ANTI-EMETIC PROPHYLAXIS MEDICATION PATTERN FOR
CHEMOTHERAPY INDUCED NAUSEA VOMITING (CINV) IN PATIENTS WITH
SOLID TUMOR AT RAJAVITHI HOSPITAL
Kulaporn Wisit1,*, Krittika Tanyasaensook2,#, Montarat Thavorncharoensap3, Jedzada
Maneechavakajorn4, Jiraporn Chiaovit5,
1
Master of Science in Pharmacy Programme in Clinical Pharmacy (International Programme)
, Mahidol University, Thailand
2
Clinical Pharmacy Section, Department of Pharmacy, Faculty of Pharmacy, Mahidol
University, Thailand
3
Social and Administrative pharmacy Section, Department of Pharmacy, Faculty of
Pharmacy, Mahidol University, Thailand
4
Department of internal medicine, Rajavithi Hospital, Thailand
5
Department of Pharmacy, Rajavithi Hospital, Thailand
*e-mail: kwon_mome@hotmail.com, #e-mail: krittika.tan@mahidol.ac.th
Abstract
Background: Chemotherapy induced nausea and vomiting (CINV) is one of the most
discomfort and fear side effects. It interferes with patient’s nutritional status and affects daily
life of cancer patients. Several guidelines recommended the best effective antiemetic
prophylaxis medication; however, implementation of treatment recommendations is less than
usual. Objectives: The purpose of this study are to examine antiemetic medication pattern for
prevention of CINV according to guideline recommendation and to determine clinical
outcome of CINV and patient’s quality of life in breast and lung cancer patients at
ambulatory setting of Rajavithi Hospital. Method: This was a prospective descriptive study
in 34 patients from June to October 2013 composed of 82 % woman, with mean age of 55
year. Antiemetic use pattern were assessed according to developed criteria which based on
guideline recommendation of antiemetic medication for Rajavithi Hospital and
nausea/vomiting clinical outcome after receiving chemotherapy during first three cycles.
Result: Regarding pattern of antiemetic medications prescription, 5-10% and 60% of
prescription was inconsistence to the developed criteria for preventing acute phase and
delayed phase emesis, respectively. Nausea/vomiting clinical outcome in term of complete
response (no emetic episode and no use of rescue medication; CR) indicated a better control
in acute phase than delayed phase emesis with approximate 85% and 50% of patients can
achieved CR. However, comparing in the group that received consistency and inconsistency
antiemetic medication found not significantly difference in CR percent. Nevertheless, almost
half of patients still experience delayed emesis and associated symptoms of nausea with
impact on their quality of life. Conclusion: Despites many antiemetic guideline
recommendations, CINV remains a significant problem in cancer patients, particularly
delayed phase emesis after received chemotherapy which impact their quality of life and may
avert patients from continuing cancer treatment. CINV continue importance targets for
developed the method to subside this problems.
Keywords: chemotherapy-induced nausea and vomiting, anti-emetic medication, supportive
care, cancer