Chemotherapy-induced nausea and vomiting (CINV) is a common side-effect of many cancer treatments. Nausea and vomiting are two of the most feared cancer treatment-related side effects for cancer patients and their families. For over 30 years, chemotherapy-induced nausea and vomiting have been the most severe and troublesome symptoms for cancer patients receiving chemotherapy. Unresolved chemotherapy-induced nausea and vomiting can lead to metabolic disorders, dehydration, nutritional depletion and esophageal tears, and can reduce patients’ daily functioning and quality of life and interfere with treatment schedules. Despite the widespread use of antiemetics, chemotherapy-induced nausea continues to be problematic. Unlike vomiting, nausea is a subjective and unobservable phenomenon making it extremely difficult to accurately assess and treat. Current research suggests that management of chemotherapy-induced nausea should focus on treating the symptoms before they occur rather than after they develop. This review highlights evidence-based interventions for the treatment of chemotherapy-related nausea.
There are several subtypes of CINV. The classifications of nausea and vomiting are:
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Your body sees the medicine as foreign. It sets off warning signals in your brain and digestive system. This flips the on switch in a part of your brain called the vomiting center. It puts out chemicals that make you queasy. Chemo can harm your digestive tract, too, which could also lead to nausea.
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Benzodiazepines are appropriate adjunct therapies to decrease treatment-related anxiety, and they are the preferred agents to treat and prevent anticipatory nausea and vomiting. dexamethasone and aprepitant are recommended against delayed nausea and emesis. Studies have shown that dexamethasone is the most potent antiemetic for prevention of delayed nausea and vomiting. Furthermore, aprepitant increases the efficacy of serotonin (5-HT3) antiemetics plus dexamethasone regimens to reduce both acute and delayed chemotherapy-induced nausea and vomiting during highly emetogenic regimens, such as cisplatin.
When suffering from nausea caused by chemotherapy treatments, your doctor will prescribe anti-nausea medications to prevent or relieve nausea.
Likewise, your doctor may not prescribe any anti-nausea drugs because not all chemotherapy cause nausea and vomiting. However, if the chemotherapy is likely to cause nausea and vomiting, your doctor may prescribe one or more of the following common anti-nausea medications:
Dexamethasone improves control of acute nausea and vomiting when given prior to chemotherapy, and continued administration of dexamethasone improves nausea and vomiting after highly emetogenic chemotherapy. It can also be given as an oral tablet for patients to take for the two days following chemotherapy to help minimise delayed nausea and vomiting.
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