How do I know the patient has it? / Background Info
Risk factors for CINV
Depression / Anxiety
Age < 50
Motion Sickness
N/V durinng pregnacny
Female
TX A
Olanzapine
NK1
5HT3 anatagonist
Dexamethasone
Acute
< 24 hours
delayed
zofran
NK1 and what you give to treat
Hiccups (Thorazine)
Patient is dehydration what do you see
Skin tugor
Increase HR
Dry Mouth
Esphagel tearing / burning
Scarring in throat
TX B
Olanzepine
Palonosetron
Dexamethasone
delayed
24 - 72 hours but up to a week
acute
zofran ODT
5HT3
Consipation
Headaches
Increase LFTs
Prolong QTC
Cisplatin
AC
Carboplatin
TX C
NK1
5HT3
Dexamethasone
breathrough
intermittent
Breakthrough
Compazine
Phenergan
Wt gain
increase BG and Lfts
Prolong QTCs
Sedation
Pathways we cover in prevention treatment?
Dopamine, NK1, and 5HT3
DE and 5HT3
anticapatory
anxiety
Anticapatory
Ativan
fluid retention
wt gain due to increase appetite
increase blood glucose
insomnia
Normal. episodes of N/V
olanzepine - PO
fos - IV
Ap - PO
Pal - IV
Gran - patch, PO
Ondan - PO, IV, ODT
Dex - PO , IV
refractory
despite proper prophylaxis
Refractory
Change prevention regimen
***** BONUS What is the NON pharm TX?
smaller meals
salty items
hydrate
peppermint
electrolyte water