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A Journal on Forensic Medicine




Minerva Medicolegale 1999 December;119(4): 231-42

language: Italian

Serotonin type 3 receptor antagonist antiemetics in antineoplastic chemotherapy

Boisio M. L., Viale M.


The control of nausea and vomiting in patients undergoing anticancer chemotherapy is one of the most important challenge in cancer treatment. In the last years, the neuronal mechanisms causing nausea and vomiting and involving, as key molecule, the serotonin type 3 receptor (5-HT3) have been explained. Granisetron, tropisetron and ondansetron, potent and selective antagonists of the 5-HT3 receptor, are drugs able to counteract the onset of acute nausea and vomiting in a great percentage of patients undergoing moderately or highly emetogenic chemotherapy. The activity of these antiemetic drugs is very rarely followed by extrapyramidal adverse effects, which in the past limited in 20% of treated patients the use of metoclopramide in the antiemetic protocols. The more frequent adverse effect of the 5-HT3 antagonists is a mild headache occurring in 10-15% of treated patients. The good tolerability of these drugs, even in pediatric patients and in those with impaired hepatic and renal function, as well as the possibility to administer them along with dexamethasone, a combination therapy resulting in an improvement of response, makes their use essential for a correct antiemetic treatment of patients undergoing antineoplastic chemotherapy.

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