• Title/Summary/Keyword: Breakthrough nausea and vomiting

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Evaluation of Antiemetic Therapy for Breakthrough Nausea and Vomiting in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포 이식 환자의 돌발성 구역·구토에 대한 항구토제 사용 현황)

  • Kim, Jiyoon;Hong, So Yeon;Jeon, Su Jeong;Namgung, Hyung Wook;Lee, Eun Sook;Lee, Euni;Bang, Soo-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.224-229
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    • 2018
  • Background: The patients receiving hematopoietic stem cell transplantation (HSCT) are known to have a high incidence of breakthrough nausea and vomiting due to the conditioning regimen. The purpose of this study was to evaluate the adequacy of antiemetic therapy for breakthrough nausea and vomiting in patients receiving HSCT and to propose an effective treatment regimen. Methods: We retrospectively reviewed the electronic medical records of 109 adult patients. The collected data were used to identify (1) antiemetic and dosing regimens prescribed for controlling breakthrough nausea and vomiting, (2) the rate of patients who developed breakthrough nausea and vomiting, and (3) the percent of antiemetics prescribed on the day of symptom onset. Based on the National Comprehensive Cancer Network guideline, we assessed the suitability of antiemetics for breakthrough nausea and vomiting, and prescription timing. Results: All patients were prescribed pro re nata antiemetics. About 40.0%, 41.4%, and 18.6% of patients were using one, two, and three or more additional drugs for breakthrough nausea and vomiting, respectively. The most frequently administered drugs were intravenous metoclopramide (43.8%) and granisetron patch (36.2%). Breakthrough nausea and vomiting occurred in 87 patients (79.1%) and they developed symptoms 320 cases. About 220 cases (68.8%) were treated with additional antiemetics on the day of symptom onset and the rate of symptom resolution was only 10.3% (9 patients). Conclusion: The breakthrough nausea and vomiting in patients receiving HSCT occurred very frequently and was hard to control, thus requiring more rapid and aggressive treatments.

Olanzapine for Preventing Nausea and Vomiting Induced by Moderately and Highly Emetogenic Chemotherapy

  • Wang, Shi-Yong;Yang, Zhen-Jun;Zhang, Lu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9587-9592
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    • 2014
  • Nausea and vomiting are common adverse events in chemotherapy. In spite of the serious effects on the quality of life and further treatment, they remain overlooked by physicians, and no standard treatment has been developed. Neurokinin-1 (NK-1) receptor antagonists and palonosetron are the major agents in the standard regimen for treating moderately and highly emetogenic chemotherapy-induced nausea and vomiting (CINV). However, NK-1 receptor antagonists first became commercially available at the end of 2013 and palonosetron has not been extensively applied in China. Olanzapine was recommended as a therapy for moderate and severe CINV in antiemesis-clinical practice guidelines in oncology in 2014 for the first time. It is an atypical antipsychotic agent, which can block multiple receptors on neurotransmitters. During more than 10 years, olanzapine has demonstrated significant effects in preventing CINV and treating breakthrough and refractor CINV, which was observed in case reports, precise retrospective studies, and phase I, II and III clinical trials, with no grade 3 to 4 adverse events. In particular, it is superior to aprepitant and dexamethasone in delayed nausea and vomiting. Therefore, this compound is worthy of further investigation.

Actual situation and prescribing patterns of opioids by pain physicians in South Korea

  • Kim, Min Jung;Kim, Ji Yeon;Lim, Yun Hee;Hong, Sung Jun;Jeong, Jae Hun;Choi, Hey Ran;Park, Sun Kyung;Kim, Jung Eun;Lee, Min Ki;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.475-487
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    • 2022
  • Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients' quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians' experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks. Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions: The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.

Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea

  • Yang, J.M.;Bang, S.;Song, S.W.;Youn, B.B.
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.51-66
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    • 1968
  • During a period of about one year(November '66 to December '67), the Yonsei University College of Medicine conducted a field trial of the oral contraceptive(Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang county. We can summarize the outstanding findings from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Most of the reasons for not wanting to use it(352 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs if still in need of a contraceptive methods are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25 of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took one or more tablets we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5 th day as directed for the first three cycles, but the percentages rose sharply to about 80% in later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among acceptors who did not quit between cycles, 80 to 90% were regular users, missing two or less tablets in each cycle. 5) More than 60% of the users felt well and sometimes lost their pre-acceptance symptoms. especially dysmenorrhea. However, 27.4% (58 women) had side effects attributable to the pill compund as nausea, vomiting, indigestion, breast tenderness, decreased lactation or breakthrough bleeding. 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 49.2% (212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months, 6 months and one year, respectively. These rates are lower than in the U.S. studies. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.

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