Treatment of nausea and vomiting in terminally ill cancer patients

Glare, P. A., Dunwoodie, D., Clark, K., Ward, A., Yates, P., Ryan, S. and Hardy, J. R. (2008) Treatment of nausea and vomiting in terminally ill cancer patients. Drugs, 68 18: 2575-2590. doi:10.2165/0003495-200868180-00004


Author Glare, P. A.
Dunwoodie, D.
Clark, K.
Ward, A.
Yates, P.
Ryan, S.
Hardy, J. R.
Title Treatment of nausea and vomiting in terminally ill cancer patients
Journal name Drugs   Check publisher's open access policy
ISSN 0012-6667
Publication date 2008
Year available 2008
Sub-type Article (original research)
DOI 10.2165/0003495-200868180-00004
Volume 68
Issue 18
Start page 2575
End page 2590
Total pages 16
Editor D. J. Peters
Place of publication Auckland, New Zealand
Publisher Adis International
Collection year 2009
Language eng
Subject 920102 Cancer and Related Disorders
111204 Cancer Therapy (excl. Chemotherapy and Radiation Therapy)
C1
Abstract Nausea and vomiting is a common and distressing symptom complex in patients with far-advanced cancer, affecting up to 60% of individuals at some stage of their illness. The current approach to the palliative care of patients with nausea and vomiting is based on identifying the cause, understanding its pathophysiology and knowing the pharmacology of the drugs available for its amelioration. The following six main syndromes are identified: gastric stasis, biochemical, raised intracranial pressure, vestibular, mechanical bowel obstruction and ileus. A careful history, focused physical examination and appropriate investigations are needed to elucidate the syndrome and its cause, so that therapy is rational. Drugs are the mainstay of treatment in terminal cancer, and the main classes of antiemetic agents are prokinetics, dopamine antagonists, antihistamines, anticholinergics and serotonin antagonists. Dexamethasone and octreotide are also used, especially in bowel obstruction. Non-drug measures are important in relieving the associated distress. Patients should be able to die comfortably, without tubes. Despite decades of practice affirming this approach, the evidence base is weak and well designed studies are urgently needed.
Keyword Palliative care
Cancer
Q-Index Code C1
Q-Index Status Confirmed Code

 
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Created: Wed, 08 Apr 2009, 14:48:20 EST by Mary Herwig on behalf of School of Medicine