Successful control of intractable nausea and vomiting requiring combined ondansetron and haloperidol in a patient with advanced cancer.
Chemically induced nausea and vomiting is a common symptom of advanced cancer effected through stimulation of dopamine (D2) or serotonin (5-HT3) receptors located in the chemoreceptor trigger zone (CTZ). These may be blocked by therapeutic doses of haloperidol and ondansetron, respectively. This case, reporting on a single patient acting as her own control, establishes that combined blockade of these receptors is sometimes required to relieve intractable nausea and vomiting. It also demonstrates the value of clinical review, audit of care, and quality assurance in the palliative care setting.
Cole
R M
RM
Bulli Hospital, New South Wales, Australia.
Robinson
F
F
Harvey
L
L
Trethowan
K
K
Murdoch
V
V
D000700:Analgesics / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000503:physiopathology / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects* / Q000627:therapeutic use; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D017294:Ondansetron / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D010166:Palliative Care; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
D000700:Analgesics; D017294:Ondansetron; D009020:Morphine; D006220:Haloperidol