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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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...

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

Chemotherapy-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,...

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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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.
Two synthetic agonists of THC,...

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

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...

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...

Cancer Therapies

Cancer Therapies

Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...

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Related Experiment Video

Updated: Dec 19, 2025

The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma

The Clinical Application of Tumor Treating Fields Therapy in Glioblastoma

Published on: April 16, 2019

Routine antiemetic prophylaxis with dexamethasone during COVID-19: Should oncologists reconsider?

Mark A Marinella¹

¹Division of Hematology-Oncology, Department of Internal Medicine, Wright Stat e University School of Medicine, Dayton, OH, USA.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners

|June 9, 2020

Summary

Oncologists should reconsider routine dexamethasone use in cancer patients during COVID-19. This steroid can deplete lymphocytes, increasing infection risk and potentially worsening outcomes for patients with SARS-CoV-2.

Keywords:

COVID-19 SARS-CoV-2 antiemetic prophylaxis cancer dexamethasone lymphocytes lymphopenia novel coronavirus

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Last Updated: Dec 19, 2025

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Area of Science:

Oncology
Immunology
Infectious Diseases

Background:

The COVID-19 pandemic, caused by SARS-CoV-2, poses significant risks to cancer patients.
SARS-CoV-2 infection is associated with lymphocyte depletion (B- and T-cells), correlating with severe illness and mortality.
Higher lymphocyte levels may indicate better outcomes in COVID-19 patients.

Purpose of the Study:

To evaluate the impact of dexamethasone on lymphocyte counts in cancer patients during the COVID-19 pandemic.
To advise oncologists on the judicious use of dexamethasone in cancer patients, considering SARS-CoV-2 risks.

Main Methods:

Review of existing literature on SARS-CoV-2, cancer, and dexamethasone effects on lymphocytes.
Analysis of the potential for dexamethasone-induced lymphopenia to exacerbate risks in cancer patients.

Main Results:

Dexamethasone, a common antiemetic, is known to cause B- and T-cell depletion.
This immunosuppressive effect of dexamethasone may increase the risk of SARS-CoV-2 infection.
Lymphopenia induced by dexamethasone could lead to poorer outcomes if cancer patients contract COVID-19.

Conclusions:

Routine prophylactic use of dexamethasone in uninfected cancer patients should be reconsidered.
Avoiding dexamethasone may prevent further lymphopenia, especially when cancer or chemotherapy already causes it.
Prioritizing alternative antiemetics is recommended during the COVID-19 crisis to mitigate infection risks.