Graves T
Department of Pharmaceutical Services, Emory University Hospital, Atlanta, GA 30322.
DICP. 1990 Nov;24(11 Suppl):S51-4.
Nausea and vomiting are serious problems for patients receiving cancer chemotherapy. Dopamine receptor and cholinergic receptor antagonism have been the target mechanism for agents used to combat drug-induced nausea and vomiting; more recently, blockade of serotonin receptors has been used for this indication. Current therapies are limited by extrapyramidal adverse effects, as well as drowsiness, sedation, respiratory depression, and cardiac effects. Ondansetron is an investigational serotonin antagonist that has documented effectiveness for cancer chemotherapy-induced emesis. Ondansetron appears to be well tolerated, with the possible exception of headaches and transient increases in liver enzymes. No extrapyramidal toxicities have been reported with this agent. While ondansetron looks promising, further studies are needed to fully define its role as an antiemetic.
恶心和呕吐是接受癌症化疗患者面临的严重问题。多巴胺受体和胆碱能受体拮抗作用一直是用于对抗药物性恶心和呕吐药物的作用机制靶点;最近,5-羟色胺受体阻断已用于这一适应症。目前的治疗方法受到锥体外系不良反应以及嗜睡、镇静、呼吸抑制和心脏效应的限制。昂丹司琼是一种正在研究的5-羟色胺拮抗剂,已证明对癌症化疗引起的呕吐有效。昂丹司琼似乎耐受性良好,可能的例外是头痛和肝酶短暂升高。尚未报道该药物有锥体外系毒性。虽然昂丹司琼看起来很有前景,但需要进一步研究以充分确定其作为止吐药的作用。