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 .
Pharmacokinetics of granisetron in adults and children with malignant diseases.
Granisetron ( GRN ) is widely used for patients with various cancers who suffer from chemotherapy-induced vomiting and nausea . The , pharmacokinetics of GRN  has not been fully evaluated in such patients , however , and its dosage regimen is still controversial . In this study , we determined  GRN  levels in serum and urine from lung cancer patients and children suffering from cancer after intravenous infusion . In lung cancer patients , the interindividual variations in t(1/2beta ) , area under the concentration-time curve ( AUC ) , and Vd(beta ) were relatively smaller than expected from previous reports on healthy subjects , while t(1/2beta ) was prolonged more than 5-fold in healthy subjects . Urinary excretion of unchanged GRN  in lung cancer patients was ca . 15 % of dose , consistent with previous reports , and one individual demonstrated an even higher urinary excretion ( ca . 45 % ) . The pharmacokinetic parameters of GRN  in child cancer patients varied markedly among individuals , and some child patients had smaller t(1/2beta ) than adult patients . In these cases , GRN should be administered at shorter intervals . These results suggested that a pharmacokinetic study of GRN was necessary for planning a dosage regimen and managing chemotherapy-induced vomiting and nausea
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 .