title: 5-Hydroxytryptamine3 receptor antagonists and cardiac side effects.
abstract: BACKGROUND
  5-Hydroxytryptamine3-receptor antagonists (5-HT3-RA) are the most widely used antiemetics in oncology, and although tolerability is high, QTC prolongation has been observed in some patients.
  
  
  METHODS
  The purpose of this article is to outline the risk of cardiac adverse events (AEs) from 5-HT3-RAs, with focus on the three most commonly used, ondansetron, granisetron and palonosetron.
  
  
  CONCLUSIONS
  Most of the studies analyze electrocardiogram (ECG) changes after 5-HT3-RA administrations in healthy, young adults, or in noncancer patients to treat postoperative nausea and vomiting (PONV). Only a few studies have addressed ECG changes in cancer patients treated for chemotherapy-induced nausea and vomiting (CINV). Investigations in cancer patients are essential, because these patients are older and have a higher incidence of comorbidity, than those usually included in clinical trials. Furthermore, polypharmacy is frequent and drug-drug interactions between chemotherapy and other QTc-prolonging drugs may influence the pharmacokinetics and pharmacodynamics of the 5-HT3-RAs. During the next 10 - 15 years a huge increase in the number of cancer patients is expected, primarily in the group of 65-plus-year old. Therefore it will be crucial to address the incidence of cardiac AEs in cancer patients with known heart disease receiving chemotherapy and a 5-HT3 RA for the prophylaxis of CINV.
authors.affiliation: Odense University Hospital, Department of Oncology R , Odense , Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Brygger
authors.forename: Jørn
authors.initials: J
authors.lastname: Herrstedt
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D017829:Granisetron / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000139:chemically induced / Q000453:epidemiology; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use; D000077924:Palonosetron; D011812:Quinuclidines / Q000009:adverse effects / Q000627:therapeutic use; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D017829:Granisetron; D007546:Isoquinolines; D017294:Ondansetron; D000077924:Palonosetron; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists
keywords: 5-Hydroxytryptamine3-receptor antagonist; QT prolongation; cardiac adverse events; cardiac side effects; granisetron; ondansetron; palonosetron