CROATIAN GUIDELINESS FOR PREVENTION OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING
Autori:
Rudolf Tomek, Eduard Vrdoljak, Damir Vrbanec, Damir Nemet, Višnja Matković, Stjepko Pleština, Damir Gugić, Renata Dobrila Dintinjana, Ante Bolanča, Miro Samaržija, Marija Petković
Sažetak
Sažetak. 70–80% bolesnika liječenih kemoterapijom izloženo je mučnini i povraćanju. Mučnina i povraćanje važne su nuspojave onkološkog liječenja te značajno utječu na kvalitetu života bolesnika, a često uzrokuju odgodu i prekid liječenja (slabiju suradljivost bolesnika tijekom liječenja). Ključno načelo antiemetske kontrole je prevencija. Trenutačno dostupni antiemetski lijekovi (kortikosteroidi, antagonisti 5-HT3-receptora i NK-1-antagonisti) primjenjuju se sami ili u kombinaciji. Koji će antiemetik biti primijenjen ovisi o emetogenom potencijalu pojedinoga kemoterapijskog protokola, prethodnom iskustvu s antiemeticima i predispozicijskim čimbenicima sa strane bolesnika. Noviji lijekovi, uključujući antagoniste 5HT3-receptora druge generacije palonosetron i NK-1-antagonist aprepitant, nude dodatnu kliničku korist u visoko i umjereno emetogenoj kemoterapiji, posebno za odgođenu mučninu i povraćanje. Namjera ovog antiemetskog vodiča je dosegnuti jedinstvene standarde u zbrinjavanju i liječenju mučnine i povraćanja u Hrvatskoj, a koji bi bili prihvatljivi u našem okružju – u vodič su uključeni dostupni lijekovi.
Summary
Summary. Approximately 70–80% of all cancer patients receiving chemotherapy experience nausea and/or vomiting. Nau-sea and vomiting are important side effects of cancer treatment, which can significantly affect a patient’s quality of life, leading to poor compliance with further chemotherapy treatment. The main principle of emesis control is prevention. Cur-rently available antiemetic agents corticosteroids, 5-hydroxytriptamine receptor antagonists, and neurokinin-1 antagonists, are used alone or in combination. Antiemetic regimen should be chosen based on the emetogenic potential of the chemo-therapy regimen, previous experience with antiemetics, and patient-specific risk factors. Newer agents, including second generation 5-HT3 receptor antagonist palonosetron and the NK-1 antagonist aprepitant, offer additional clinical benefit in highly and moderately emetogenic therapy, especially in delayed nausea and vomiting. The aim of this Guidelines is to achieve same standards of care in the treatment of nausea and vomiting across Croatia that are applicable in our environ-ment – only available drugs are included in the Guidelines.
