title: Guidelines for the optimal management of chemotherapy-induced nausea and vomiting: a consensus.
abstract: Nausea and vomiting are the most frequently reported adverse effects of cancer chemotherapy and have a significant impact on patients' daily functioning, quality of life and compliance with chemotherapy. Summarized in this article are the recommendations for the optimal management of nausea and vomiting developed by a multidisciplinary group of health care professionals. Issues relating to chemotherapy-induced nausea and vomiting are discussed; general principles of treatment are reviewed; treatment algorithms based on emetogenicity and types of chemotherapy are presented; and the importance of issues including non-pharmacological approaches, patient education and pharmacoeconomic perspectives are considered. The goal of antiemetic therapy should be no episodes of vomiting or retching and minimal or no nausea. Data from clinical trials support the clear superiority of 5-HT3 receptor antagonists in a variety of clinical situations. Their cost must be considered not only as an isolated item from the institutional perspective, but also from the perspective of the impact of successful therapy on the patient.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver.
authors.forename: D
authors.initials: D
authors.lastname: Osoba
authors.forename: D G
authors.initials: DG
authors.lastname: Warr
authors.forename: M I
authors.initials: MI
authors.lastname: Fitch
authors.forename: L
authors.initials: L
authors.lastname: Nakashima
authors.forename: B
authors.initials: B
authors.lastname: Warren
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D018492:Dopamine Antagonists / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy* / Q000523:psychology; D010353:Patient Education as Topic; D015742:Propofol / Q000008:administration & dosage; D012702:Serotonin Antagonists / Q000008:administration & dosage; D014839:Vomiting / Q000139:chemically induced* / Q000188:drug therapy* / Q000523:psychology
chemical_list: D018492:Dopamine Antagonists; D012702:Serotonin Antagonists; D001569:Benzodiazepines; D003907:Dexamethasone; D015742:Propofol