Gulzar Ahmad Malik, Abid Mehmood, Muhammad Ishaque Khan, Muhammad Muneer, Riaz Hussain, Muhammad Rasheed Ch.
Efficacy of various antiemetics in the control of nausea and vomiting induced by cancer chemotherapy
Pak Armed Forces Med J Dec 2004;54(2):159-64.
Quaid I Azam Medical College, Bahawalpur
To assess the potency and efficacy of various antiemetic agents in the prevention of nausea and vomiting observed in the patients taking various cytotoxic chemotherapy protocols. Prospective comparative study. Department of Surgery, Unit 2 BVH Bahawalpur. Hundred patients with various malignancies taking combined cytotoxic chemotherapy were evaluated for the efficacy and potency of three antiemetic agents, Metoclopramide, Ondansetron and Tropisetron with and without corticosteroids. Sixty-two patients were males and 38 females, aged ranging from 3 to 65 years. Patients received each antiemetic agent during one or more course of chemotherapy for a total of 600 courses administered intravenously exclusively. Each agent was administered as a single intravenous dose slowly before the start of chemotherapy on day 1 or by mouth on subsequent days (median treatment duration: 5 days). The patients receiving cancer chemotherapy had a 40%, 65% and 70% complete response rate and 10%, 20% and 24% partial response rate respectively for metoclopramide, ondansetron and tropisetron during the first 24 hours period of the first course. We observed drowsiness (six cases), extrapyramidal signs (seven cases) and headache (seventeen cases) of metoclopramide while with ondansetron and tropisetron diarrhea was seen in 5 & 3 cases and headache in 7 & 5 cases respectively as side effects. 5-HT3 receptor antagonists are safe, effective, easy to use, has no serious side effects and can be recommended for all age patients. The efficacy of all antiemetics may be enhanced by the addition of corticosteroids, with a more superior edge in 5-HT3 receptors antagonists especially in patients receiving highly emetogenic cytotoxic chemotherapy.
Category: Oncology
Keywords: Chemotherapy. Vomiting. Metoclopramide. Serotonin Antagonists. Ondansetron. Tropisetron. Dexamethasone.
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