tropisetron and Drug-Related-Side-Effects-and-Adverse-Reactions

Topics: Antiemetics; Cytochrome P-450 CYP2D6; Drug-Related Side Effects and Adverse Reactions; Genetic Testing; Humans; Ondansetron; Pharmacogenetics; Polymorphism, Genetic; Postoperative Nausea and Vomiting; Radiotherapy; Serotonin 5-HT3 Receptor Agonists; Tropisetron

This state-of-the-art review describes the development, over the past 12 years, of new agents for the control of chemotherapy- and radiotherapy-induced emesis. While the mechanism of chemotherapy-induced nausea and vomiting is still not fully understood, significant progress in prevention of the symptoms has been achieved. The discovery that high-dose metoclopramide was very effective in antiemetic control ultimately led to the development of a new class of antiemetics, the 5-HT3 receptor antagonists, of which tropisetron is the most recent to be introduced. The emphasis of the review is on acute chemotherapy-induced emesis and includes current thinking on the influence of patient characteristics on the emetic outcome. The new 5-HT3 receptor antagonists do not demonstrate any of the distressing extrapyramidal reactions so frequently encountered with conventional antiemetics acting at dopamine receptor sites. Mild headache is the most characteristic side effect of this class of agents. The major advantages of the newer 5-HT3 receptor antagonists, such as tropisetron, over the conventional antiemetic regimens are convenience, flexibility and, above all, single-dose usage.

Topics: Antiemetics; Antineoplastic Agents; Drug-Related Side Effects and Adverse Reactions; Humans; Indoles; Nausea; Serotonin Antagonists; Tropisetron; Vomiting

The objective of this study was to evaluate the efficacy and safety of ramosetron hydrochloride for the management of nausea and vomiting induced by chemotherapy in patients with hematological malignancies. A total of 30 patients with hematological malignancies were included in the ramosetron group. Ramosetron (0.3 mg i.v.) was administered 0.5 h before chemotherapy. The impact of ramosetron on anorexia, nausea and vomiting as well as other adverse effects were assessed. Meanwhile, another 39 patients received tropisetron (o.d. for 3 days). As compared to the tropisetron group, the response rate of the ramosetron group in controlling anorexia within 18-24 h after chemotherapy was higher (p < 0.05); within 18-24 h after chemotherapy, the complete response rate and effective rate in controlling nausea was higher (p < 0.05); within 12-18 h and 18-24 h after chemotherapy, the complete response rate and effective rate in controlling vomiting was higher (p < 0.05). The incidence of adverse effects was similar in both groups. We conclude that ramosetron belongs to a new generation of 5-HT3 receptor antagonists and that it is a safe, economic and effective antiemetic drug.

Topics: Adolescent; Adult; Aged; Antiemetics; Antineoplastic Combined Chemotherapy Protocols; Appetite; Benzimidazoles; Constipation; Dizziness; Drug-Related Side Effects and Adverse Reactions; Female; Flushing; Gastrointestinal Diseases; Headache; Hematologic Neoplasms; Humans; Indoles; Male; Middle Aged; Nausea; Thirst; Treatment Outcome; Tropisetron; Vomiting