Antiemetic guidelines: Creating a more practical treatment approach Journal Article


Authors: Koeller, J. M.; Aapro, M. S.; Gralla, R. J.; Grunberg, S. M.; Hesketh, P. J.; Kris, M. G.; Clark-Snow, R. A.
Article Title: Antiemetic guidelines: Creating a more practical treatment approach
Abstract: Antiemetic guidelines from a variety of professional organizations have been available for several years. It is unclear just how often these guidelines have been used, however; data indicate that some practitioners still do not treat their patients according to the recommendations. Some of those involved in the creation of the original guidelines convened to try to create a simpler, more practical approach to the use of antiemetics in preventing chemotherapy-induced nausea and vomiting. The group's intention was to clarify available guidelines and produce a practical document, based on evidence, that could be used in everyday practice. The group created four consensus statements that would serve as a basis for their recommendations. One primary strategy used was to have chemotherapy-induced nausea and vomiting viewed as a single process that can occur throughout a treatment cycle, and not so much as an acute and a delayed process, as is usual in clinical trials. Patients' management should be considered over a 4- to 5-day period, rather than primarily dealing with the day of treatment only. The group created three tables: emetic risk of chemotherapy; treatment options based on emetic category; and antiemetic dosing recommendations. Use of these tables should make appropriate antiemetic selection more straightforward and easier for the practitioner in an everyday setting. Although this document alone may not solve all the challenges with appropriate antiemetic management, it will hopefully prove to be a step in the right direction.
Keywords: treatment outcome; clinical trial; cisplatin; doxorubicin; dose response; treatment planning; antineoplastic agents; cytarabine; antineoplastic agent; clinical practice; evidence based medicine; reproducibility; carboplatin; unindexed drug; nausea; vomiting; cyclophosphamide; dexamethasone; melphalan; practice guideline; carmustine; chlormethine; ifosfamide; lomustine; procarbazine; risk assessment; irinotecan; prescription; chemotherapy induced emesis; mitoxantrone; dactinomycin; granisetron; ondansetron; altretamine; epirubicin; reliability; antiemetic agent; antiemetics; idarubicin; high risk population; metoclopramide; meta analysis; pentostatin; serotonin 3 antagonist; streptozocin; drug choice; documentation; dolasetron mesilate; tropisetron; practice guidelines; humans; human; priority journal; article; antiemetic treatment guidelines; appropriate use; chemotherapy-induced nausea and vomiting; azasetron
Journal Title: Supportive Care in Cancer
Volume: 10
Issue: 7
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2002-10-01
Start Page: 519
End Page: 522
Language: English
DOI: 10.1007/s00520-001-0335-y
PUBMED: 12324805
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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  1. Mark Kris
    869 Kris