For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .
Results of a double blind placebo controlled study of ondansetron as an antiemetic during total body irradiation in patients undergoing bone marrow transplantation.
Total body irradiation ( TBI ) is a highly emetogenic component of the majority of conditioning regimens in use for bone marrow transplantation . Conventional antiemetic therapy fails to control nausea and vomiting induced by single fraction TBI in as many as 50 % of patients . In a double blind study of 20 patients undergoing marrow transplantation , a single 8 mg ondansetron dose was compared with placebo given immediately prior to TBI . Our routine premedication of phenobarbitone and corticosteroid was also administered to all patients . All patients had received high dose melphalan the previous evening . Only 1 of the 10 patients in the ondansetron group experienced an emetic event compared with 5 of the 10 in the comparison group ( p = 0.029 ) . No significant adverse events were observed . Ondansetron appears to have extremely useful antiemetic activity during single fraction low dose rate TBI
For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .