The cardiotoxic potential of the 5-HT3 receptor antagonist antiemetics: Is there cause for concern? Journal Article


Author: Keefe, D. L.
Article Title: The cardiotoxic potential of the 5-HT3 receptor antagonist antiemetics: Is there cause for concern?
Abstract: Purpose. To review and evaluate the potential cardiac effects of 5-HT3 antiemetic treatment in patients who may be predisposed to cardiac complications resulting from malignancy, cytotoxic oncologic regimens, or preexisting comorbid conditions. Design. A literature review was conducted on the negative cardiovascular effects of chemotherapeutic agents, and, more specifically, on the cardiac interactions of the 5-HT3 receptor antagonists commonly used to treat chemotherapy-induced nausea and vomiting. Results. Clinical studies in healthy subjects have reported electrocardiograph changes following administration of 5-HT3 receptor antagonists. However, there are limited data on the use of 5-HT3 antiemetics when administered with cardiotoxic chemotherapy. Nonetheless, the development of significant electrocardiograph changes with some agents may indicate a potential for significant cardiac effects in patients, particularly those who may be predisposed to cardiac complication. Conclusions. As the predicted human life span increases, clinicians will be treating a larger, older oncology population. Because two of the most common major comorbidities are cardiovascular related, we need to be acutely aware of the toxic effects of chemotherapy, as well as the possible cardiac interaction of supportive agents, specifically the 5-HT3 antiemetics. Until more data are made available, the best antiemetic option for patients receiving emetogenic and cardiotoxic chemotherapy may be the agent with the fewest apparent cardiac effects.
Keywords: aged; middle aged; clinical trial; cisplatin; doxorubicin; fluorouracil; drug potentiation; cytarabine; methotrexate; antineoplastic agent; neoplasms; carboplatin; interleukin 2; unindexed drug; etoposide; heart disease; nausea; vomiting; antineoplastic combined chemotherapy protocols; cyclophosphamide; vincristine; ifosfamide; vinblastine; chemotherapy induced emesis; prednisolone; cardiovascular risk; heart infarction; cardiotoxicity; comorbidity; daunorubicin; dactinomycin; bleomycin; granisetron; ondansetron; epirubicin; antiemetic agent; antiemetics; idarubicin; anthracycline derivative; indoles; electrocardiography; congestive heart failure; heart ventricle arrhythmia; drug interactions; heart muscle ischemia; pericarditis; serotonin 3 antagonist; tricyclic antidepressant agent; heart supraventricular arrhythmia; mithramycin; angina pectoris; dolasetron mesilate; pirarubicin; myocarditis; serotonin antagonists; cisapride; heart failure, congestive; humans; human; priority journal; article; 5-ht3 antiemetics; dolasetron; quinolizines
Journal Title: The Oncologist
Volume: 7
Issue: 1
ISSN: 1083-7159
Publisher: Oxford University Press  
Date Published: 2002-02-01
Start Page: 65
End Page: 72
Language: English
DOI: 10.1634/theoncologist.7-1-65
PUBMED: 11854548
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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  1. Deborah Keefe
    36 Keefe