Related Experiment Video

Updated: Jun 23, 2026

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
08:36

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment

Published on: April 19, 2024

1.3K

Aprepitant in pediatric patients using moderate and highly emetogenic protocols: a systematic review and

Lucas Miyake Okumura1, Fernanda D'Athayde Rodrigues2, Maria Angelica Pires Ferreira2

  • 1Clinical Pharmacy Division, Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos St, Porto Alegre, Brazil.

British Journal of Clinical Pharmacology
|November 22, 2016
PubMed

Insights

Triple therapy, including aprepitant, ondansetron, and dexamethasone, effectively reduces chemotherapy-induced vomiting in pediatric patients. This combination therapy did not increase the risk of febrile neutropenia, offering a safer antiemetic option.

Area of Science:

  • Pediatric Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Chemotherapy-induced vomiting (CIV) is a significant challenge in pediatric cancer treatment.
  • Standard antiemetic regimens may not provide complete symptom control for all patients.
  • The triple therapy of aprepitant, ondansetron, and dexamethasone is a potential strategy to improve antiemetic control.

Purpose of the Study:

  • To review the efficacy and safety of aprepitant, ondansetron, and dexamethasone (triple therapy) for managing CIV in pediatric and adolescent patients.
  • To assess the impact of triple therapy on overall complete response rates and toxicities.

Main Methods:

  • A systematic review and meta-analysis of published studies up to September 2016.
  • Data sources included Medline, Embase, Scielo, Lilacs, Cochrane, and congress abstracts.
  • Primary outcome was overall complete response (no vomiting from 0 to 120 hours); secondary outcomes included phase-specific response and toxicities.

Main Results:

  • Three trials involving 451 pediatric patients were included.
  • Triple therapy significantly reduced the risk of chemotherapy-induced vomiting (RR = 0.48; 95% CI 0.34-0.67).
  • No significant difference in the incidence of febrile neutropenia was observed between groups (RR = 1.02; 95% CI 0.66-1.58).

Conclusions:

  • Triple therapy demonstrates efficacy in decreasing CIV risk in pediatric patients without increasing febrile neutropenia.
  • Further research is needed to identify subpopulations that would benefit most from this strategy.
  • Additional studies should investigate risk factors for nausea and vomiting, as complete antiemetic response was not achieved in all patients.
Abstract

Keywords:
childnauseapaediatricsrandomized controlled trialsvomiting

More Related Videos

Laparoscopic Posterior Radical Antegrade Modular Pancreatosplenectomy for Distal Pancreatic Carcinoma03:55

Laparoscopic Posterior Radical Antegrade Modular Pancreatosplenectomy for Distal Pancreatic Carcinoma

Published on: December 29, 2023

1.3K
Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting05:56

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

Published on: June 21, 2024

2.3K

Related Concept Videos

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...
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-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...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...