Relieving nausea and vomiting in patients with cancer: a treatment algorithm

Abstract

Purpose/objectives: To describe a treatment algorithm for the choice of antiemetic therapy for the patient receiving chemotherapy.

Data sources: Published literature, data collected on an inpatient oncology unit.

Data synthesis: Because little information is available to systematically guide clinicians in choosing the best antiemetic for an individual patient who is receiving a particular chemotherapy protocol, a treatment algorithm was developed. The four main variables include emetogenicity of the protocol, patient's age, previous adverse reaction to antiemetics, and failure of previous antiemetics. Other factors to consider include alcohol use, anticipatory nausea, patient health status, nausea history not related to chemotherapy, and type and availability of IV access.

Conclusion: The use of this algorithm resulted in appropriate choice of antiemetics and improved patient outcomes associated with reduced incidence of nausea and vomiting.

Implications for nursing practice: Nurses can have a significant impact on a patient's experience with chemotherapy treatment by improving symptom management of nausea and vomiting.