Related Experiment Video
Updated: Aug 11, 2026
05:56
Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
Published on: June 21, 2024
Emerging drugs for chemotherapy-induced emesis
Rudolph M Navari1, Paula S Province
1University of Notre Dame, Notre Dame, IN 46556, USA. navari.1@nd.edu
Expert Opinion on Emerging Drugs
|March 1, 2006
Summary
New antiemetic drugs, palonosetron and aprepitant, offer improved control of chemotherapy-induced nausea and vomiting (CINV), addressing challenges in both acute and delayed symptoms. Future research will explore their use with other agents for better patient outcomes.
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Chemotherapy-induced nausea and vomiting (CINV) significantly impacts patient quality of life.
- Risk factors for CINV include agent emetogenicity, cycle frequency, and patient characteristics like female gender and no alcohol consumption.
- While 5-hydroxytryptamine-3 (5-HT3) receptor antagonists plus dexamethasone improve acute CINV, delayed CINV remains a challenge.
Purpose of the Study:
- To review the efficacy of new antiemetic agents, palonosetron and aprepitant, for CINV prevention.
- To discuss revised antiemetic guidelines for CINV management.
- To explore future research directions for CINV control.
Main Methods:
- Review of current literature on CINV and antiemetic therapies.
- Analysis of the mechanisms and clinical data for palonosetron (a 5-HT3 antagonist) and aprepitant (a neurokinin-1 receptor antagonist).
- Examination of ongoing clinical trials for novel antiemetic agents.
Main Results:
- Palonosetron and aprepitant are approved for preventing both acute and delayed CINV.
- Palonosetron exhibits a longer half-life and higher binding affinity compared to first-generation 5-HT3 antagonists.
- Aprepitant represents a new class of neurokinin-1 receptor antagonists.
- Several other 5-HT3 and NK-1 antagonists are in clinical development.
Conclusions:
- Palonosetron and aprepitant represent significant advancements in managing CINV.
- Revised antiemetic guidelines incorporate these new agents.
- Future studies should investigate combinations of palonosetron, aprepitant, and other agents (e.g., olanzapine, gabapentin) for various chemotherapy regimens and clinical settings.
Related Concept Videos
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
01:29Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates these...
01:21Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
01:14Prevention of Further Absorption of Poison
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
01:28Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists
Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...