Exam 2 - supportive care 1 Flashcards
(30 cards)
types of NV
anticipatory
acute
delayed
breakthrough
refractory
reason for targeting 5HT3 and NK1 for NV
they are in the stomach which then crosses to chemo receptor zone
chemoreceptor trigger zone contains what receptors
5HT, D2, M, H1, NK1
H1, ACh
refractory
5HT, substance P
most used, most regimens have these
single agent level 5 emesis
single drug with >90% frequency of emesis
single agent level 3-4 emesis
single drug with 30-90% frequency of emesis
single agent level 2 emesis
10-30%
single agent level 1 emesis
<10%
oral chemo agents are what level emetogenic potential
low to moderate 10-30%
highly emetogenic regimen A
NK-1 antagonist
steroid
5HT3 antagonist
atypical antipsychotic
highly emetogenic regimen
atypical antipsych: olanzapine
5HT: palonosetron
steroid: dex
highly emetogenic regimen
NK1
steroid: dex
5HT
moderately emetogenic regimen A
steroid
5HT
moderately emetogenic regimen B
olanzapine
palonosetron
dexamethasone
moderately emetogenic regimen C
Nk1
steroid
5HT3
low emetogenic regimen
-pick any one of these
dexamethasone
metoclopramide
prochlorperazine
dolasetron
granisetron
ondansetron
NK1 antagonist options
aprepitant oral
-injection
fosaprepitant IV
rolaprepitant oral
netupitant/palonsetron
fosnetupitant/palonosetron
steroid options
dexamethasone
5HT3 antagonist options
dolasetron
granisetron
ondansetron
palonosetron
atypical antipsychotic options
olanzapine
two drug classes you can add to any antiemetic regimen
benzodiazepine
PPI
breakthrough NV regimen
-pick 1
haloperidol
metoclopramide
prochlorperazine
promethazine
olanzapine
lorazepam
dronabinol
nabilone
dolasetron
granisetron
ondansetron
dexamethasone
scopolamine
if pt shows delayed NV after chemo initially, give antiemetics then chemo
-agents include:
dex
NK1
olanzapine
