easy-to-place surface electrode and increasing current until Qi is elicited.

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confidence: 99%

Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy

Dundee¹,

Yang²,

McMillan³

1991

J R Soc Med

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“…Recent interest has focused on the use of a combination antiemetics acting at different receptors and the adoption of a multimodal approach to tackle this problem. Ondansetron in combination with dexamethasone has been used successfully to treat PONV refractory to ondansetron alone 7 .…”

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confidence: 99%

“…The major concern regarding use of dexamethasone is infection, delayed wound healing and other side effect. But various studies in literature have shown that a single dose of dexamethasone does not increase complications 5,7,13 .…”

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confidence: 99%

“…The mechanism of action of dexamethasone is unknown; however there have been some suggestions, such as central/ peripheral inhibition of production of 5 HT, central inhibition of synthesis of prostaglandins, or changes in permeability of the blood brain barrier to serum protein 7,12 . The major concern regarding use of dexamethasone is infection, delayed wound healing and other side effect.…”

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confidence: 99%

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Comparison of ondansetron used alone and in combination with dexamethasone as a prophylaxis for postoperative nausea and vomiting following laparoscopic cholecystectomy

Sanjowal¹,

Biswas²,

Saha³

2015

Faridpur Med Coll J

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:Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence can be as high as 76% which would cause unexpected delay in hospital discharge. This study was designed to compare the efficacy of the ondansetron alone with combination of ondansetron and dexamethasone the given as prophylaxis for PONV in patients undergoing laparoscopic cholecystectomy. One hundred patients undergoing elective laparoscopic cholecystectomy were selected and randomly divided into 2 groups of 50 each. Group I received 4mg of ondansetron intravenously (iv), whereas Group II received ondansetron 4mg and dexamethasone 4mg just before induction of anaesthesia. Postoperatively, the patients were assessed for episodes of nausea, vomiting and need for rescue antiemetic. Complete response defined as no nausea and vomiting during first 24 hours, was noted in 76% of patients in Group I and in 92% of patients in Group II. Rescue anti emetic requirement was less in Group II (4%) than Group I (20%). So it can be concluded that the combination of ondansetron and dexamethasone is more effective in preventing PONV in patients undergoing laparoscopic cholecystectomy than ondansetron alone.

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“…One study conducted by Smith et al [4] investigated the efficacy of oral ondansetron 8 mg, 15 min prior to car boplatin 400 mg/m2, followed by ondansetron 8 mg orally 3 times a day. Results showed that 73% of refractory patients and 87% of chemotherapy-naive patients re ported complete control of emesis (0 emetic episodes) on day 1.…”

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confidence: 99%

A Randomised, Double-Blind, Parallel-Group Study to Compare the Efficacy and Safety of Ondansetron (GR38032F) plus Dexamethasone with Metoclopramide plus Dexamethasone in the Prophylaxis of Nausea and Emesis Induced by Carboplatin Chemotherapy

et al. 1997

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A double-blind, parallel-group study in 189 ovarian cancer patients compared the efficacy of ondansetron 8 mg i.v. (OND) and metoclopramide 60 mg i.v. (MET) both in combination with dexamethasone 20 mg i.v. in the prevention of carboplatin-induced emesis. On day 1, complete or major control of emesis (0–2 emetic episodes) was observed in 97% patients from the OND group compared with 74% patients from the MET group (p < 0.001). Similarly, a worst-day analysis over days 1–3 showed complete or major control of emesis in 87% patients (OND) compared wth 66% patients (MET) (p < 0.001). Similar findings in favour of the OND group were observed for nausea grade on day 1 and the worst-day grade during days 1-3. OND was better tolerated than MET. Fewer patients from the OND group (13%) reported adverse events compared with the MET group (21 %). Extrapyramidal type symptoms were observed in 6 (6%) patients from the MET group (paraesthesia, involuntary movement of the jaw and tongue, and restlessness), compared with none from the OND group. Ondansetron plus dexamethasone is a highly effective and well-tolerated treatment and is significantly superior to metoclopramide plus dexamethasone in the prevention of carboplatin-induced emesis.

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Ondansetron (GR38032F) plus dexamethasone: effective anti-emetic prophylaxis for patients receiving cytotoxic chemotherapy

Cited by 49 publications

References 7 publications

Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy

Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy

Comparison of ondansetron used alone and in combination with dexamethasone as a prophylaxis for postoperative nausea and vomiting following laparoscopic cholecystectomy

A Randomised, Double-Blind, Parallel-Group Study to Compare the Efficacy and Safety of Ondansetron (GR38032F) plus Dexamethasone with Metoclopramide plus Dexamethasone in the Prophylaxis of Nausea and Emesis Induced by Carboplatin Chemotherapy

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