Murakami M, Ota K
Gan To Kagaku Ryoho. 1986 Mar;13(3 Pt 1):401-11.
Nausea and vomiting induced by cisplatin are very severe and intractable to standard antiemetics. During the past several years, many studies of antiemetic management in the patients receiving cisplatin have been performed. In this paper recent advances in the management of cisplatin-induced emesis were reviewed. To date, high dose (2 mg/kg every 2 hours 3-5 times) metoclopramide is considered to be the most effective drug against emesis induced by high-dose (100-120 mg/m2) cisplatin, and a combination therapy of metoclopramide, dexamethasone, diphenhydramin and lorazepam appears to be the most effective. In antiemetic management the problem of anticipatory emesis and delayed or persistent emesis must be considered as well as acute chemotherapy-induced emesis. On the other hand, we have experienced that antiemetic trials are more ineffective in women than in men, so it is more important to control chemotherapy-induced emesis in women. For obtaining more effective control of cisplatin-induced emesis, a combination of antiemetic agents affecting more than one of several neurotransmitter receptors is necessary. In Japan, antiemetic trials have only strated, so we must make an effort to work towards reducing the distressing emesis induced by cisplatin.
顺铂所致的恶心和呕吐非常严重，且对标准止吐药难以奏效。在过去几年中，针对接受顺铂治疗患者的止吐管理开展了许多研究。本文对顺铂所致呕吐管理的近期进展进行了综述。迄今为止，高剂量（每2小时2mg/kg，共3 - 5次）甲氧氯普胺被认为是对抗高剂量（100 - 120mg/m²）顺铂所致呕吐最有效的药物，而甲氧氯普胺、地塞米松、苯海拉明和劳拉西泮的联合疗法似乎最为有效。在止吐管理中，除了急性化疗所致呕吐外，还必须考虑预期性呕吐以及延迟性或持续性呕吐的问题。另一方面，我们发现止吐试验对女性的效果比对男性更差，所以控制女性化疗所致呕吐更为重要。为了更有效地控制顺铂所致呕吐，需要联合使用作用于多种神经递质受体中不止一种的止吐药物。在日本，止吐试验才刚刚起步，因此我们必须努力减少顺铂所致的令人痛苦的呕吐。
