A patient is beginning the second round of high-dose cisplatin. Severe, chemotherapy-induced nausea and vomiting (CINV) occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer?

Question

Quizplus · Accepted Answer

Parenteral ondansetron before chemotherapy followed by oral ondansetron for the next 4 days is the best option. Ondansetron is a potent antiemetic that is effective for both acute and delayed CINV. The use of parenteral ondansetron before chemotherapy provides immediate relief, while the use of oral ondansetron for the next 4 days provides continued control of CINV. Prochlorperazine and anticholinergic agents may also provide some relief, but they are less effective than ondansetron for high-dose cisplatin-induced CINV. Prochlorperazine suppositories may cause sedation, urinary retention, and dystonic reactions, while anticholinergic agents may cause dry mouth, blurred vision, and constipation.

A Patient Is Beginning the Second Round of High-Dose Cisplatin