Antiemetic Therapy in Patients Receiving Cancer Chemotherapy

Cassandra Marek

ONF 2003, 30(2), 259-271. DOI: 10.1188/03.ONF.259-271

Purpose/Objectives: To examine the currently available antiemetic medications and review their uses in the treatment of chemotherapy-induced nausea and vomiting (N&V).

Data Sources: Published articles and book chapters.

Data Synthesis: N&V is a common yet potentially serious side effect of chemotherapy. Nurses must understand the physiology of N&V, its impact on patients, and the proper use of antiemetic medications to effectively manage this problem. Antiemetic medications vary in mechanism of action, indications for use, and adverse effects.

Conclusions: Nurses are in a position to identify patients who are at risk for N&V and to manage their care using accepted practice guidelines.

Implications for Nursing: Although practice guidelines have been established, the nurse's role in assessment and implementation of care is critical in the prevention and management of chemotherapy-induced N&V.

Jump to a section

    References

    American Society of Health-System Pharmacists (ASHP). (1999). ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. American Journal of Health-System Pharmacists, 56, 729-764.

    Anastasia, P.J. (2000). Effectiveness of oral 5-HT receptor antagonists for emetogenic chemotherapy. Oncology Nursing Forum, 27, 483-493.

    Bauduer, F. (1999). Granisetron plus or minus alprazolam for emesis prevention in chemotherapy of lymphomas. Leukemia and Lymphoma, 34, 341-348.

    Bender, C.M., McDaniel, R.W., Murphy-Ende, K., Pickett, M., Rittenberg, C.N., Rogers, M.P., et al. (2002). Chemotherapy-induced nausea and vomiting. Clinical Journal of Oncology Nursing, 6, 94-102.

    Brown, K.A., Esper, P., Kelleher, L.O., Brace O'Neill, J.E., Polovich, M., & White, J.M. (Eds.) (2001). Chemotherapy and biotherapy guidelines and recommendations for practice. Pittsburgh, PA: Oncology Nursing Society.

    Campos, D., Pereira, J.R., Reinhardt, R.R., Carracedo, C., Poli, S., Vogel, C., et al. (2001). Prevention of cisplatin-induced emesis by the oral neurokinin-1 antagonist, MK-869, in combination with gransetron and dexamethasone or with dexamethasone alone. Journal of Clinical Oncology, 19, 1759-1767.

    Dranitsaris, G., Leung, P., Ciotti, R., Ortega, A., Spinthouri, M., Liaropoulos, L., et al. (2001). A multinational study to measure the value that patients with cancer place on improved emesis control following cisplatin chemotherapy. Pharmacoeconomics, 19, 955-967.

    Eckert, R.M. (2001). Understanding anticipatory nausea. Oncology Nursing Forum, 28, 1553-1560.

    Gralla, R.J., Navari, R.M., Hasketh, P.J., Popovic, W., Strupp, J., Noy, J., et al. (1998). Single-dose oral granisetron has equivalent antiemetic efficacy to intravenous ondansetron for highly emetogenic cisplatin-based chemotherapy. Journal of Clinical Oncology, 16, 1568-1573.

    Gralla, R.J., Osoba, D., Kris, M.G., Kirkbride, P., Hesketh, P.J., Chinnery, L.W., et al. (1999). Recommendations for the use of antiemetics: Evidence-based clinical practice guidelines. Journal of Clinical Oncology, 17, 2971-2994.

    Hickok, J.T., Roscoe, J.A., & Morrow, G.R. (2001). The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer. Journal of Pain and Symptom Management, 22, 843-850.

    Italian Group for Antiemetic Research. (2000). Dexamethasone alone or in combination with ondansetron for the prevention of delayed nausea and vomiting induced by chemotherapy. New England Journal of Medicine, 342, 1554-1559.

    Itano, J., & Taoka, K. (1998). Core curriculum for oncology nursing, (3rd ed.) Philadelphia: Saunders.

    Kraut, L., & Fauser, A.A. (2001). Antiemetics for cancer chemotherapy-induced emesis: Potential of alternative delivery systems. Drugs, 61, 1553-1562.

    Latreille, J., Pater, J., Johnston, D., Laberge, F., Stewart, D., Rusthoven, J., et al. (1998). Use of dexamethasone and granisetron in the control of delayed emesis for patients who receive highly emetogenic chemotherapy. Journal of Clinical Oncology, 16, 1174-1178.

    National Comprehensive Cancer Network. (2001). Nausea and vomiting: Treatment guidelines for patients with cancer, version I. Washington, D.C.: American Cancer Society and Author.

    Navari, R.M., Reinhardt, R.R., Gralla, R.J., Kris, M.G., Hesketh, P.J., Khojasteh, A., et al. (1999). Reduction of cisplatin-induced emesis by a selective neurokinin-1 receptor antagonist. New England Journal of Medicine, 340, 190-195.

    Otto, S.E. (2001). Oncology nursing (4th ed.). St. Louis, MO: Mosby, Inc.

    Pendergrass, K.B. (1998). Options in the treatment of chemotherapy-induced emesis. Cancer Practice, 6, 276-281.

    Perez, E.A. (1998). Use of dexamethasone with 5-HT 3-receptor antagonists for chemotherapy-induced nausea and vomiting. Cancer Journal, 4(2), 72-78.

    Perez, E.A., Sandbach, J., Reeves, J., Chawla, S., Markman, M., Hainsworth, J., et al. (1998). Comparison of single-dose oral granisetron versus intravenous ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: A multicenter, double-blind, randomized parallel study. Journal of Clinical Oncology, 16, 754-760.

    Rittenberg, C. (2002). A new class of antiemetic agents on the horizon. Clinical Journal of Oncology Nursing, 6, 103-104.

    Roscoe, J.A., Morrow, G.R., Hickok, J.T., & Stern, R.M. (2000). Nausea and vomiting remain a significant clinical problem: Trends over time in controlling chemotherapy-induced nausea and vomiting in 1, 413 patients treated in community clinical practices. Journal of Pain and Symptom Management, 20, 113-121.

    Skidmore-Roth, L. (2002). Nursing drug reference. St. Louis, MO: Mosby.

    Spratto, G.R., & Woods, A.L. (2002). PDR nurse's drug handbook. Montvale, NJ: Delmar.

    Thongprasert, S. (2000). Efficacy and tolerability of tropisetron in the prevention of cisplatin-induced nausea and vomiting in advanced non-small cell lung cancer. Acta Oncologica, 39, 221-224.

    Tramer, M.R., Carroll, D., Campbell, F.A., Reynolds, D.J.M., Moore, R.A., & McQuay, H.J. (2001). Cannabinoids for control of chemotherapy-induced nausea and vomiting: Quantitative systematic review. BMJ, 323, 1-9.

    Valley, A.W. (2000). A review of dolasetron as management of nausea and vomiting in cancer patients. Journal of Oncology Pharmaceutical Practice, 6(3 Suppl.), S28-S40.

    Wilkes, G.M., Ingwersen, K., & Barton-Burke, M. (2000). Oncology nursing drug handbook. Boston: Jones and Bartlett.