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What is Best anti - Emetic for patient treated with radiotherapy- and explain in detail?
Ans. is 'c' i.e., OndansetronChemotherapy induced nausea and vomiting:o Cytotoxic drugs and radiation cause cellular damage which leads to release of 5-HT from intestine and activation of emetogenic 5-HT3 receptors. Therefore, 5-HT3 receptor antagonists (e.g. ondenstron) are the DOC for this condition.o Cisplatin is the most common culprit causing chemotherapy induced nausea and vomiting.o Drugs used to treat chemotherapy induced nausea and vomiting are:i) 5-HT3 antagonists (drug of choice): Ondansetron, dolasetron, palonosetron, granisetron.ii) Other drugs: Dexamethasone, methylprednisolone, metoclopramide, BZDs (lorazepam) and aprepitant.o Cisplatin can induce vomiting within 24 hours or after 2 days. DOC for the early vomiting is ondensetron while for delayed vomiting is aprepitant (substant P antagonist).