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What are some patient related risk factors of CINV
Younger than 50 years old
Female
Hx of motion sickness
Hx of N/V during pregnancy
Poor Control of N/V in previous chemo cycle
what are the side effects of 5-HT3 receptor antagonist?
HA
Constipation
QT prolongation
What are the side effects of the dopamine antagonist?
- sedation
- lethargy
- acute EPS
What medication is reserved for highly emeticogenic regimens?
Olanzapine
What medication classes are used breakthrough CINV
Dopamine antagonsit
Weed
What is a positive risk factor of CINV
hx of chronic alcohol
What are the side effects of NK-1 Receptor Antagonist?
Diarrhea
Fatigue
Weakness
Hiccups
What medication has a BBW for tardive dyskinesia with long term use
Metoclopramide
What are the side effects of lorazepam?
What formulations are available?
Sedation
Short-term memory loss
IV/SL/PO
What medication classes are used for refractory CINV
Olanzapine
Weed
what is are some treatment specific risk factors of CINV?
Dose
Infusion rate, cycle, and time of infusion
Radiation therapy --> large areas, more areas of body, and more frequent
Granisteron
What medication can be give IM but can be give PO to reduce the risk of extravasation?
Promethazine
What medication is used for anticipatory CINV
Lorazepam
Match the area of radiation treated with the risk of CINV (High Risk, Moderate Risk, Low Risk, Minimal Risk)
A. Arms
B. Chest or Pelvis
C. Whole body
D. Upper Abdomen
E. Head & neck
F. Brain & Spine
G. Breast
H. Legs
High Risk - C
Moderate Risk - D F
Low Risk - B E
Minimal Risk- A G H
What NK-1 antagonist is not a CYP3A4 inhibitor? and what is it instead?
Rolapitant; CYP2D6
What dopamine antagonist has a BBW for QT prolongation?
Droperdiol
What medication classes are used for acute CINV
-5HT3
-Corticosteroids
-Olanzapine
-NK1 antagonist
Why can palonsteron be used for delayed CINV?
Long half-life (40 hours)
Breakthrough CINV
Nausea and/or vomiting that occurs within 5 days post chemo despite optimal anti-emetic regimen used that requires rescue therapy with other antiemetics
Label if the med is PO or IV
- Aprepitant
- Aprepitant Emulsion
- Neturpitant + Palnosteron
- Fosneturpitant + Palnosteron
- Rolapitant
- Fosaprepitant
- Aprepitant -PO
- Aprepitant Emulsion -IV
- Neturpitant + Palnosteron -PO
- Fosneturpitant + Palnosteron -IV
- Rolapitant -PO
- Fosaprepitant -IV
What side effects does olanzapine cause?
-Sedation
-Dry mouth
-Dizziness
-Postural Hypotension
what medication classes are used for delayed CNIV
-Corticosteroids
-Olanzapine
-NK1 antagonist with palonosteron
Dopamine antagonist are effective for mild/moderate CINV. True or False
True