The Effectiveness of Outpatient Antiemetic for Patients on Platinum, Camptosar, and Anthracycline-Based Chemotherapy




Wiggins, Jenny Marie


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Abstract. Chemotherapy-induced nausea and vomiting (CINV) is a serious problem affecting at least 50% of patients. Some nausea and vomit pathways involve serotonin and serotonin type-3 (5-HT3) receptors for propagation of the reflex. 5-HT3 antagonists were developed to block the 5-HT3 receptors and inhibit emesis. Anzemet, Kytril, and Zofran are 5-HT3 antagonists used as antiemetics in patients receiving emetogenic chemotherapy. This study was designed to determine if current antiemetic therapy involving these 5-HT3 antagonists is effective for patents on platinum, camptosar, and anthracycline-based chemotherapy. The data from this study could be used to assert or adjust antiemetic therapy in patients on these chemotherapy regimens, thus providing better quality of life for patients as they undergo chemotherapy. Patients on platinum, camptosar, or anthracycline-based chemotherapies from three Fort Worth area clinics of Texas Cancer Care were chosen to gauge the effectiveness of their antiemetic regimen based on chemotherapy regimen, patient compliance, and specific 5-HT3 antagonist. Data was gathered based on questionnaires filled out by the patient for seven days and their chemotherapy nurse on the day of their treatment. It was found that Zofran was the 5-HT3 antagonist most often prescribed by the nurses. Patient compliance was not a factor in patient perception of CINV, because of the high levels of patient cooperation. Each of the chemotherapy regimens differed by day in overall average level of CINV. Patients on Kytril were found to experience more “severe” CINV than those taking Anzemet or those not taking a 5-HT3 antagonist as an outpatient. A recommendation from this study would be a larger sample size and a larger span of time. Each of the study sites should also be compared for nurse prescribing habits and patient compliance, as well as a higher level of decadron usage for patients experiencing moderate and severe CINV.