Intravenous metoclopramide: Prevention of chemotherapy‐induced nausea and vomiting. A preliminary evaluation
Intravenous metoclopramide: Prevention of chemotherapy‐induced nausea and vomiting. A preliminary evaluation
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静脉注射甲氧氯普胺：预防化疗引起的恶心和呕吐的初步评估。
作者：
S. Strum;J. Mcdermed;J. Pileggi;L. Riech;Helen Whitaker
作者测试了静脉注射甲氧氯普胺预防化疗引起的恶心和呕吐的安全性和有效性。这些研究包括接受强效、致吐的不含顺铂方案初始治疗的住院患者，以及接受初始和维持不含顺铂化疗的门诊患者。50例患者接受甲氧氯普胺与一个或多个静脉甲氧氯普胺剂量方案，根据他们是否接受他们的化疗住院或门诊的基础上。在接受治疗的50例患者中，39例（78%）达到了完全的保护（无呕吐），9例（18%）达到了主要的止吐保护（一个或两个呕吐）时，所有的剂量方案的甲氧氯普胺相结合。因此，在接受广泛的潜在致吐化疗的50例患者中，有48例（96%）观察到完全或主要的止吐保护。止吐保护显示不依赖于所用甲氧氯普胺给药的时间表，而是依赖于所用化疗药物或联合用药的呕吐潜力。此外，与既往未接受过治疗或既往化疗未发生呕吐的患者相比，既往接受过治疗且化疗相关恶心或呕吐在过去曾造成严重问题的患者的总止吐和抗恶心保护的发生率总体较低。30例患者静脉注射甲氧氯普胺后未发生恶心或呕吐;在20例发生恶心的患者中，其发生率与所用化疗药物的呕吐潜力成正比。副作用与剂量相关，但没有严重到需要停药的程度。可以得出结论，静脉注射甲氧氯普胺在接受强效、不含顺铂化疗的患者中具有显著的止吐活性。提供对恶心和呕吐的完全保护所需的剂量和时间表似乎取决于所用化疗的固有催吐效力。涉及大量患者的进一步研究需要确定这种药物的最佳剂量和时间表。癌症53：1432 - 1439，1984。
The authors tested the safety and efficacy of intravenous metoclopramide in the prevention of chemotherapy‐induced nausea and vomiting. Those studied included hospitalized patients receiving their initial treatment with potent, emetogenic non‐cisplatin‐containing regimens, and outpatients receiving both their initial and maintenance non‐cisplatin‐containing chemotherapy. Fifty patients received metoclopramide with one or more of three intravenous metoclopramide dosage schedules, based on whether they received their chemotherapy on an inpatient or outpatient basis. Of the 50 patients treated, 39 (78%) achieved total protection (no emesis), and 9 (18%) attained major antiemetic protection (one or two emeses) when all dosage schedules of metoclopramide were combined. Therefore, total or major antiemetic protection was observed in 48 of 50 patients (96%) receiving a broad range of potentially emetogenic chemotherapy. Antiemetic protection was shown not to depend on the schedule of metoclopramide dosing used, but rather on the emetic potential of the chemotherapeutic agents or combinations employed. In addition, previously treated patients in whom chemotherapy‐related nausea or vomiting had posed a significant problem in the past, were shown to have an overall lower incidence of total antiemetic and antinausea protection as compared with patients who were previously untreated or did not experience emesis with prior chemotherapy. Thirty patients experienced no nausea or vomiting with intravenous metoclopramide; in the 20 patients who experienced nausea, its incidence was shown to be directly proportional to the emetic potential of the chemotherapy agents employed. Side effects were dose‐related, however none were serious enough to warrant drug withdrawal. It is concluded that intravenous metoclopramide possesses significant antiemetic activity in patients receiving potent, non‐cisplatin‐containing chemotherapy. The dosage and scheduling required to provide total protection against nausea and vomiting appears to be dependent on the inherent emetic potency of the chemotherapy used. Further studies involving large numbers of patients are required to determine the optimal dosage and scheduling of this agent. Cancer 53:1432‐1439, 1984.