Ondansetron compared with high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting: a multicenter, randomized, double-blind, crossover study

Article Abstract:

Although progress has been made in ameliorating patients' nausea immediately after they undergo chemotherapy, control of nausea and vomiting both before treatment and well after it remain important clinical problems. Two antiemetic agents, metoclopramide and ondansetron, were compared for their abilities to prevent the vomiting and nausea caused by cisplatin, a chemotherapeutic drug. Both acute and longer-term effects were tested. Patients (121) were scheduled to undergo at least two cycles of cisplatin, and they received either ondansetron or metoclopramide with the first cycle, then the other drug with the second, according to a randomized study design. Patients' nausea and retching or vomiting were assessed by observers. Patients completed diary cards on days two through six, including such information as the episodes of retching or vomiting and their appetite levels. Results showed that ondansetron was associated with a higher probability of success than metoclopramide (0.77 versus 0.32). Seventy-two percent of the patients who received ondansetron had a major or complete acute-phase response to treatment (a major response), compared with 41 percent of those who took metoclopramide. Ondansetron was associated with a longer latency between cisplatin treatment and the first episode of vomiting (21 versus 4.5 hours) and a longer time between the first and last episodes of vomiting (9 versus 4 hours). For the 79 patients evaluated during the delayed phase, however, no statistically significant differences between the two drugs were seen in the proportion of patients with complete responses. Nausea control was better after metoclopramide than ondansetron. Patients' overall preference was for the latter drug: 54 versus 30 percent. Men responded better than women to treatment with antiemetics, and they responded much more to ondansetron (95 versus 65 percent). Overall, ondansetron was more effective than metoclopramide in the acute phase, but neither was outstanding for controlling vomiting in the delayed phase. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Physiological aspects, Cancer, Chemotherapy, Antiemetics, Ondansetron

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Efficacy of P6 acupressure in the treatment of nausea and vomiting during pregnancy

Article Abstract:

The use of acupressure on the wrist may not be any more effective than other nondrug methods of relieving pregnancy-related nausea and vomiting. Researchers compared the effect of acupressure wrist bands to that of incorrectly placed bands and to no bands at all on 161 pregnant women experiencing nausea, vomiting, and retching. Women in all three groups experienced major decreases in their symptoms. Women who did not receive acupressure wrist bands may have experienced relief from their symptoms because they were given information about how to deal with nausea. Some of the women took anti-vomiting drugs, but participation in this study alone produced a greater reduction of symptoms than did the drugs when symptoms were severe.

Care and treatment, Acupressure, Morning sickness (during pregnancy), Morning sickness

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Granisetron, droperidol, and metoclopramide for the treatment of established postoperative nausea and vomiting in women undergoing gynecology surgery

Article Abstract:

The drug granisetron is more effective than droperidol or metoclopramide in treating postoperative nausea and vomiting, according to a study of 120 patients. General anesthesia often causes nausea and vomiting when the patient regains consciousness.

Drug therapy, Nausea, Granisetron

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