FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 329:1790-1796 December 9, 1993 Number 24 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Chemotherapy regimens for the treatment of cancer are unfortunately better known for their toxicity than for their efficacy. Although some of the toxic effects may be life-threatening, patients are often most fearful of the nausea and emesis caused by chemotherapy, which are generally self-limited and seldom life-threatening¹. Effective control of nausea and emesis is therefore a central goal of physicians using chemotherapy regimens.

Treatment of emesis in a patient with cancer begins with an evaluation of the possible causes. Physical complications of cancer (a brain metastasis or bowel obstruction), metabolic complications (hypercalcemia), or unrelated factors (a gastric ulcer or . . . [Full Text of this Article]

Mechanism of the Emetic Response

Neurotransmitters Involved in Emesis

Dopamine

Histamine and Acetylcholine

Opiates

Serotonin

Antiemetic Drugs

Phenothiazines

Butyrophenones

Corticosteroids

Cannabinoids

Benzodiazepines

Substituted Benzamides

Serotonin Antagonists

Combinations of Antiemetic Drugs

Delayed Vomiting

Anticipatory Vomiting

Summary

Source Information

From the Section of Hematology/Oncology, Vermont Cancer Center, University of Vermont, Burlington (S.M.G.), and the Section of Medical Oncology, Evans Memorial Department of Clinical Research, Boston University Medical Center, Boston (P.J.H.).

Address reprint requests to Dr. Grunberg at the Section of Hematology/Oncology, Vermont Cancer Center, 1 S. Prospect St., Burlington, VT 05402.

References

This article has been cited by other articles:

• Wender, R. H. (2009). Do current antiemetic practices result in positive patient outcomes? Results of a new study. Am J Health Syst Pharm 66: S3-S10 [Abstract] [Full Text]  
• Kloth, D. D. (2009). New pharmacologic findings for the treatment of PONV and PDNV. Am J Health Syst Pharm 66: S11-S18 [Abstract] [Full Text]  
• Barbour, S. Y. (2008). Caring for the treatment-experienced breast cancer patient: The pharmacist's role. Am J Health Syst Pharm 65: S16-S22 [Abstract] [Full Text]  
• Diemunsch, P., Gan, T. J., Philip, B. K., Girao, M. J., Eberhart, L., Irwin, M. G., Pueyo, J., Chelly, J. E., Carides, A. D., Reiss, T., Evans, J. K., Lawson, F. C., for the Aprepitant-PONV Protocol 091 International, (2007). Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind Phase III trial in patients undergoing open abdominal surgery. Br J Anaesth 99: 202-211 [Abstract] [Full Text]  
• Hamadani, M., Chaudhary, L., Awan, F. T., Khan, J. K., Kojouri, K., Ozer, H., Tfayli, A. (2007). Management of platinum-based chemotherapy-induced acute nausea and vomiting: is there a superior serotonin receptor antagonist?. J Oncol Pharm Pract 13: 69-75 [Abstract]  
• Gan, T. J., Apfel, C. C., Kovac, A., Philip, B. K., Singla, N., Minkowitz, H., Habib, A. S., Knighton, J., Carides, A. D., Zhang, H., Horgan, K. J., Evans, J. K., Lawson, F. C., The Aprepitant-PONV Study Group, (2007). A Randomized, Double-Blind Comparison of the NK1 Antagonist, Aprepitant, Versus Ondansetron for the Prevention of Postoperative Nausea and Vomiting. Anesth. Analg. 104: 1082-1089 [Abstract] [Full Text]  
• Aapro, M., Grunberg, S., Manikhas, G., Olivares, G, Suarez, T, Tjulandin, S., Bertoli, L., Yunus, F, Morrica, B, Lordick, F, Macciocchi, A (2006). A phase III, double-blind, randomized trial of palonosetron compared with ondansetron in preventing chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Ann Oncol 17: 1441-1449 [Abstract] [Full Text]  
• Suk, R., Gurubhagavatula, S., Park, S., Zhou, W., Su, L., Lynch, T. J., Wain, J. C., Neuberg, D., Liu, G., Christiani, D. C. (2005). Polymorphisms in ERCC1 and Grade 3 or 4 Toxicity in Non-Small Cell Lung Cancer Patients. Clin. Cancer Res. 11: 1534-1538 [Abstract] [Full Text]  
• Hesketh, P. J., Grunberg, S. M., Gralla, R. J., Warr, D. G., Roila, F., de Wit, R., Chawla, S. P., Carides, A. D., Ianus, J., Elmer, M. E., Evans, J. K., Beck, K., Reines, S., Horgan, K. J. (2003). The Oral Neurokinin-1 Antagonist Aprepitant for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Multinational, Randomized, Double-Blind, Placebo-Controlled Trial in Patients Receiving High-Dose Cisplatin--The Aprepitant Protocol 052 Study Group. JCO 21: 4112-4119 [Abstract] [Full Text]  
• Rosen, R. H. (2002). Management of Chemotherapy-Induced Nausea and Vomiting. Journal of Pharmacy Practice 15: 32-41 [Abstract]  
• Shen, J., Wenger, N., Glaspy, J., Hays, R. D., Albert, P. S., Choi, C., Shekelle, P. G. (2000). Electroacupuncture for Control of Myeloablative Chemotherapy-Induced Emesis: A Randomized Controlled Trial. JAMA 284: 2755-2761 [Abstract] [Full Text]  
• Ioannidis, J. P. A., Hesketh, P. J., Lau, J. (2000). Contribution of Dexamethasone to Control of Chemotherapy-Induced Nausea and Vomiting: A Meta-Analysis of Randomized Evidence. JCO 18: 3409-3422 [Abstract] [Full Text]  
• Junker, A., Wiedemann, G. J (1999). Antiemetic guidelines: A cooperation between a non-university hospital (Klinikum Remscheid) and a university center (Medical University of Lubeck) in Germany. J Oncol Pharm Pract 5: 125-127  
• Hesketh, P. J. (1999). Defining the Emetogenicity of Cancer Chemotherapy Regimens: Relevance to Clinical Practice. The Oncologist 4: 191-196 [Abstract] [Full Text]  
• Hesketh, P. J., Gralla, R. J., Webb, R. T., Ueno, W., DelPrete, S., Bachinsky, M. E., Dirlam, N. L., Stack, C. B., Silberman, S. L. (1999). Randomized Phase II Study of the Neurokinin 1 Receptor Antagonist CJ-11,974 in the Control of Cisplatin-Induced Emesis. JCO 17: 338-338 [Abstract] [Full Text]  
• Rousseau, P. (1995). Antiemetic therapy in adults with terminal disease: A brief review. AM J HOSP PALLIAT CARE 12: 13-18 [Abstract]