马斯克抗的共识建议:资源有限的环境.
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.
概括
在资源有限的环境中,为预防化疗诱导的恶心和吐 (CINV) 提出了替代性抗疗方案. 这些治疗方案,包括奥兰扎平,当标准NK1受体对抗剂无法获得时是有效的.
科学领域:
- 在瘤学瘤学.
- 支持性护理是一种支持性护理.
- 药理学 药理学是指药理学的学科.
背景情况:
- 化疗诱导的恶心和吐 (CINV) 显著影响癌症患者的生活质量.
- 在全球许多地区,获得指导方针推的抗 Prophylaxis 是有限的.
- 需要新的策略来管理在资源有限的环境中CINV.
研究的目的:
- 制定替代性抗emetic推用于CINV预防在设置有限的访问NK1受体对抗剂的环境.
- 定义高性化疗 (HEC) 和中度性化疗 (MEC) 的有效NK1受体对抗剂免费方案.
主要方法:
- 使用MASCC/ESMO 2023指南更新作为主要参考.
- 使用元分析 (Filetti等人,2023) 根据疗效对无NK1受体抗剂的疗法进行排名.
- 拟议的基于 olanzapine 的替代疗法,分为"更好的"和"好的"选择.
主要成果:
- 对于没有NK1受体抗剂的HEC,建议使用3种药物治疗方案 (5-HT3抗剂,德甲,奥兰扎平).
- O10PD疗法 (奥兰扎,帕洛诺塞,德克萨米他) 是一个"更好的"替代方案;其他5-HT3抗剂提供了"好的"选择.
- 在特拉斯图祖马布-德鲁克斯坦之后,对替代MEC疗法和CINV的数据有限.
结论:
- 优先考虑MASCC/ESMO 2023指南推的饮食方案,只要可获得和负担得起.
- 这些替代方案提供了关键的选择,当NK1受体对抗剂是不可用的或负担不起.
- 促进在资源有限的环境中为CINV管理提供知情决策.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
173
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,...
173
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
215
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...
215
Cholinergic Antagonists: Pharmacokinetics
401
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...
401
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...
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...
704
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
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...
147
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...
777


