Palliation of nausea and vomiting in malignancy

Abstract

Nausea and vomiting are common symptoms that can cause enormous misery for cancer patients It is possible to palliate the symptoms by selecting anti-emetic drugs on the basis of their site of action in the emesis pathway The efficacy of a drug as an anti-emetic is proportional to its binding affinity for its receptor The more selective the binding of an anti-emetic drug, the fewer its side effects The aim of therapy is control of nausea Choose a non-oral route for anti-emetics until nausea has been absent for 24 hours 5HT3 receptors have no identified role in palliative care Medical management of bowel obstruction does not usually include permanent nasogastric intubation or intravenous fluids Nausea at introduction of opioids occurs in about 30% of patients, but tolerance to nausea arises within two weeks so that anti-emetics can then be withdrawn.