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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-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...
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The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
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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,...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Errors involving patients receiving intrathecal chemotherapy.

M Scalzone1, P Coccia, G Cerchiara

  • 1Division of Pediatric Oncology, Catholic University, Rome, Italy.

Journal of Chemotherapy (Florence, Italy)
|May 4, 2010
PubMed
Summary

Medication errors in intrathecal chemotherapy, including wrong drug administration or overdose, pose severe neurotoxicity risks. Prevention is the most effective strategy to manage these potentially fatal oncology treatment errors.

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Area of Science:

  • Oncology
  • Neurotoxicity
  • Medication Safety

Background:

  • Intrathecal chemotherapy errors are a significant problem in cancer treatment.
  • Unintentional intrathecal administration of systemic drugs or overdose of intrathecal drugs can occur despite improved antineoplastic agent management.

Purpose of the Study:

  • To review reported cases of medication errors in intrathecal chemotherapy administration.
  • To identify effective management strategies for these errors.

Main Methods:

  • Literature review of reported cases of intrathecal chemotherapy medication errors.

Main Results:

  • Intrathecal chemotherapy errors can lead to severe, often fatal, neurotoxicity.
  • Various rescue therapies have been proposed for managing these errors.

Conclusions:

  • Prevention of intrathecal chemotherapy medication errors is crucial.
  • Effective management strategies focus on preventing these adverse events.