Review: The Management of Nausea and Vomiting in Clinical Oncology

Antiemesis

“…Several classifications have been developed to define the emetogenicity of chemotherapy; however, none have been universally accepted. 12,[24][25][26][27] Hesketh et al 28 developed a classification of acute emetogenicity for anticancer chemotherapeutic agents and an algorithm to define the emetogenicity of combination chemotherapeutic regimens. The classification, which was updated by Grunberg et al, 29 divides chemotherapeutic agents into 4 levels according to the percentage of patients not receiving antiemetic prophylaxis who experience acute emesis.…”

The impact of a supplementary medication review and counselling service within the oncology outpatient setting

“…He found that although a basic awareness of how and when to take medicines was one pre-requisite for adherence it was insufficient on its own; other factors such as the patient's general health beliefs and specific beliefs about medicines also played an important part; furthermore, patients who were more satisfied with their care were more likely to adhere to their treatment regimen. More specifically, Craig and Powell (1987) observed that effective management of chemotherapy-induced emesis improved overall patient adherence and enhanced the effectiveness of patients' chemotherapy. The pharmacy technician-led clinic in our study provided the opportunity for a full discussion on the support medication in the context of the patient's primary cancer chemotherapy, both in terms of symptom recognition, choice of support medication and clarification of dosage instructions.…”

“…A recent study in women receiving chemotherapy in the first 12 months after diagnosis for breast cancer showed that the incidence of serious effects requiring emergency intervention in hospital (61%) is likely to be higher than that predicted from clinical trial data (Hassett et al, 2006). While support medication strategies have improved over the years, it is not uncommon for patients to become reluctant to continue with further cycles of treatment if they have already experienced side effects from initial cycles of chemotherapy (Craig and Powell, 1987;Atkins and Fallowfield, 2006). Chemotherapy support medication is co-prescribed with the intention of minimising side effects with the hope that this will improve chemotherapy concordance, which in turn will assist the success of chemotherapy.…”

Quinoxalin-2-carboxamides: synthesis and pharmacological evaluation as serotonin type-3 (5-HT3) receptor antagonists

“…Although nausea and vomiting seems like harmless sideeffects, inadequately controlled emesis can result in serious dehydration, loss of sodium and other electrolytes, nutritional depletion and loss of appetite, weight loss, oesophageal tears, deterioration of patient's physical, and mental status (anxiety and depression) which prompt them into non-adherence to the life saving anticancer treatment [5][6] . The recent incorporation of supportive treatment, that is 5-HT 3 antagonists substantially increase the patience compliance of anticancer treatment 3 by decreasing their side-effects (nausea and vomiting), but this 5-HT 3 receptor antagonists are ineffective in 10-30% of patients [7][8] and they possess chiral centres, which increases the synthetic cost of these drugs 9 and further only a very few selective 5-HT 3 antagonist are available 10 .…”