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

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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...
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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.
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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.
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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
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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,...
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Perceived cognitive changes with chemotherapy for breast cancer: A pilot study.

Linda B Piacentine1, Judith Fitzgerald Miller2, Sara Haberlein1

  • 1College of Nursing, Marquette University, P.O. Box 1881, Milwaukee, Wisconsin, 53201-1881.

Applied Nursing Research : ANR
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Summary

Women undergoing chemotherapy for breast cancer experience more fatigue and depression, and report worse cognitive function after treatment compared to healthy individuals. Understanding these changes is crucial for supportive care.

Keywords:
Breast cancerChemotherapyCognitive changesDepressionFatigueWell-being

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Area of Science:

  • Oncology
  • Psychology
  • Quality of Life Research

Background:

  • Breast cancer treatment, particularly chemotherapy, can significantly impact a patient's well-being.
  • Cognitive functioning, fatigue, and mood disturbances are commonly reported side effects.
  • Assessing these changes longitudinally is vital for patient management.

Purpose of the Study:

  • To evaluate perceived cognitive functioning, fatigue, depression, and overall well-being in breast cancer patients before and after chemotherapy initiation.
  • To compare these outcomes with a control group of healthy women.

Main Methods:

  • A descriptive, repeated measures study design was employed.
  • Participants included women undergoing chemotherapy for breast cancer and a matched sample of healthy women.
  • Standardized measures assessed quality of life, fatigue, cognitive changes, and depression.

Main Results:

  • Prior to chemotherapy, breast cancer patients reported higher levels of fatigue and depression than healthy controls.
  • Following chemotherapy, patients experienced diminished cognitive functioning, increased fatigue, and exacerbated depressive symptoms compared to the control group.

Conclusions:

  • This research provides early insights into the multifaceted symptom experience of breast cancer patients undergoing chemotherapy.
  • Recognizing the pre- and post-chemotherapy changes in cognitive function and associated symptoms is a critical step in developing effective coping strategies for patients.
  • Further research is needed to elucidate the mechanisms and long-term effects of chemotherapy on cognitive function and well-being.