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Treatment of nausea and vomiting in terminally ill cancer patients

Glare, Paul A., Dunwoodie, David, Clark, Katherine, Ward, Alicia, Yates, Patsy, & Ryan, Sharon (2008) Treatment of nausea and vomiting in terminally ill cancer patients. Drugs, 68(18), pp. 1-16.

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Abstract

Nausea and vomiting is a common and distressing symptom complex in patients with far-advanced cancer, affecting up to 60% of individuals at some stage of their illness. The current approach to the palliative care of patients with nausea and vomiting is based on identifying the cause, understanding its pathophysiology and knowing the pharmacology of the drugs available for its amelioration. The following six main syndromes are identified: gastric stasis, biochemical, raised intracranial pressure, vestibular, mechanical bowel obstruction and ileus. A careful history, focused physical examination and appropriate investigations are needed to elucidate the syndrome and its cause, so that therapy is rational. Drugs are the mainstay of treatment in terminal cancer, and the main classes of antiemetic agents are prokinetics, dopamine antagonists, antihistamines, anticholinergics and serotonin antagonists. Dexamethasone and octreotide are also used, especially in bowel obstruction. Non-drug measures are important in relieving the associated distress. Patients should be able to die comfortably, without tubes. Despite decades of practice affirming this approach, the evidence base is weak and well designed studies are urgently needed.

Impact and interest:

30 citations in Scopus
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17 citations in Web of Science®

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ID Code: 19594
Item Type: Journal Article
Additional URLs:
Keywords: Nausea, Cancer
ISSN: 0012-6667
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > ONCOLOGY AND CARCINOGENESIS (111200) > Oncology and Carcinogenesis not elsewhere classified (111299)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500) > Clinical Pharmacology and Therapeutics (111502)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 16 Apr 2009 13:18
Last Modified: 29 Feb 2012 23:52

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