Which of the following is highly emetogenic: (LQ)
|B||High dose methotrexate|
|C||High dose cyclophosphamide|
· Nausea & vomiting is a prominent feature of many of cytotoxic drugs.
· This is due to CTZ stimulation as well as generating the emetogenic stimuli from upper GIT as well as other areas.
However Harrison, 17th, mentions –
- Highly emetogenic drugs (>90%) include mechlorethamine, streptozotocin, DTIC, cyclophosphamide at >1500 mg/m2, and cisplatin;
- Moderately emetogenic drugs (30–90% risk) include carboplatin, cytosine arabinoside (>1 mg/m2), ifosfamide, conventional-dose cyclophosphamide, and anthracycline;
- Low-risk (10–30%) agents include fluorouracil, taxanes, etoposide, and bortezomib, with minimal risk (<10%) afforded by treatment with antibodies, bleomycin, busulfan, fludarabine, and vinca alkaloids.
Drugs which are effective in chemotherapy induced vomiting:
A. 5-HT3 receptor antagonists – granisetron, palanocetron, ondansetron etc.
B. NK1 antagonists (Substance P antagonist): Aprepitant