title: Acute benzodiazepine toxicity exacerbated by concomitant oral olanzapine.
abstract: Improvements in antiemetic therapy constitute a major advance in oncology. A recent poll of the oncology community by the American Society of Clinical Oncology ranked it as one of the top 5 advances in cancer in the last 50 years. Emetogenicity of chemotherapy is defined by risk of emesis in the patient given no antiemetics; high-risk regimens cause nausea and vomiting in >90% of patients, moderate risk in 30%-90%, and low risk in <30%. This risk profile serves as the basis for empiric antiemetic prophylaxis and offers alternatives to refractory patients. Modern antiemetic prophylaxis is extremely effective for high-risk chemotherapy, reducing the risk for breakthrough nausea and vomiting to 0%-13% in the acute setting (<24 hours from receipt of chemotherapy) and to 25%-30% in the delayed setting (24-72 hours from receipt of chemotherapy).
authors.affiliation: University of Kansas Cancer Center, Overland Park, Kansas, USA. mhoffmann@kumc.edu.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Hoffmann
authors.affiliation: Department of Cancer Medicine, MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Overman
authors.affiliation: Department of Critical Care, MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Nates
keywords: CINV; benzodiazepine; chemotherapy induced nausea and vomiting; olanzapine