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Related Concept Videos

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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

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

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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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.
Phenothiazines, such as prochlorperazine...
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Cholinergic Antagonists: Pharmacokinetics01:24

Cholinergic Antagonists: Pharmacokinetics

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Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations,  while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
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Cholinergic Antagonists: Therapeutic Uses01:26

Cholinergic Antagonists: Therapeutic Uses

704
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

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

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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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Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

777
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...
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Related Experiment Video

Updated: May 28, 2025

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
05:56

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

Published on: June 21, 2024

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MASCC antiemetic consensus recommendations: resource-limited settings.

Snezana M Bosnjak1, Ana Zilic2, Venkatraman Radhakrishnan3

  • 1Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia. nena.bosnjak@gmail.com.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|February 12, 2025
PubMed
Summary

Alternative antiemetic regimens are proposed for chemotherapy-induced nausea and vomiting (CINV) prevention in resource-limited settings. These regimens, including olanzapine, are effective when standard NK1-receptor antagonists are inaccessible.

Keywords:
AntiemeticsGuidelineHECHigh-emetic risk chemotherapyMECModerately emetic risk chemotherapyOlanzapine

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Area of Science:

  • Oncology
  • Supportive Care
  • Pharmacology

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) significantly impacts cancer patient quality of life.
  • Access to guideline-recommended antiemetic prophylaxis is limited in many global regions.
  • Novel strategies are needed to manage CINV in resource-constrained environments.

Purpose of the Study:

  • To develop alternative antiemetic recommendations for CINV prophylaxis in settings with limited access to NK1-receptor antagonists.
  • To define effective NK1-receptor antagonist-free regimens for highly emetic chemotherapy (HEC) and moderately emetic chemotherapy (MEC).

Main Methods:

  • Utilized the MASCC/ESMO 2023 Guideline Update as the primary reference.
  • Employed a meta-analysis (Filetti et al., 2023) to rank NK1-receptor antagonist-free regimens by efficacy.
  • Proposed olanzapine-based alternative regimens, categorized as 'better' and 'good' options.

Main Results:

  • For HEC without NK1-receptor antagonists, a 3-drug regimen (5-HT3 antagonist, dexamethasone, olanzapine) is recommended.
  • The O10PD regimen (olanzapine, palonosetron, dexamethasone) is a 'better' alternative; other 5-HT3 antagonists offer 'good' options.
  • Data for alternative MEC regimens and CINV after trastuzumab-deruxtecan are limited.

Conclusions:

  • Prioritize MASCC/ESMO 2023 guideline-recommended regimens when accessible and affordable.
  • These alternative regimens provide crucial options when NK1-receptor antagonists are unavailable or unaffordable.
  • Facilitates informed decision-making for CINV management in resource-limited settings.