Oral Nutritional Interventions
Oral nutritional interventions involve the provision of dietary advice or education with or without dietary modification or nutritional supplements. Nutritional supplements included in this type of intervention are those involving general protein-calorie supplements and multiple combinations of vitamins, minerals, and other compounds. Specific herbal supplements and some highly specific supplements such as carnitine and individual vitamins are considered as separate interventions.
Netupitant-Palonosetron Combination (NEPA)
Netupitant-Palonosetron Combination (NEPA) is a single-day, fixed-dose combination drug that targets dual antiemetic pathways. It is a combination of netupitant, an NK1 receptor antagonist, and palonosetron, a 5-HT3 receptor antagonist. This drug has been used to prevent chemotherapy-induced nausea and vomiting in patients with cancer receiving chemotherapy.
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CJON 2007 article—Putting Evidence Into Practice®: Evidence-Based Interventions for Chemotherapy-Induced Nausea and Vomiting
CINV Search Strategy and Results
Cannabis/Cannabinoids
Cannabinoids are compounds present in the Cannabis plant that bind to cannabinoid receptors and exert pharmacologic effects that stimulate appetite, act as antiemetics, and have analgesic effects. Cannabinoids approved for use in the United States include dronabinol and nabilone. Cannabis compounds studied for symptom management in patients with cancer have been in oral forms, oral spray, or ingested through smoking. It should be noted that not all Cannabis formulations or methods of ingestion necessarily provide the same effects and results.
Chemotherapy-Induced Nausea and Vomiting—Adult
Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared and severe side effects of cancer treatment. CINV generally is classified as anticipatory (a conditioned response, because of prior CINV, which may be triggered when exposed to some stimuli), acute (occurring within 24 hours of chemotherapy administration), delayed (occurring after 24 hours and lasting up to 7 days), breakthrough (occurring despite prophylactic medications), and refractory (occurring because of a failure of prophylactic and breakthrough medications to control the symptoms).
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