Chemotherapy anti-emetics

Ondansetron is a 5HT3 antagonist indicated as an anti-emetic agent in nausea and vomiting associated with chemotherapy. The dose administered depends on the emetogenic degree of the chemotherapeutic agents used. 

The cannabinoids have previously been noted to have anti-emetic properties and nabilone has been available for the treatment of emesis due to chemotherapy for some years. Recently, there have been reports of its use in preventing postoperative nausea and vomiting in gynaecological patients with some limited success. 

Hamik A. Peroutka SJ. Differential interactions of traditional and novel anti-emetics with dopamine D2 and 5-hydroxytryptamine3 receptors. Cancer Chemotherapy Pharmacology. 1989 24(5) 307-10. Peroutka SJ, Snyder SH. Anti-emetics Neurotransmitter receptor binding predicts therapeutic actions. Lancet 1982 i 658-69. 

Olver IN. Update on anti-emetics for chemotherapy-induced emesis. Intern Med J. 2005 35 478-481. 

FDA approves synthetic THC, or dronabinol (Marinol) as an anti-emetic for cancer patients undergoing chemotherapy. 

PARP-1 inhibitor with the specificity and in vivo activity to enhance chemotherapy and radiation therapy of human cancer (Calabrese et al, 2004). GR205171 has the most potent anti-emetic activity of any tachykinin NKl receptor antagonist described to date. The compound is orally active in the ferret and dog, long-lasting, and warrants further investigation as a potential broad-spectrum anti-emetic agent (Gardner et al, 1996). 

Sesame oU solubilizes 2.5 mg, 5 mg or 10 mg dronabinol, also known as A-9-tetrahydrocannabinol, in Marinol soft gelatin capsules. Dronabinol is the principal psychoactive component of cannabis and hnds therapeutic application as an anti-emetic for treatment of the nausea and vomiting associated with cancer chemotherapy or as an appetite stimulant to treat AIDS wasting syndrome. Dronabinol exists as a hydrophobic oil at ambient room temperature, and after oral administration is almost completely absorbed (90-95%). However, the bioavailability of dronabinol is only about 10-20% due to extensive hepatic hrst-pass metabolism. The dose of dronabinol is 2.5-10 mg (one capsule) twice daily. Marinol soft gelatin capsules should be stored at 8-15° C and must be protected from freezing. Marinol is available in the USA. 

Penta JS, Poster DS, Bruno S, et al (1981) Clinical trials with anti-emetic agents in cancer patients receiving chemotherapy. J Clin Pharmacol 21 11S-22S... 

Furthermore, delavirdine (Rescriptor) is a novel HIV-1 reverse transcriptase inhibitor for HIV-positive individuals and zafirlukast (Accolate) is an anti-asthma drug. The anti-emetics ramosetron (Nasea) and dolasetron (Anzemet) are potent and highly selective 5-HTj receptor antagonists for die treatment of chemotherapy-induced nausea and vomiting. 

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