Protocolo diagnóstico y terapéutico de las náuseas y vómitos en el paciente oncológico

Abstract

Nausea and vomiting in the cancer patient may have different causes. However, these frequently occur in relation to chemo- and radiotherapy treatments. Their types are: acute emesis, which occurs in the first 24 hours of treatment; delayed, which appears after and may last for several days; and anticipatory, which occurs prior to chemotherapy treatment. The following are used for their treatment: serotonin receptor inhibitors (ondansetron, granisetron and palonosetron), which are frequently used in combination with steroids (dexamethasone); neurokinin receptor inhibitors (aprepitant and fosaprepitant); other drugs (phenothiazines, haloperidol, metoclopramide, domperidone, benzodiazepines, antacids, anticholinergic, cannabinoids, etc.). Cytostatics are classified as highly emetogenic (they are treated with neurokinin inhibitors, antiserotoninergics and dexamethasone), moderately emetogenic (antiserotoninergics, dexamethasone and occasional neurokinin inhibitors are recommended), low risk (treatment with dexamethasone) and minimum risk (they do not require prophylactic antiemetics). Their efficacy should be reevaluated in each cycle to adapt the treatment to each individual need.