Likely to Be Effective

Benzodiazepine for Anticipatory Chemotherapy-Induced Nausea and Vomiting

for Chemotherapy-Induced Nausea and Vomiting—Adult

Anticipatory chemotherapy-induced nausea and vomiting is the experience of these symptoms prior to chemotherapy treatment because of the expectation of nausea and vomiting. Benzodiazepines are a class of tranquilizers commonly used to treat a range of conditions, such as anxiety.

Guideline / Expert Opinion

Dupuis, L., Roscoe, J., Olver, I., Aapro, M., Molassiotis, A., Dupuis, L.L., & Roscoe, J.A. (2017). 2016 updated MASCC/ESMO consensus recommendations: Anticipatory nausea and vomiting in children and adults receiving chemotherapy. Supportive Care in Cancer, 25, 317–321. 

Purpose & Patient Population

PURPOSE: To update the 2011 recommendations for the prevention and treatment of anticipatory nausea and vomiting (ANV) in children and adults receiving chemotherapy
 
TYPES OF PATIENTS ADDRESSED: Patient undergoing chemotherapy and experiencing ANV

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Evidence-based guideline

PROCESS OF DEVELOPMENT: Expert clinicians panel in treating and preventing ANV were invited to meet. All the found studies were reviewed, discrepancies were solved, and were discussed between the members through teleconferences and at a face-to-face meeting.
 
DATABASES USED: MEDLINE and EMBASE
 
INCLUSION CRITERIA: Randomized, primary studies; published in full text; English language; included at least ten10 participants per study arm for comparative studies and at least 10 participants overall for noncomparative studies
 
EXCLUSION CRITERIA: Did not evaluate an intervention for the prevention or treatment of ANV or did not report the proportion of patients experiencing complete control of ANV consistently

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Pediatrics, elder care, palliative care

Results Provided in the Reference

In all, 88 citations were found and 9 were excluded. No new information regarding the treatment of ANV was found in these articles. The 2015 MASCC recommendations should be considered for the prevention and the treatment of ANV.

Guidelines & Recommendations

Best approach to control ANV is to control acute and delayed nausea and vomiting (level of evidence: MASCC moderate, high consensus; ESMO: III, grade of recommendation A). Benzodiazepines can reduce the occurrence of ANV (level of evidence: MASCC moderate, moderate consensus; ESMO: II, grade of recommendation A). Behavioral therapies (progressive muscle relaxation training, systematic desensitization, and hypnosis) (level of evidence: MASCC moderate, moderate consensus; ESMO: II, grade of recommendation B).

Limitations

Limitation of the pediatric studies; the behavioral therapies methods applied in the studies differ in their methods.

Nursing Implications

The best approach to controlling ANV is by controlling acute and delayed nausea and vomiting. Some pharmaceutical and non-pharmaceutical treatment modalities are used for the prevention and treatment of ANV.

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