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Anales del Sistema Sanitario de Navarra

Print version ISSN 1137-6627

Abstract

VERA, R. et al. Treatment of emesis induced by chemotherapy. Anales Sis San Navarra [online]. 2004, vol.27, suppl.3, pp.117-123. ISSN 1137-6627.

Nausea and vomiting are the most frequent secondary effect in patients receiving chemotheraphy treatment, to such a degree that they can result in the treatment being suspended. The physiology of the vomiting induced by chemotherapy is not well known, but it is related to localised receptors of Chemoreceptor Trigger Zone (CTZ), which will be the target of the treatments. The principal factor in unleashing the vomiting is the chemotherapy drug, which, depending on its emetogenic strength, is classified as: high, intermediate or low risk. Other factors depend on the patient himself. Depending on the time of the appearance of the vomit, reference is made to acute emesis when it occurs in the first 24 hours; delayed emesis when it occurs in after the after the first 16-54 hours, or anticipatory emesis, which occurs before the administration of the chemotherapy and is due to a conditioned reflex. The most efficient medicines in the treatment of vomiting related to chemotherapy are the antagonists of the serotonin receptors (ondansetron, granisetron, dolasetron), alone or in combination with corticoids. The dopamine antagonist (metoclopramide), are less efficient at normal close. They require high doses and show greater secondary effects. Aprepitant has recently come onto the market, which is a selective antagonist of the NK1 receptors of the neurokonis. This medicine, associated with a standard therapy of corticoids and serotonin receptors antagonists is able to increase the anti-emetic response in patients subjected to higly emetogenic chemotherapy.

Keywords : Nausea; Vomiting; Chemotherapy; Treatment.

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