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Acute Onset Nausea
and Vomiting
Acute
onset nausea and vomiting:
- is the most common type of CINV and usually
happens up to 24-hours after chemotherapy
- is often the most severe, however using antiemetic
drugs before chemotherapy treatments can
help prevent it
- treatment is based on the chemotherapy drug that
is being used and its risk for causing nausea
and vomiting
When a Person is
Receiving High-Risk Chemotherapy:
(Includes people taking high-risk cisplatin or high-risk non-cisplatin chemotherapy)
-
serotonin antagonists like Kytril®, Zofran® , Navoban®, Anzemet® and Aloxi ™, plus steroids (e.g. Decadron® and Medrol®) and the NK1- receptor antagonist , Emend®, are the most effective drugs
for acute onset CINV; these medicines are given before chemotherapy that has a high-risk of nausea and vomiting. Care should be taken to use the combination with the lowest risk for drug– drug interactions
-
other choices which are less effective and often
have more side effects, include Reglan® (a benzamide), Haldol® (a butyrophenone), Compazine® (a phenothiazine), and Marinol® (a cannabinoid). But, these are not first-choice
drugs. They are usually given when people
can’t take serotonin antagonists and steroids,
or if these drugs don’t work
- benzodiazepines can decrease anxiety and
are a useful addition to the antiemetic combination
(adjunctive therapy)
When a Person is
Receiving Medium-Risk Chemotherapy:
- it is advised to use a serotonin antagonist (e.g. Kytril®) in combination with a steroid (e.g. Decadron®) when chemotherapy drugs of medium-risk are used
When a Person is
Receiving Low-Risk Chemotherapy:
- people usually do not need an antiemetic drug
before chemotherapy
When a Person is
Taking More Than One Chemotherapy Drug:
- treatment for acute CINV is based on the chemotherapy
drug with the highest risk for causing
vomiting
- the antiemetic medication is given on each day
of chemotherapy
- the antiemetic used should have a low risk of producing drug–drug interactions
Click here to view a table
listing the antiemetic drugs commonly used to prevent
and treat CINV.
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