Chemotherapy causes nausea and vomiting

Chemotherapy causes nausea and vomiting. It is a matter of fact. Most of the drugs use for the cancer treatment are potentially causing nausea and vomiting. There are several reasons for this. Stomach irritation by the chemotherapy drugs is one of the causes of nausea and vomiting in patients with cancers.

But the main factor which triggers nausea and vomiting in cancer patients is the stimulation of the vomiting center by anticancer drugs (chemotherapy). Some drugs are capable of stimulating the vomiting center directly whereas most of the anticancer drugs cause nausea and vomiting by stimulating the vomiting center indirectly. The vomiting center is stimulated directly by afferent input from the vagal and splanchnic nerves, the pharynx, the cerebral cortex, cholinergic and histamine stimulation from the vestibular system, and efferent input from the chemoreceptor trigger zone (CTZ). The CTZ is in the area postrema, outside the blood-brain barrier, and is thus susceptible to stimulation by substances present in the blood or cerebral spinal fluid. The neurotransmitters dopamine and serotonin stimulate the vomiting center indirectly via stimulation of the CTZ.

Management of nausea and vomiting caused by chemotherapy

Dolasetron, Granisetron, Ondansetron and palonosetron are the most effective antiemetics that can be used to reduce nausea and vomiting caused by chemotherapy. These drugs belong to the drug class called 5-HT3 inhibitors. These are effective because the most sensitive signal during the first 24 hours after chemotherapy appears to be 5-HT3.

aprepitant is one of the newest drugs which are very effective in the management of the nausea and vomiting caused by cancer chemotherapy.

There are some reports available that suggestive of the effectiveness of marijuana as an antiemetic during cancer chemotherapy.