Predictive factors for nausea or vomiting in patients with cancer who receive oral oxycodone for the first time: is prophylactic medication for prevention of opioid-induced nausea or vomiting necessary?
OBJECTIVE
To identify predictive factors for nausea or vomiting in patients with cancer who receive oral opioid analgesics for the first time.


METHODS
The participants were 280 hospitalized patients with cancer who were given oral opioid analgesics for relief of cancer pain for the first time at our hospital between January 2008 and December 2011. According to previous studies, predictors evaluated were factors potentially affecting nausea or vomiting. For nausea, the following scoring for response was used: 0=absence of nausea; 1=presence of nausea for 3 days after the start of oral oxycodone but continued to take oxycodone; 2=presence of nausea for 3 days and discontinued oxycodone due to nausea. For vomiting, at least 1 vomiting episode during the 3 days was regarded as vomiting-positive. Multivariate ordered logistic regression analysis was performed to identify the predictive factors for nausea or vomiting in cancer patients.


RESULTS
This analysis identified gender (male) (odds ratio [OR]=0.429), lung cancer (OR=2.049), and steroid use (OR=0.417) were significant factors for the occurrence of opioid-induced nausea. For vomiting, gender (male) (OR=0.4) and use of dopamine D2 blockers (OR=2.778) were significant factors.


CONCLUSIONS
Female gender was found to be predictive factors for the occurrence of nausea. Lung cancer might be closely associated with opioid-induced nausea. The use of steroids might be effective as prophylaxis for nausea. Female gender was also a predictive factor for the occurrence of vomiting. Vomiting occurred even if dopamine D2 blockers (prophylactic medication) were given.
1 Department of Hospital Pharmacy, Kyoto Prefectural University of Medicine , Kyoto, Japan .
Yuko
Y
Kanbayashi
Toyoshi
T
Hosokawa
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D000932:Antiemetics / Q000627:therapeutic use*; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007297:Inpatients; D007564:Japan; D016015:Logistic Models; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced* / Q000517:prevention & control; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced* / Q000517:prevention & control; D055815:Young Adult
D000701:Analgesics, Opioid; D000932:Antiemetics; D018492:Dopamine Antagonists; D013256:Steroids; D010098:Oxycodone