Metoclopramide's Role in Chemotherapy-Induced Nausea and Vomiting
Author Information
Author(s): M.E.R. O'Brien, M.H. Cullen, C. Woodroffe, K. Kelly, C. Burman, K. Palmer, N.S.A. Stuart, G.R.P. Blackledge, J. Sharpe
Primary Institution: Cancer Research Campaign, Clinical Trials Unit, Queen Elizabeth Hospital, Birmingham, UK
Hypothesis
Does high dose metoclopramide improve anti-emetic control when combined with dexamethasone and lorazepam in chemotherapy patients?
Conclusion
The combination of dexamethasone, lorazepam, and metoclopramide significantly improves control of vomiting in chemotherapy patients but can cause extrapyramidal reactions.
Supporting Evidence
- High dose metoclopramide improved control of vomiting in 67% of patients on first exposure to chemotherapy.
- Extrapyramidal reactions occurred in 11.5% of patients receiving metoclopramide.
- Patients receiving the metoclopramide combination had a significant reduction in vomiting episodes.
Takeaway
This study found that a mix of three medicines helps stop patients from throwing up during chemotherapy, but one of them can cause some side effects.
Methodology
A randomized double-blind crossover trial comparing anti-emetic regimens in patients receiving chemotherapy.
Potential Biases
Potential bias in patient preference reporting and the subjective nature of nausea and vomiting assessments.
Limitations
The study had a small sample size and excluded patients with prior chemotherapy or contraindications.
Participant Demographics
Patients aged less than 70, mainly female, receiving chemotherapy for gynaecological malignancies.
Statistical Information
P-Value
0.0001
Confidence Interval
10.6-12.8
Statistical Significance
p<0.05
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