Effectiveness of antiemetics in control of antineoplastic chemotherapy-induced emesis at home

Abstract

Objective: Evaluating if antiemetics are effective in the prevention or treatment at home, of chemotherapyinduced emesis. Methods: In total, were included 42 women with breast cancer in moderately emetogenic chemotherapy, using dexamethasone/ondansetron before each cycle. The frequency of nausea and vomiting was obtained by applying the instrument in the pre-chemotherapy period, and 24h, 48h, 72h and 96h after chemotherapy. The use of antiemetics was considered in accordance with adherence to medical prescription. Results: All patients (n = 42, 100%) reported emesis at some point. Only five cases (11.9%) were anticipatory. In the first 24 hours (acute emesis), 38 (90.5%)ayed), emesis was reported by all despite the regular use (n = 20, 47.6%) or not (n = 22, 52.4%) of antiemetics (ondansetron, dexamethasone and metoclopramide/or dimenhydrinate). Conclusion: Antiemetics were not effective in the prevention or treatment at home, of chemotherapy-induced emesis. ResumoObjetivo: Avaliar se antieméticos são eficazes na prevenção ou tratamento da emese induzida pela quimioterapia antineoplásica, em domicílio. Métodos: Foram incluídas 42 mulheres com câncer de mama, em quimioterapia moderadamente emetogênica, submetidas à dexametasona/ondansetrona antes de cada ciclo. A frequência de náuseas e vômitos foi obtida por instrumento aplicado nos tempos pré-quimioterapia e 24h, 48h, 72h e 96h pós-quimioterapia. O uso de antieméticos foi considerado conforme adesão à prescrição médica. Resultados: Todas as pacientes (n=42, 100%) relataram emese em algum momento. Apenas cinco casos (11,9%) foram antecipatórios. Nas primeiras 24h (emese aguda), 38 (90,5%) apresentaram náuseas associadas (n=20, 47,6%) ou não (n=18, 42,8%) a vômitos e, após este período (tardio), a emese foi referida por todas, apesar da utilização regular (n=20, 47,6%) ou não (n=22, 52,4%) de antieméticos (ondansetrona, dexametasona, metoclopramida e/ou dimenidrinato). Conclusão: Os antieméticos não foram eficazes na prevenção ou no tratamento da emese induzida pela quimioterapia, em domicílio.

Prevalence of xerostomia in women during breast cancer chemotherapy

“…Antiemetics are widely prescribed during chemotherapy in hospitals, outpatient clinics and at home, especially serotonin receptor antagonists such as ondansetron, however there are few studies that describe their action and side effects in this scenario (23) .…”

“…In 2014, a study was carried out to assess the impact of antiemetics on the control of emesis in patients with breast cancer undergoing chemotherapy, and concluded that they are not effective in preventing or treating chemotherapy-induced nausea and vomiting (23) .…”

Impact of chemotherapy on perceptions related to food intake in women with breast cancer: A prospective study

“…In the present study (after the first CT cycle), 10.91% (n = 6) of patients reported nausea, reaching 32.73% (n = 18) after the last CT cycle (p = 0.018). Castro et al [ 40 ] investigated the prevalence of CINV in 42 women with BC in the same institution and found 52.4% of patients had late-onset nausea. The highest prevalence found by these authors is explained by CINV being evaluated up to 4 days after CT infusion, while we evaluated CINV on the infusion day of the next CT cycle (i.e., after 21 days).…”

Stress perception among patients in pre-colonoscopy period and those undergoing chemotherapy treatment

“…This is strengthened by the assertion that chemotherapy has provided remarkable optimism in the treatment of cancer and has been increasing the survival rate of patients, although the time between diagnosis and acceptance of the disease varies according to each individual (22) . In addition to the above, it is important to highlight that progress in the pharmaceutical field has also provided more effective control of the side effects from chemotherapy, for example nausea and vomiting through the association of different drugs, which makes this a less demanding process nowadays (23) . So it is important that effective coping strategies are developed and used by the patients, and social support provided by family and health professionals is effective in minimizing stress, especially during the diagnosis period.…”