By Maurizio Tonato (auth.), Maurizio Tonato M.D. (eds.)
Much development has been made within the therapy of emesis brought on by antineoplastic treatment, and especially chemotherapy. although, a few features stay arguable and the topic of persevered examine. This thoroughly up-to-date accomplished guide on antiemetics covers quite a lot of clinically correct issues, delivering the reader with an excellent resource of simple session, and giving an total photo of the state-of-the-art and a few clues for destiny development.
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Extra info for Antiemetics in the Supportive Care of Cancer Patients
N Engl J Med 1983 (309):796 99 Spiess JL, Adelstein DJ, Hines JD: Evaluation of ethanol as an antiemetic in patients receiving cisplatin. Clin Ther 1987 (9):400-404 100 D'Acquisto RW, Tyson LB, Gralla RJ et al: The influence of a chronic high alcohol intake on chemotherapy-induced nausea and vomiting. Proc Am Soc Clin Oncol 1986 (5):257 101 Stern RM, Hu S, LeBlanc R, Koch KL: Chinese hyper-susceptibility to vection-induced motion sickness. Aviat Space Environ Med 1995 (in press) 102 Xu LH, Koch KL, Summy-Long J et al: Hypothalamic and gastric myoelectrical responses during vection-induced nausea in healthy Chinese subjects.
In cases where efficacy of the initial antiemetic dose is insufficient, the act of vomiting itself may make delivery and retention of further oral antiemetic doses difficult. In addition, continuous nausea during chemotherapy or anticipatory nausea after a poor experience with previous chemotherapy may limit patient compliance with an oral regimen. Several alternative routes have therefore been proposed to avoid hepatic metabolism while maintaining ease of administration and high rates of absorption.
This pattern might suggest a threshold value at which full saturation of the relevant receptor is achieved (although 100% efficacy is still not achieved). Various schedules of administration have also been studied with other antiemetic families. Extended infusion of antidopaminergic antiemetics has been viewed as both a method to increase overall efficacy and a method to decrease toxicity. Extended infusion schedules for both metoclopramide and prochlorperazine have therefore been studied. 0 I 40 lAg/kg DOLASETRON.