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CINV (Types of NV incidences (Delayed NV (Cisplatin (81%, D1-7, D3 is…
CINV
Types of NV incidences
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Delayed NV
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Results in loss of appetite, weight loss and distress
Associated with highly emetogenic drugs (platins, cyclophosphamide, doxorubicin)
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Anticipatory NV
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Matches previous experiences - sight, smell, sounds - of chemotherapy with emesis
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Drugs
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Phenothiazine, butyrophenone
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Binds to D, M, H1 receptors
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SE: hypotension, sedation, extrapyramidal effects
cannabinoids
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SE: anticholinergic effects; hallucination, delusion, disorientation
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Benzodiazepine
Low emetogenic drug, rarely used alone
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Mainstream drugs
Metoclopramide
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SE: Extrapyramidal side effects (give diphenhydramine), dizziness, dysphoria, anxiety, depression
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Aprepitant
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SE: dizziness, diarrhoea, mild anorexia
Consequences of CINV
Lack of nutrition
Loss of appetite, unable to eat
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Weight loss, distress, lower compliance to therapy
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Risk factors
Individual
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Exhibits high anxiety, nervousness
History of CINV in previous therapy; shows tendency to vomit due to morning sickness, motion sickness
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Drug factor
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Route of administration: oral< IV, bolus > infusion
Doses (Higher doses, higher emetogenic potential)
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