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Chemotherapy-induced nausea and vomiting (CINV) is a common side-effect of many cancer treatments. Nausea and vomiting are two of the most feared cancer treatment-related side effects for cancer patients and their families.
The discovery of neurokinin 1 (NK 1) receptor antagonists was a turning point in the prevention of nausea and vomiting associated with cancer chemotherapy. [4] An example of a drug in this class is aprepitant. Chemotherapy-induced emesis appears to consist of acute and delayed phases.
A painting from 1681 depicting a person affected by nausea and vomiting. Cancer and nausea are associated in about fifty percent of people affected by cancer. [1] This may be as a result of the cancer itself, or as an effect of the treatment such as chemotherapy, radiation therapy, or other medication such as opiates used for pain relief.
Chemotherapy-induced nausea and vomiting (CINV) are common with many treatments and some forms of cancer. Since the 1990s, several novel classes of antiemetics have been developed and commercialized, becoming a nearly universal standard in chemotherapy regimens, and helping to successfully manage these symptoms in many people.
Palonosetron, sold under the brand name Aloxi, is a medication used for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV). [2] [4] [5] It is a 5-HT 3 antagonist. [2] [4] [5] Palonosetron is administered intravenously, [6] or as a single oral capsule. [7] It has a longer duration of action than other 5-HT 3 antagonists.
Aprepitant, sold under the brand name Emend among others, is a medication used to prevent chemotherapy-induced nausea and vomiting and to prevent postoperative nausea and vomiting. [5] It may be used together with ondansetron and dexamethasone. [5] It is taken by mouth [5] or administered by intravenous injection. [3]
The vomiting center of the brain refers to the groups of loosely organized neurons in the medulla that include the CTZ within the area postrema and the nucleus tractus solitarii. [2] One of the ways the chemoreceptor trigger zone implements its effects on the vomiting center is by activation of the opioid mu receptors and delta receptors. [6]
Hair that is lost returns in the months after completion of chemotherapy. Nausea and vomiting can occur with ABVD, although treatments for chemotherapy-induced nausea and vomiting have improved substantially (see Supportive care below). Low blood counts, or myelosuppression, occur about 50% of the time with ABVD.