olanzapine治疗有效缓解突破性化疗诱导的恶心和吐:一个现实世界的经验
Akihiro Uchiike1,2,3, Haruka Kono4,5, Katsuhiro Miura6,7
1Nihon University Itabashi Hospital Tumor Center, 30-1 Oyaguchikamicho, Itabashi, 173-8610, Tokyo, Japan.
Journal of pharmaceutical health care and sciences
|July 31, 2023
概括
奥兰沙平有效地预防癌症患者突破性化疗诱导的恶心和吐 (CINV). 这项研究支持其用于二次CINV预防的使用,其中83%的患者表现出改善.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床治疗学 临床治疗学
背景情况:
- 化疗诱导的恶心和吐 (CINV) 是癌症患者的一个重大挑战.
- 奥兰沙平在预防CINV方面表现有前途,但其对二次预防的实际有效性需要进一步评估.
研究的目的:
- 评估 olanzapine 在突破性 CINV 的二次预防中对标准抗emetic 治疗不耐药的患者的有效性.
- 为了比较接受高排泄性化疗 (HEC) 和非HEC的患者之间的结果,以及标准剂量和低剂量 olanzapine 之间的结果.
主要方法:
- 对127名接受 olanzapine 治疗突破性 CINV 的癌症患者进行了回顾性研究.
- 测量结果包括CINV症状的改善和完全响应 (0级),根据化疗类型和 olanzapine 剂量进行分析.
- 还记录了一些不良事件 (AE).
主要成果:
- 在83%的患者中,olanzapine改善了CINV,完全响应率为33%.
- 在高排泄性化疗 (HEC) 组 (86%) 与非HEC组 (71%) 相比,观察到更高的改善率.
- 标准剂量和低剂量的 olanzapine 显示出类似的疗效,但低剂量的 olanzapine 与非HEC 患者的标准剂量 (28%) 相比,与更高的完全响应率 (52%) 相关. 大多数AE都是轻微的 (昏昏欲睡).
结论:
- 奥兰沙平在临床上有效用于突破性CINV的二次预防.
- 这些发现支持在现实癌症治疗中使用 olanzapine 治疗耐火性 CINV.
- 进一步的研究可能会探索基于化疗类型的最佳剂量策略.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
338
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...
Phenothiazines, such as prochlorperazine...
338
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
243
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,...
243
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
199
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...
199
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
316
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,...
Two synthetic agonists of THC,...
316
Psychosis: Goals of Pharmacotherapy
168
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
168
Antiepileptic Drugs: Potassium Channel Activators
214
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
214


