Antiemetic therapy in adults with terminal disease: a brief review

Although nausea and vomiting (NV) are common complaints among individuals with terminal illness, there are few studies evaluating the magnitude of this disabling syndrome. Most research has emphasized chemotherapy-induced emesis, however, Reuben and Mor analyzed National Hospice Study data and noted NV in 62 percent of patients with advanced malignancy during the last two months of life. In addition, NV was observed more frequently in women, persons younger than 65 years of age, and patients with stomach and breast cancer. Lamentably, physicians were less likely to prescribe antiemetics in the elderly and in patients with an impaired level of awareness. With such a paucity of studies on NV in terminally-ill patients, there is frequent confusion regarding the etiology of emesis and the selection of appropriate antiemetics. This article will review the syndrome of NV, and discuss available drug regimens.